spirituality and the physician

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Spirituality and Spirituality and Medicine Medicine (Prayer and Healing) (Prayer and Healing) Shahid Athar, Shahid Athar, MD,FACP MD,FACP Presented at IMANA Presented at IMANA Convention December 2013 Convention December 2013 Jeddah ,KSA Jeddah ,KSA

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Shahid Athar, MD,FACP

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Page 1: Spirituality and the Physician

Spirituality and MedicineSpirituality and Medicine(Prayer and Healing)(Prayer and Healing)

Shahid Athar, MD,FACPShahid Athar, MD,FACP

Presented at IMANAPresented at IMANAConvention December 2013Convention December 2013

Jeddah ,KSAJeddah ,KSA

Page 2: Spirituality and the Physician

• With respect to personal financial relationships, contracted research includes research funding where the institution gets the grant and manages the funds and the person is the principal or named investigator on the grant.

• Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship.

• The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest. The ACCME considers “content of CME about the products or services of that commercial interest” to include content about specific agents/devices, but not necessarily about the class of agents/devices, and not necessarily content about the whole disease class in which those agents/devices are used.

• With respect to financial relationships with commercial interests, when a person divests themselves of a relationship it is immediately not relevant to conflicts of interest but it must be disclosed to the learners for 12 months.

• The provider collects disclosure information from all • Individuals in control of content. Those who refuse to disclose

this • information are disqualified from participating. For any person • who reports a relevant financial relationship, the provider uses • a peer review process to resolve the potential conflict of • interest. For presentations that have the greatest potential for • bias, the provider asks an independent third party reviewer to • conduct a second peer review as an additional mechanism to • resolve conflicts of interest. (SCS 2.1, SCS 2.2, SCS 2.3)

disclose relevant financial relationships to me and to the learners who participate in my activities?

Disclosure InformationDisclosure Information

In compliance with the guidelines established by ACCME

I have NO actual or potential conflict of interest in relation.

I have no relevant financial interest

to this program or presentation.

Page 3: Spirituality and the Physician
Page 4: Spirituality and the Physician

The Prayer of Moses (as)The Prayer of Moses (as)

• Rabbi Sharheli sadri wa yussril Amri wahlul uqdatammillisani yafqahu qawli

• Translation “O Lord!, expand my heart, make my task easy for me, and untie the knot from my tongue, so that they can understand me”

Page 5: Spirituality and the Physician

The QuestionsThe Questions• What is the role of the physician beyond offering

the diagnostic and therapeutic options for his/her patients ?

• Does he/she need to understand the spiritual needs of his/her patient ?

• How does his/her own spirituality affect the way he/she treats his/her patients ?

• Should he/she also incorporate spirituality in the treatment modalities he/she offers ?

• Does it make any difference in the outcome ?

Page 6: Spirituality and the Physician

What is Spirituality ?What is Spirituality ?

“ Spirituality is the recognition of the presence of God within us. Man was created by God, who had “blown His spirit into him”. Thus, man is always connected to or tries to be connected to God like a child connected to mother via the umbilical cord”.

Page 7: Spirituality and the Physician

Spirituality and MedicineSpirituality and Medicine Physician is an instrument of healing by

God. He diagnoses with the knowledge given by God. He dispenses the medicines created by God, but discovered by man and then asks God to make the medicine work for his patient.

Page 8: Spirituality and the Physician

Exploring the Spirituality of the Exploring the Spirituality of the PatientPatient

The illness brings a patient closer to God. The patient sees his physician not only as a healer but a priest as well. He is not just a dispenser of medicine (a pharmacist) but also as someone who has special knowledge of healing. Thus, the expression “Doctor, you have saved my life!”, knowing that the actual savior is God only.

Page 9: Spirituality and the Physician

Religion and Spirituality Religion and Spirituality

The purpose of the religion is to make us a better human being , reflect and start questioning: Who created us? What is the purpose of our creation? What is our mission? What is our duty towards ourselves, our fellow humans and our Creator?, hoping that the answers may modify our behavior.

