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We sit down with Robert Raschke, a critical care physician and the author of One Hundred Prayers: God’s Answer to Prayer in a COVID ICU. We explore the power of prayer in the midst of a health care crisis. Robert shares profound insights and experiences, revealing the role of prayer in providing hope, comfort, and strength to patients, families, and health care professionals during the COVID-19 pandemic. Discover how faith and spirituality intersect with critical care medicine, offering solace and inspiration in challenging times.

Robert Raschke is a critical care physician.

He discusses his book, One Hundred Prayers: God’s answer to prayer in a COVID ICU.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Bob Raschke. He’s a critical care physician, and he’s the author of the book One Hundred Prayers: God’s Answer to Prayer in a COVID ICU. Of note, he wrote it under a pseudonym, and we’re going to talk about his book today. Bob, welcome to the show.

Robert Raschke: Thanks so much, Kevin. Thanks for inviting me to be on with you.

Kevin Pho: We’ll talk about your book in a little bit, but first off, briefly share your story and journey.

Robert Raschke: I’m a critical care doc. I’ve been in practice 38 years, I live in the Phoenix metropolitan area, and I teach and do some research, but I’m mostly a bedside critical care physician. I was raised Catholic, and I’ve kept my faith private. I’m not a churchgoer, but during the COVID pandemic I had a rebirth of my faith, and that’s basically what I wrote about.

Kevin Pho: All right, so let’s talk about that story. Of course, your book is One Hundred Prayers: God’s Answer to Prayer in a COVID ICU. So tell us the story behind the book, and tell us why you decided to write it.

Robert Raschke: Well, one thing I wanted to start with is that it’s hard to remember now. We’re so used to COVID now; it’s become like the common cold. But this story that I’ve told started in March of 2020, and it’s almost hard to remember how scared we were. We saw this disease exploding across China, exploding across Europe, and then coming to the United States in March of 2020. When my book started, on March 1, New York State reported its very first case of COVID. By the end of the month they had 77,000 cases, and their health care system was completely overwhelmed. They were even talking about two patients sharing one ventilator. Here we were, the greatest nation on Earth, and the strongest health care system on Earth was being overwhelmed within one month by this disease.

Out in Arizona in March of 2020, we didn’t have enough N95 masks for more than one mask per day. Back then, if you’ll remember, it was before the CDC was recommending masking, so we were being asked to go into the rooms of patients with pneumonia of unknown origin who were coughing, and we were told we didn’t need to wear N95 masks. So in March of 2020 I was afraid. I was scared for my life. I thought I was going to get COVID, I thought I was going to bring it home to my family, and I was worried for all my co-workers.

And I decided to say a prayer a day. I said, I’ll say a prayer a day for 100 days. But at the end of the 100 days, it was the middle of July, and Arizona was the hot spot globally. We had the highest attack rate for COVID of any state or country in the world, and it became clear that 100 days of prayer wasn’t going to be enough. So over the next two years, essentially the time it took for the ICU part of the pandemic to resolve, I recorded over 270 prayers. By the end I was praying with every one of my patients every day, and I collected the contemporaneous stories of what was happening to me and the nurses, the miracles we were seeing occur, that I perceived in my workplace. Somewhere along the line, in the middle there, I decided, hey, I’ve got to write this down. This is too important. It’s the most important event of my professional career, and I need to record it. So that’s when I started to make notes and try to record the history that’s recalled in the book.

Kevin Pho: Now take us back to those first few months of COVID. You did mention that there wasn’t enough personal protective equipment. You were going into these rooms with pneumonia of unknown origin, and people were dying across the country. Did you ever have a thought about just stopping, not going in, and protecting yourself and your family? Was there ever that decision point?

Robert Raschke: No, that never crossed my mind, Kevin, but I know several other doctors who decided that early on. We had some specialists at our hospital who left our hospital staff when COVID hit in March of 2020. One of the physicians who stayed behind is 72 years old, and he took call continuously for five months in his specialty. He took call 24 hours a day, seven days a week, for five months straight during COVID, because the other specialists in his field dropped their privileges when COVID hit. I asked him about it one time, and he’s in the book. I asked him why he did it, and he said, “Ah, I just did what anyone would do.” He didn’t consider it any special thing that he did.

