When I first met Ralph, he was 82-years-old.  He suffered from shortness of breath which started when his wife of 56 years was diagnosed with a rare bone cancer.  Upon further investigation, I diagnosed him with a weak heart and a very tight aortic valve which required immediate surgery.  Ralph made it; his wife died.  Today, twelve years later, he brings me treasures from his metal detecting hobby on the beaches of Santa Monica.  In that interim, he was diagnosed with non-Hodgkin’s lymphoma with a nasty relapse and was treated twice, now in full remission.  He has a full set of hair, and by the way, he remarried last year.

There is a Persian poem which describes a porcelain bowl that falls from great height and remains intact, whereas hundreds of others fall from much shorter stances and shatter. There is comfort in surrender.  There is truth in surrender.  There is love in surrender.  And so I pray.

Modern medicine can be viewed as miraculous.  Whereas, at the outset of my life, women died in childbirth, diabetes was imminently terminal, premature babies had no chance of survival and common bacteria killed the young by the masses, in the U.S., today’s medicine expects nothing less than cure or near normal lives for many such complicated conditions.  When I graduated medical school, heart failure had a greater than 50% mortality rate at two years, worse than most cancers; today heart failure patients can live for decades.  Most of us are expected to live clear past 85.

We physicians are present at the most crucial parts of our patients’ lives.  The birth of a child.  The death of a loved one.  The recovery from a heart attack, when the patient wonders if he can resume sex.  The molested wife, too fearful to discuss her memories with her therapist or her husband.  And so I pray.

In my first consultation, I tell my patients, that I am only part of a team assisting with the road to recovery.  I diagnose.  I set a course for treatment.  The patient must follow the plan and what he does is even more important than what I do.  I am a coach.  I am a teacher.  I am a vessel through which knowledge and the power of healing flow.  Just as priests are instructed and reminded that they are not the source of blessings, I too know my place, that I am not the source of healing, but its conduit.  And so I pray.

In Latin, “patient” means “sufferer.”  Part of my job is to ease suffering, relieve pain.  There is large temptation for a physician to develop a God complex, given the science, the technology, the immense knowledge and readily available medicine on the one hand, and the vulnerable, weak patient, on the other.  Arrogance in the operating room is the norm.  Yet our very blessings can make us stumble and turn into curses if not dashed with humility.  And so I pray.

Still, to see so much suffering can be disheartening.  After all, few come to see the doctor because they are well.  At the top of each intake form is the “chief complaint.”  There are those we cannot help.  There are patients that merely melt away, crushed under chronic uncontrollable pain, anxiety, depression.  There are those who challenge us to the limits of our knowledge, patience, resources.  Some simply cannot tolerate any medications and suffer multiple side effects.  Often, when we break the news, we cut the patient’s life line, we take a knife to their core. And so I pray.

I don’t really need the studies that show prayer promotes healing.  Nor am I naive: I know God does not bring back the child that commits suicide, no matter how the parents pray, or the young mother with uterine sarcoma.  There is randomness in God’s design, or we would all be robots.  There is evil, and as the brilliant pop philosophy correctly points out “shit happens.” The purpose of prayer is not to get God to act differently, but to draw close to one another with love, then reorient our hearts like a love compass toward the source of all life.  When a patient knows her doctor is praying for her, she realizes she matters, and yes there is healing in that.

Every day I hear in multiple languages, “First God, second you.”  That is an expression of love, of affection, of respect and gives me the energy I need to work hard for my patients.  Believers walk with death on one side and God on the other.  When tragedy hits, they are comforted by my medicine, by my love, by my care and by my prayers. And so I pray.

I pray that God makes me right, more than smart.
I pray that my patient knows that I too am human, with my limits.
I pray to admit powerlessness. As kindness is a sign of strength, surrender is a sign of confidence.
I pray to have the strength to love my noble profession, and use its powers, never abuse them.
I pray to the Great Physician who holds life and death in His hands.

Dear God, I am your blade.  Sharpen me on one side, dull me on the other and give me the wisdom to know when to use which.  Lay me down at night, and give me luster in the morn.  Teach me the humility to know that in your hands I heal, without you I wound. Make me an instrument of healing.  Inspire me with your love for your creation and respect for your diversity.  Let your light illuminate my mind and my soul so that I can protect the body with your sacred truth.  Let me be kind in the face of harshness.

Amen.

Afshine Ash Emrani is a cardiologist and can be reached at Los Angeles Heart Specialists.