By way of an introduction, I should tell you that I am a physician in mid-career who has spent the majority of his time in training and practice working in very rural areas. I am an internist and geriatrician with an interest in palliative medicine. That translates into a physician who cares for elderly adults and has worked in managing the care that is needed at the end of life. My career path has taken me through clinics and hospitals, nursing homes and hospices. Along the way, I have worked in medical administration and have had a long career as a medical educator, teaching medical students and resident physicians and fellows.

Thus, I am a physician who is acquainted with death and the process of dying – something that we all will experience. Moreover, I have had the opportunity to observe how we deal with death – as we die and as we, as loved ones connected to a dying patient by family relationship or by friendship, are impacted by the dying process our friend or relative is experiencing. The matter is obviously charged with a great deal of emotion and meaning and, despite the frequency with which it occurs in my practice setting, is always the focus of powerful sentiments for the patient, the family/friends of the patient, and the staff of health care professionals who care for the patient.

The first area which I’d like to explore in discussing my own Orthodox Christian spirituality is the way in which that interplay between faith and medical practice affects the patient. And here, I’d like to stress the value and importance of the ethical sensibility imparted to us, as physicians, by the Church. The Church, through its teachings and through the writings of its leaders, has given us a moral and ethical compass to use as we navigate the increasingly complex landscape of medical practice. The kinds of decisions which we must make as we care for patients – especially those with serious and often life-terminating illnesses – are difficult. And, the clinical situations which we find ourselves managing are always changing. Some of the changes are the result of medical technologic advances; some, however, are the result of societal and attitudinal changes. As an example of the former, I will point out that only a decade or so ago, implantable automatic defibrillators were a “high-tech” and rare option – not so anymore, they are routinely available and used in high risk patients. Since they self-activate at the point of a lethal cardiac rhythm disturbance, they pose a dilemma at the end of life. As an example of societal/attitudinal changes which are troubling, I will point out that there has been a trend away from valuing human life in the way that our Orthodox Christian belief system teaches us is correct to a more relativistic and “humanist” approach – sometimes the two approaches coincide from the standpoint of outcomes but sometimes they don’t and here, the Orthodox physician must be aware of the conflict and know where to stand ethically in managing his/her patient. Simply stated, the Orthodox Christian physician may consider euthanasia, for example, to be wrong; and that has not changed over the years of my medical practice. But, the frequency with which I encounter patients and family members of patients who seriously pose this as an option has certainly increased over the last thirty years.

The value of this ethical compass has therefore increased over the years and is the greatest “gift” the Church gives to its physicians and to the world through the actions of the physicians who are guided by it. There are other “gifts” imparted by the Church through its physicians to patients. One of the greatest is the general tone of compassion and understanding which our Lord taught us. His example and that of His Saints are great guides for us to follow as we approach our patients, their families and our fellow professionals. I, of course, fall very fall short in this regard; however, I believe that something very good comes out of the striving to act with Charity and Love as I see my patients. From this come the attributes of the good physician: responsibility, professionalism, understanding and attentiveness.

Another way in which Orthodox Christian spirituality provides benefits for patients is through the example which the Church has set over the centuries as an institution which values learning. The value placed upon scholarship sets a tone for an Orthodox physician which encourages and supports learning. This is critical for the correct practice of a profession which the American Medical Association has described as consisting of “life-long learners”.

My Orthodox Christian spirituality also is important for me – as a person. The rigors of medical practice are many and, in many ways, are an increasingly powerful source of stress and fatigue. Here the Church gives its physicians the gifts of its Sacraments and Divine Services and very importantly, prayer. The spiritual healing of the physician through Confession and regular participation in the Eucharist are of great importance in my life as is daily prayer. I find it hard to incorporate more than a few minutes of prayer into my busy days but I have found it helpful to pray at the beginning of the day and then, briefly (sometimes only with the Jesus Prayer) at many points throughout the day. This approach was suggested to me by our parish priest earlier in my career and has allowed me to feel that I am in touch with God as I go through my day filled with clinical, educational and administrative responsibilities. And, even though I still fall far short in this regard, it has allowed me to deal with at least some situations with greater patience.

Finally, I’d like to comment on how my Orthodox Christian spirituality has grown and really, how the issues I’ve discussed earlier in this essay have had the consequence of a greater sense of awareness, for me, of the importance God and the Church have for me as a person. The whole awareness of this has led me to feel closer to the Church and to feel more a part of it – not just when I’m praying or in church for a service – but instead to feel part of it throughout the day whether I’m at work or at home. It’s sort of an “unintended consequence” of the way in which the Church helps me with the care of my patients and the way in which it helps me cope with the stresses engendered by the practice of medicine.

ENDNOTES

[I] Because the author works in the public sector. He asked to remain anonymous. Thus the article is authored by “A Physician of the Orthodox Church. V. Rev. Fr. George Morelli, Ph.D., Editor