Kevin Pho: And you mentioned that you started praying one prayer a day. Go into more detail about the effect that had on you.

Robert Raschke: You know, the effects took a while. I think, like anything you do to try to deal with things spiritually, you have to stick with it, and I don’t know that a great benefit was apparent to me at first. But over the course of months, sticking with it, what I found it did for me was make me more aware of God’s presence in my life. The things that were happening to me had purpose, and the things that I did had a purpose. It was important how I treated a person, even if no one saw me, even if their family couldn’t visit, and even if that patient died. The way I treated them was important; God saw that. In the actions of other people, I could see God guiding them, in their kindness and in their devotion to their jobs. It just brought a great sense of meaning to my life, and a sense that I was doing the right thing and that it had a purpose.

It reminded me why I went into medicine to begin with. I think we probably spend something like 70 percent of our time now doing data entry, and that’s not why any of us went into medicine. Praying to myself, and also sharing those prayers with patients, was a way of expressing something that was uniquely human. It showed them that I cared, and it showed me that I cared, which I had to convince myself of, because there were times when my compassion was almost exhausted. We saw over 400 people die in our ICU from COVID pneumonia, and obviously that affects you. You have to actively cling to your humanity when you’re in a situation like that, or you’re going to lose it.

Kevin Pho: In your ICU, you mentioned that you also prayed with your colleagues and staff. Did you feel that prayer also helped the team pull through the despair of the worst days of COVID?

Robert Raschke: I hope so, Kevin. I’ve got to say, when I’ve asked patients, and I always ask their permission if they’re conscious, I’d say 99 percent of the time they are happy that you’re going to pray with them. If anyone else is in the room, the nurses or the respiratory techs, I invite them to pray, and they have universally held hands together with me and the patient and prayed with us. People don’t usually tell you what they think about that, but I think people were deeply moved in most cases.

And I think as doctors we still have a little bit of hierarchical authority. I feel like it’s harder for other people on the health care team to do something like praying, because they’re afraid the doctor might not like it. But as a physician, you are still looked to as the leader to this day, and I think if you’re the one who initiates it, other people who are willing will be glad to follow. So that’s a long-winded answer, but I think you’re right. I think it helped the team.

Kevin Pho: Your book is titled One Hundred Prayers: God’s Answer to Prayer in a COVID ICU, and it’s noted that it’s written under a pseudonym. Now tell us some of the other main messages you want readers to come away with after reading your book.

Robert Raschke: You know, I think one of the things I learned is that I always prayed with two minds. One was the mind of the medical doctor, looking at the prognosis of the patient, and I had the tendency to not want to pray for things that I thought weren’t going to happen.

One of my friends, and this is an account that’s in the book, caught COVID. He’s a nephrologist, and he caught COVID in January of 2021 and ended up spending 145 days in the ICU. During that time he had several cardiac arrests, and there were times when I knew scientifically that his chance of surviving was very close to zero. It dawned on me that if we prayed for his complete recovery, that was a fool’s prayer, and that it would be unrealistic for us to pray that way. But we decided to pray that way. His wife wanted to pray that way, and I said, I think that’s how you’re supposed to pray. You’re supposed to pray for what you really want. You’ve got to accept God’s will if he doesn’t give you 100 percent of what you want, and later on you’ll understand why. So we prayed for my friend’s complete recovery. Even after five months on the ventilator in a coma, with his lungs completely destroyed and multiple cardiac arrests, we kept praying for a complete recovery. And in his case, he received a double lung transplant five months later, and he survived and went home, and he’s loving life with his family and his grandkids, and he’s traveling again.