Page 10: Spirituality and the Physician

When visiting a patient When visiting a patient

• We should take time to listen to him• Befriend him and become a trusted partner in his

health care • Try to know what else is happening in his life. • Know about his family, his job and relations with

others• Convince him that God loves and cares for him• Offer hope to him, not just statistics • Pray for him and pray with him- with permission

Page 11: Spirituality and the Physician

Effects of Spirituality on Health Effects of Spirituality on Health

• The patient will be motivated to get well• He will accept the negative out come if any• He will take the “bitter” medicine willingly• His compliance will improve• He will thank you when he gets well• He will not complain if the medicine did not work• He will be at peace even at the time of death

Page 12: Spirituality and the Physician

Influence of Religion on HealthInfluence of Religion on Health(Benson in “Timeless Healing”)(Benson in “Timeless Healing”)

# OF STUDIES SHOWING BENEFICIAL EFFECTS OF RELIGION

Reduced Alcohol use -----------------------------16 out of 18Reduced Nicotine use----------------------------- 6 out of 6Reduced Drug use -------------------------------- 12 out of 12Reduced Depression------------------------------ 12 out of 17Reduced Blood pressure ------------------------ 4 out of 5 Improved Quality of life in heart patients----- 4 out of 6Improved Quality of life in cancer patients--- 7 out of 8Reduced Anxiety----------------------------------- 8 out of 11

Page 13: Spirituality and the Physician

La Forge in J. of CV Nursing La Forge in J. of CV Nursing 11/9711/97

Benefits of Meditation and Mind / Body Exercise• Reduced blood pressure• Improved glucose tolerance • Improved pulmonary function• Decrease pain and pain sensitization• Improved lipid profile• Reduced responsiveness to stressors• Improved memory• Improved cardiac response to work stress

Page 14: Spirituality and the Physician

Survey – when asked “how often Survey – when asked “how often do you pray?”do you pray?”

St . Louis Dispatch 1995– Once a day 5%– Once a week 22%– Only during crisis 68%– Never 5%

Page 15: Spirituality and the Physician

What do you pray for?What do you pray for?

• Family 95%• For Forgiveness 92%• Sports Victory 23%• For others 5%

Page 16: Spirituality and the Physician

Annual Request For PrayersAnnual Request For Prayers

• National prayer center– 100,000( 1994)• Nashville prayer center- 110,000 (1995)• Prayer center in Kansas City, Mo

(3300/week)

Page 17: Spirituality and the Physician

Have your prayers been answered ?Have your prayers been answered ?

• 95 % said YES • 3-4 prayers answered in life time

( Indianapolis star – March 1994 )

Page 18: Spirituality and the Physician

For how long do you pray ?For how long do you pray ?

• 25 % said 1 min or less

• 47 % said 5 min or less

• 28 % said 1 hour or less

Page 19: Spirituality and the Physician

If you pray daily then how often ?If you pray daily then how often ?

• 25% said once a day or less

• 51 % said 1-2 times a day

• 24 % said over 3 times a day

Page 20: Spirituality and the Physician

HEALING WORDS HEALING WORDS BYBY

LARRY DOSSEY, M.D. LARRY DOSSEY, M.D. (HARPER)(HARPER)

Page 21: Spirituality and the Physician

An Experiment on Prayer & HealingAn Experiment on Prayer & Healing

• San Francisco Gen Hospital—1988• 293 critically ill patients in coronary ICU• Group A- patients who were prayed for by

name by prayer makers• Group B- patients who were not prayed for

Page 22: Spirituality and the Physician

The results------The results------

• GROUP A HAD – LESS COMPLICATED COURSE AND CHF – TWO AND ONE HALF TIMES LESS

ANTIBIOTIC USAGE – ONE FIFTH LESS CARDIAC ARREST

( CODE 1 )– LEFT HOSPITAL EARLY

Page 23: Spirituality and the Physician

How or what to pray?How or what to pray?

• Prayer makers were not told what to pray

• Many used simple prayers such as – “Lord ! Have mercy on ---- (patient)” Or--“Thy Will shall be done !”

