The pediatrician Margaret Mohrmann tells the story of caring for a young girl in the ICU who developed a devastating case of meningitis. One day when she came to check on her patient, the girl’s mother asked Mohrmann why her daughter had become sick. As Mohrmann began to explain what meningitis is and how it is transmitted, it quickly became clear to her she was missing the meaning of the mother’s question. Like Job, the mother was struggling to understand why her daughter was being made to suffer.
Whether we realize it or not, each of us operates with beliefs about causality and meaning. Who or what controls the course of events in our lives and the world? Do blind physical forces alone determine our destiny? Is God or some other force like karma in control? These basic beliefs often come into play when we get sick and seek to make sense of our suffering.
For instance, some people may interpret their disease as a kind of punishment for bad health decisions like smoking or alcohol abuse. Others may find a spiritual purpose in being ill. Still others may believe they became sick due to sheer bad luck.
The meaning we attribute to a symptom such as pain can influence how we experience it. This is because our perception of pain is mediated through our brain. For example, if I had a headache right now, I would experience it in a radically different way depending on if I attributed it to stress or if I feared it was due to a life-threatening brain tumor.
Our emotional and spiritual state of being can also influence how physical ailments feel. In my work in hospice, I have cared for patients with severe pain that did not respond to higher and higher doses of potent analgesics. Only after somebody identified and addressed a spiritual crisis, such as a fear of dying or an agonizing regret, did the suffering person find relief.
In sum, an individual’s thoughts and emotions can powerfully influence how a symptom or disease manifests itself. Thus, to be effective healers physicians must approach patients holistically. This means taking into account the multiple factors — psychological, cultural, economic, social, and spiritual — that affect a person’s health.
James Marroquin is an internal medicine physician who blogs at his self-titled site, James Marroquin.