So one thing I learned is that when you’re under adversity, go to God. I didn’t know much about the Bible; I wasn’t even going to church. But I went to God during adversity, and I think that he blessed me greatly for doing that, and I appreciate it. That’s why I wrote the book. It’s my testimony, and my way of saying thanks to God for getting me through this and for being faithful in hearing our prayers. He listens, he hears and he answers.

Kevin Pho: Now, for those other physicians who want to incorporate more spirituality into their practice, whether in the ICU, the hospital setting or even the outpatient setting: You said that there was no guidebook for this, and the trials of the COVID pandemic made you turn to God. What kind of advice do you have for other clinicians who want to incorporate more spirituality?

Robert Raschke: I think one thing, one of the simple things, is that I don’t try to force it. I actually pray that I’m not using it as a technique. I don’t want it to be a technique for rapport; it needs to be a genuine prayer to God. Sometimes when you’re in someone’s room, you get a sense that the timing isn’t right, and sometimes you get a sense that the person is struggling. If the thought pops into your mind to say a prayer with them, I would just recommend that people give it a try. Just ask. I ask the patient humbly. I just say, “Hey, would you mind if we said a little prayer together?” And they’ll almost always say yes. Sometimes they’ll start crying a little bit, and you hold their hand and say a prayer with them.

I’ve prayed with people who are Christian, Jewish, Muslim, Hindu, of traditional Native American religions, probably some people who are agnostic, and probably some people who just prayed because they thought I wanted to. But you can pray to God. I pray to Jesus, but if the patient is Muslim, I think it’s OK for me to pray to God with them. I’d say give it a try, see what happens, and I think good things will happen.

Kevin Pho: So we’re speaking now at the end of October 2023. COVID is perceived as being more endemic, and we’re certainly a long way from the worst days in the ICU. Tell me how your experiences, the trials that you documented in your book, have changed you as a person and as a physician going forward.

Robert Raschke: Well, I’m in my early 60s now, so I’m toward the end of my critical care career, and I’ve got to say it’s brought a great sense of meaning to my whole career. It sounds weird to say, but I was grateful to have gotten to be part of this, and it makes me feel like I did something really important at the end of my career.

The other thing I realized is how much I love the people I work with, the team. I know all fields of medicine aren’t exactly the same, but in critical care, I can’t do anything by myself. If I had to start an IV and hang fluids on an IMED pump, I don’t know if I could do it, the simplest thing. But with the team of people I work with, I realized at the end of the pandemic that we had very little turnover. Just about everyone on the team hung in there, no matter how bad it got. And that sense of being part of a great team went from the nurses, even to the housekeepers, to the guys in the cafeteria who were feeding us. Everyone was working together to get through this. I don’t know if I ever really realized before in my career how lucky I was to be working with the nurses and the respiratory therapists, all the people we had. You just couldn’t have had a better team of people to work with.

Kevin Pho: We’re talking to Bob Raschke. He’s a critical care physician. His book, which is written under a pseudonym, is titled One Hundred Prayers: God’s Answer to Prayer in a COVID ICU. Bob, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Robert Raschke: Well, Kevin, this may be some of the same things that I said. One thing that drives me nuts on TV is that whenever people get in trouble, whenever they’re feeling fear or anxiety, it’s depicted that what you do is start drinking; you go and have a drink. I would say, under adversity, consider reaching out to God. Just try praying to him. Try looking in the Bible a little bit. The Bible will be confusing if you haven’t been through it very much, as I had not, but things will be revealed to you. And then look for God in your life. Look for him in the people around you, in nature and in the things that happen, and just keep asking for his help and his guidance in your decisions. In my life it was 100 percent crystal clear to me that he was here in my prayers and answering them every day, and that’s what helped me get through.

And I think for physicians nowadays, especially as we get more and more computerized, that is going to be a key way for us to maintain our humanism and show patients that we really care for them. They’re not just a computer entry in the EMR. They’re a human being that we care about as their physician. I think that’s really going to enhance our practice of medicine.

Kevin Pho: Bob, thank you so much for sharing your story, time, and insight, and thanks again for coming on the show.

Robert Raschke: Thanks.