Page 24: Spirituality and the Physician

Prayer combined with loving carePrayer combined with loving care

• Men with coronary artery disease and angina who had supportive wives who also prayed for their husbands reported 50% less angina than the men who were single

• (ref Dr. Dossey in “Healing Words”)

Page 25: Spirituality and the Physician

The spiritual needs of the patientThe spiritual needs of the patient

• A good physician not only looks at the physical stigmas or the symptoms due to it but, also other factors influencing patient’s illness including social and spiritual states.

• For example if the diagnosis is Cirrhosis of liver then he must go beyond and find out what led to patient’s alcoholism. I have seen DKA and Hyperthyroidism precipitated by severe family stress.

Page 26: Spirituality and the Physician

Spiritual Needs During LossSpiritual Needs During Loss

The physician is best equipped to offer sympathy, comfort and counseling during death, loss and mourning. Such offerings by the physician have better effect on patients recovery than any tranquilizer . We must treat our patients as we like ourselves and our relatives to be treated.

Page 27: Spirituality and the Physician

Spirituality and the Dying PatientSpirituality and the Dying Patient

• Spirituality as measured by inner peace and faith in terminally ill patients with less than 3 months to live, helped them avoid despair, wanting to die, or suicidal tendencies as compared to similar patients without spirituality.

------ Rosenfield et all, Lancet 5-10-03

Page 28: Spirituality and the Physician

Recommendation by RosenfieldRecommendation by Rosenfield

• Health care workers should incorporate psychological and spiritual elements into the palliative care of dying patients.

Page 29: Spirituality and the Physician

Hope as a MedicineHope as a Medicine

The physician may find that sometimes disbelief leads to wrong actions and unbelief leads to despair and hopelessness. By rediscovering a patient’s spirituality, the physician may be able to connect him to God and offer hope as an adjunct to conventional treatment. This will improve the compliance of the patient in the treatments offered to him.

Page 30: Spirituality and the Physician

The levels of Spirituality The levels of Spirituality

Our duty is to uncover the built in but buried spirituality within us and our patients. This awareness can be achieved by silent meditation, prayers, exploring nature, religious chanting ( zikr ), reading Sacred Scriptures, listening to soothing spiritual music and caring for those in need.

Page 31: Spirituality and the Physician

Spirituality and musicSpirituality and music

When asked if music was good or bad, Ghazali, a famous saint, said “ the music which increases your spirituality and brings you closer to God is good but the one which dulls your spirituality and takes you away from God is bad”.

spiritual music has a healing effect

Page 32: Spirituality and the Physician

Healing from QuranHealing from Quran

• Three types of healing from Quran

• The legislative effects• Health Guidelines• Direct healing (Ruqiya & Zikr)

Page 33: Spirituality and the Physician

Medical effects of meditationMedical effects of meditation

• Lowers heart rate and blood pressure• Relaxes smooth muscles• Improves breathing• Improves memory• Echo effects of certain words• Legislative effects of injunctions ----- Late Ahmed El-Kadi , M.D.

Page 34: Spirituality and the Physician

Who is the Healer?Who is the Healer?

• Prophet Abraham (p) said ( Quran 26: 80)• “And when I am ill, it is He ( God ) who

heals me”

• Socrates said “I dress the wound and God heals it”

Page 35: Spirituality and the Physician

Who is Who is The The Healer?Healer?

• “IF GOD TOUCHES THEE WITH AN AFFLICTION, NO ONE REMOVE IT BUT HE”

• Holy Quran 6:17

Page 36: Spirituality and the Physician

Quran 17: 82Quran 17: 82

“We have sent down in the Quran that which is healing and mercy to mankind”

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Quran 10 : 57 Quran 10 : 57

“ O mankind, there has come unto you a direction from your Lord and a healing for the heart for those who believe in the Guidance and Mercy”

Page 38: Spirituality and the Physician

Peace and Meditation (dhikr)Peace and Meditation (dhikr)

“ Those who believe and whose heart find peace in the remembrance of God, for sure, in the remembrance of God do hearts find peace” (Quran 13-28)

Page 39: Spirituality and the Physician

Does Allah listen to each prayer ?Does Allah listen to each prayer ?

