Spirituality, Religious Wisdom, and the Care of the Patient

Gratitude and the Care of the Patient: Introduction

Alan B. Astrow, M.D.
aastrow@maimonidesmed.org

On February 4, 2002, we held a Hindu-Protestant dialogue entitled "Gratitude and the Care of the Patient."  Our previous session, "Healing and the Care of the Patient" had focused on ways in which the health care team might acknowledge and even support a patient's spiritual search during illness. In examining the significance of gratitude in the context of illness, we asked our speakers to reflect on the range of emotional responses a person might experience in the face of serious illness, from gratitude to bitterness.

It's one thing to feel grateful when things are going well. I sometimes wonder how some of our patients manage to carry on without giving in to what seems to me fully justified anger and even self-pity. We asked our speakers to consider whether their religious tradition might address this aspect of illness, to prepare people for illness. For a patient who identifies with a particular religious faith, might the patient's tradition provide helpful resources that doctor or nurse might call upon in a crisis? We also asked that our speakers consider the possibility that religious wisdom might be beside the point at best for the sick patient, at worst counter-productive.

We hoped that the discussion might call into question some commonly held assumptions about illness. If religions can sometimes promote the unhelpful and inaccurate idea that illness is a direct consequence of sin, and the converse that righteous behavior guarantees freedom from disease, our secular culture seems at times to have adopted a similar outlook in disguised form. For sin in the contemporary world, substitute unhealthy living habits-cigarette smoking, failure to exercise, a high fat diet, a bad attitude. 

I'm not suggesting that we shouldn't urge our patients to adopt healthy practices and avoid high-risk behaviors. What I am arguing against is the temptation to attribute all illness to factors under our direct person control.  If we believe that illness is something that each of us through our own personal efforts can entirely prevent, this can lead to an air of excessive pride and condescension on the part of the well. The sick person would be not only sick, but also at fault and if that person has lived a blameless life from the standpoint of heath risk factors, he is entitled to feel cheated and embittered.  

Can our religions provide us with some other understanding of illness, scientifically sound but also realistic about human needs, that might help us avoid the twin perils of depressive self-blame and angry resentment?

In a culture that worships fitness, youth, and success, are the sick made to feel as if they are losers, outside of the mainstream of the social world? Can a religious understanding of gratitude help us to view the sick individual with respect and as a valued member of the community? These are some of the questions that we posed to our two speakers and to the audience.

Uma Mysorekar, "Gratitude As Viewed in Hinduism"
Joel James Shuman, "Reflections on the Possibility of Gratitude as a Christian Virtue for Patients and Caregivers"
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Published: February 25, 2002