I was standing outside of the patient room with two family members, a faithful wife, and a devoted mother. In the sea of faces that surrounded his bed on a daily basis, these were the two that stood out to me. For this young man in his 30s who was battling metastatic colon cancer, his wife, and his mother were his strongest advocates, constantly seeking answers about his prognosis and making sure that he was comfortable as he dealt with his illness.

I asked them how they were holding up with everything, and the mother talked about how she was still praying for a miracle. With her Christian faith guiding how she looked at her son’s situation, she believed that prayer could potentially reverse his clinical course. While she was saying this, I caught a glimpse of his wife’s face, and it was apparent that she was uncomfortable with where the conversation turned. Later on in that day, she talked privately with me, and she talked about how she was a Christian as well, but that also, as an ICU nurse, she had a tough time believing that things would change based on what she saw in the ICU on a daily basis. She knew how sick he really was, and wanted to focus her prayers at that point more on comfort for her husband, but she ran into problems in terms of getting the rest of the family on the same page. By the end of the conversation, I realized that she had touched a nerve with me, because even with my own Christian faith, practicing as a physician who is constantly exposed to similar situations has caused me to wonder how exactly to pray in different medical situations.

Growing up in church, prayer was often emphasized as a way through which God could intercede in our world. It was taught that even with faith “as small as a mustard seed,” amazing things could happen, and that nothing would be impossible if we believed. Irrespective of the type of situation, my thought growing up was that praying consistently for a particular outcome would lead to a manifestation of that outcome. For some of the more challenging situations, prayers that were not answered in a certain way did not usually have much emotional ramifications, but the stakes with those prayers were not so high most of the time. Usually, the progression of an illness was not the main issue, and the well-being of a loved one who was on the brink of death was not a concern.

However, once I entered medicine, the tenor of the prayers I constantly heard from people around me changed. Many times, and mostly from concerned family members and patients, the main subject of the prayers would be focused on recovery or the halting of a progression of an illness. Sometimes I saw family members at a bedside next to their loved one who was dealing with a terminal illness, hoping for a miracle when they were told by others that the prognosis was grim.

As I heard these prayers and saw the fervor by which people prayed them, a part of me was torn. There was the part of me that grew up in the Christian faith and that hoped that the prayers of these patients and family members would be answered in a dramatic way, if anything as a reward for the passion and strong faith that they demonstrated, putting their emotional and spiritual well-being on the line depending on how or whether that prayer was answered.

But there was another part of me, the part that had been developing in medical school and medical training, that could not forget the cases of progression of illnesses or the ultimate passing of very sick patients, usually in textbook fashion. How could I pray for a miraculous turnaround for a critically ill and likely terminal patient when I was constantly confronted with scenes to the contrary? The hardest part was seeing the tearful disappointment on the faces of family members or patients who were hoping for a change due to their prayers, and to be honest, seeing that made me hesitant to pray for recovery at times out of fear of patient and family disappointment.

In the midst of all this, however, I noticed that a common denominator in all these experiences was the desire for comfort and hope in the midst of illness. I realized that patients and their loved ones were looking to me to provide these things to them in difficult circumstances. The awesome responsibility of this dawned on me, and there began to be a desire to want to help provide the comfort and hope that seemed tough for families to find at times.

As a result, my prayers started to change. There was still a desire to see dramatic recovery for patients, but now, the focus of my prayers was to become a physician that could help bring comfort and hope to ailing patients and families. I found that as that became a focus of my prayers, I was more willing to have honest conversations about prognosis, and if the discussion was focused on terminal illness, I talked more about options ensuring patient comfort. I realized that at times, families were not aware of these options, and that their main concern was to minimize suffering as much as possible. Even though they were hoping for a miracle, they took comfort in knowing that their concerns about patient comfort were being addressed.

There is still that part of me that is hoping for miracles when it comes to the health of people, especially when things look grim, and thankfully I have seen dramatic recovery of patients when everything pointed to a bleak outcome. To be honest, however, these instances are few and far between, but the need for comfort and hope in trying times has remained constant. My hope is that the prayers I pray now would still make me sensitive to the desire to comfort others, while leaving myself open to believing that at times, even I may be surprised by miracles.

Chiduzie Madubata is a cardiology fellow.  

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