“ When My servants ask you about Me, (tell them ) I am closer to them than their jugular vein. I listen to the prayer of each supplicant when he prays to Me. Let them listen to My call and believe in Me that they may be guided” ( Quran 2:186)

Page 40: Spirituality and the Physician

Healing effects of Al-Fateha Healing effects of Al-Fateha

Page 41: Spirituality and the Physician

How to remove the rust of heart ?How to remove the rust of heart ?

“ There is a polish for everything and the polish for removing the rust of heart is the remembrance of God.”

.. a saying of the Prophet Muhammad (p)

Page 42: Spirituality and the Physician

The Most Beautiful NamesThe Most Beautiful Names

• Healing effects of Asmaa e Husnaa

• Ash-Shaafi• Al-Shakoor ( eyesight)• Al-Majeed (skin)• Al-Hayye (heart)

Page 43: Spirituality and the Physician

““Sufi Healing”- Hakim Chishti Sufi Healing”- Hakim Chishti

Page 44: Spirituality and the Physician

My Own PracticesMy Own Practices

I pray for my patients I pray for my myself I ask my doctor to pray for me

Page 45: Spirituality and the Physician

Duaa (prayer) for Healing Duaa (prayer) for Healing

• Transliteration “ Allahumma afini fi badni, afini fi Qalbi wa afini fi basri” ( 3 times)

• Translation ----“O God, cure my body , cure my heart and cure my eyes from all illness” --Taught by Prophet Muhammad (p)

Page 46: Spirituality and the Physician

Duaah (prayer) for the sickDuaah (prayer) for the sick

• Transliteration “Allahumma azhabilbaas, rabbanas”

• “Ishfi wa anta shaafi, la shifaa illashafuka”• “Shifaal la yaghadiro saqama”• Translation- “O God, remove his (her)

hardship. O Lord of mankind ! grant cure for You are the Healer. There is no cure but from You, a cure which leaves no trace of illness”- taught by Prophet Muhammad(p)

Page 47: Spirituality and the Physician

The Need For SpiritualityThe Need For Spirituality

“ The technology has over taken Spirituality. We have created guided missiles and misguided men” ---- Dr. Martin Luther King ( 1963 )

Page 48: Spirituality and the Physician

Spiritual Growth of the SelfSpiritual Growth of the Self

• Take time to pause and reflect• Observe life and bounties of life• Observe death • Conquest the self• Annihilate the self• Mend relationship with God• Serve others

Page 49: Spirituality and the Physician

Dispensing the gift of Spirituality to Dispensing the gift of Spirituality to the patient the patient

• Take time to listen to him• Befriend him and become a trusted partner in his

health care • Try to know what else is happening in his life. • Know about his family, his job and relations with

others• Convince him that God loves and cares for him• Offer hope to him, not just statistics • Pray for him and pray with him

Page 50: Spirituality and the Physician

Results of Spirituality on Health Results of Spirituality on Health

• The patient will be motivated to get well• He will accept the negative out come if any• He will take the “bitter” medicine willingly• His compliance will improve• He will thank you when he gets well• He will not complain if the medicine did not work• He will be at peace even at the time of death

Page 51: Spirituality and the Physician

Some Healing WordsSome Healing Words

“THOSE WHO ARE HEALED BECOME THE INSTRUMENTS OF HEALING”

Page 52: Spirituality and the Physician

From a NurseFrom a Nurse

“Nothing is needed in our lives more than healing, both for the patient and for the healer”.

Page 53: Spirituality and the Physician

Compassion for the Self Compassion for the Self

Unwavering Love, in difficult timesHelp me to attend to my own spiritMy headaches also need compassionTeach me how to offer kindnessTo parts of me that hurtRemembering Your great love for meI can reach out and lovingly embrace myself

Page 54: Spirituality and the Physician

Articles by Dr. Shahid AtharArticles by Dr. Shahid Athar

• Human Longing for Spirituality (Sufism) • Human Dignity and Spiritual Healing of the Heart• Prayers and Healing (Indianapolis star)• A Physician’s Personal Journey to Spirituality

(The Bulletin of U of Chicago)• Spiritual Encounters of a Wandering Soul • Health Consciousness is God Consciousness

(Health Concerns for Believers – Kazi 1994)