A first trip to Africa has a major pre-requisite: a million injections. You name it, I've been inoculated for it. Mostly, though, these shots are for the diseases that can kill you, and what's left is a whole host of other nasty bugs that can make you wish you were dead.
In my trip to do research in Ghana last summer, I fortunately steered clear of serious illness. The same could not be said for my friends. Each of my four best American friends in Ghana came down with something terrible: two cases of malaria, one possible case of malaria, thrush, amoebic dysentery, and multiple cases of what I'll courteously term "food poisoning."
After returning stateside, I gave my grandmother a call to assure her that I had indeed survived Africa-and with barely a scratch to prove it. Although she sounded relieved on the other end of the line, she wasn't that surprised that I had stayed so healthy.
"I prayed for you everyday," she said, matter-of-factly. "So of course you turned out all right."
For me this is a glimpse into the longstanding relationship between spirituality and medicine. Although I responded with a bemused smile to my grandmother's comment, it's hard to deny the traditional connection between the two topics, regardless of where you fall on the issue of religion.
Ever since the days of Darwin, science and faith have been pitted against each other-but the same cannot be said for medicine. Here at Duke, there are medical researchers hard at work addressing the correlations between religious activity and health. And at Duke Medical Center-like many hospitals around the country-chaplains are on-call and included alongside surgeons and nurses as part of the "care team."
"Overall the [Duke] administration and the medical profession have been very supportive and responsive to the pastoral care department, realizing that caring for patients has to involve caring for their spiritual needs as well," says Jim Travis, former director of pastoral care at Duke Hospital.
Twenty years ago, the idea of a spirituality research center, in a medical center of all places, may have seemed unlikely, says Harold Koenig, founder and co-director of Duke's Center for Spirituality, Theology and Health.
But with a growing body of research that suggests positive associations between religious activity and improved health, serious research institutions have begun to welcome their own spirituality-based centers. At Duke, for instance, what began as a tiny program in 1995 now has the resources to fund research projects at $200,000 apiece.
So with a topic as loaded and broad as spirituality, where do medical researchers begin? The patients, Koenig says.
One might imagine the founder of a center of spirituality to be devoutly religious, but Koenig-in the calm, charming cadence of an archetypal doctor-deemphasizes his own religious involvement. Raised in a Catholic household, Koenig says he drifted from his faith while a student at Stanford University amidst the chaos of college life. Eventually, he returned, this time in a Protestant tradition.
As a family physician in the mid-80s, Koenig became interested in how patients were coping with major illnesses, from heart attacks to hip fractures. Religion, above all else, continued to surface.
"People would tear up talking about their reliance on God," he says. "I was intrigued by that, because there had been nothing in my training that would suggest that this had any bearing at all."
Members of faith communities at Duke, however, were not surprised to hear that researchers were studying a link between healing and spirituality.
"I think in our faith, like a lot of faiths, the ultimate is salvation-that word means wholeness," says Cherrie Barton, the Presbyterian campus minister at Duke. "That would mean mind, body, spirit, everything. So it would make sense that there's a connection between prayer and health and physical wholeness as well."
Barton also notes that when her students come together for prayer, a large majority of prayers concern those who are suffering from illness.
In the late '80s, as his interest in spirituality and medicine grew, Koenig turned to Duke for support. Fortunately, he says, Duke was receptive.
Throughout the '90s, Koenig examined the effects religious involvement has on a number of factors-including blood pressure, immune functioning and length of hospital stay. While controlling for lurking variables, Koenig and his researchers found, in nearly all cases, that those who engaged in regular religious activity were on average healthier than those who did not.
As the scope of his research broadened, so did his program. Soon Koenig began to enlist the aid of other scholars, including Keith Meador, Koenig's colleague and co-director. And in 1998, the "program" officially became a "center," complete with a full-time staff, a community of scholars that meets regularly to discuss breaking topics in the field and a yearly conference on campus.
But with all the support Koenig and Meador have received for their research, there are the occasional detractors.
One of the topic's most vocal critics, Richard Sloan, a professor of psychiatry at Columbia University Medical Center, continues to lambast the field in the public arena. Last year Sloan published his book, Blind Faith: The Unholy Alliance of Religion and Medicine, and he continues to speak against the mixture of medicine and spirituality, both in the media and on college campuses.
Koenig, however, says Sloan and other critics are missing a major crux of his center's research.
"We're not trying to prove that God exists, God may not exist," he says. "This research will be the same whether God exists or not. We are trying to understand, given that two-thirds of the American population are members of churches [and] 95 percent believe in God-these beliefs and practices, what health effects do they have?"
This is an argument that almost everyone echoed: it's hard to deny the power of religion. People in trauma tend to call on the things they can count on; family and friends normally top that list, but so does religion. There are few events more traumatic than losing one's health, and with a vast majority of Americans believing in a deity of some form, it is inevitable that people will call on that spirituality in their time of need. To deny religion's connection with medicine, some researchers say, is almost na've.
"I think there's a lot in medicine that's yearning for a voice that religious and spiritual communities can offer," Meador said.
Paige Martin, a Duke divinity student, says her experience as an intern in the pastoral care department at WakeMed Hospital in Raleigh has opened up her eyes to how inviting doctors are to the spiritual aid of chaplains. At WakeMed, there's a full-time pastoral care department, and patients are guaranteed an on-call chaplain 24-hours a day, every day.
"They really do see the chaplain as a vital, integral part of the care team," she says.
As an intern, Martin fills a number of roles-many of them non-religious-from contacting trauma-victims' families to comforting patients who have just been diagnosed with cancer. It's an emotional job, but one that the doctors take very seriously, she adds.
With all the potential of the field, there is a lot researchers still do not know. For one, researchers are uncertain as to why those who are active in religious activity have improved health, Meador says. Uncovering these mechanisms is a major goal of future research.
After all of this, I wonder, what does science have to say about the possibility that my grandmother's prayers saved me from bouts with malaria? In reality, the issue of "intercessory prayer" is the most contentious in the field-and one that many researchers, like Koenig, are quick to debunk.
"This is a non-credible area because it's not based within science. Theologically, it's highly flawed anyway, because even if you're working from a Judeo-Christian tradition, how do you predict God's actions?" he says. "No credible scientist will be able to say that. You just cannot study this."
But putting all science aside, I tend to think my grandmother also has a pretty reasonable stance on the issue of prayer and healing:
"A little prayer never hurt anybody."
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