March 10, 2020

What praying with a patient's family taught this doctor about patient care

Daily Briefing

    Erica Kaye, a pediatric oncologist at St. Jude Children's Research Hospital, was once asked to pray with the family of a patient, and in an essay published last month in JAMA, she wrote about how the experience changed her life. Now, she's hearing from hundreds of health caree providers and parents who connected with her story.

    Primer: Work with faith leaders to optimize health system engagement

    A doctor reflects on praying with a patient's family

    In the JAMA essay, Kaye, who was raised in a secular Jewish family, writes about her struggle to "reconcile my understanding of faith with the carnage of my daily clinical work." As a physician in pediatric palliative oncology, Kaye writes that she "cares for children for high-risk cancer who often do not survive their illness."

    She recalls a time shortly into her fellowship in pediatric hematology-oncology and hospice and palliative medicine that gave her "a crash course on spirituality at the bedside."

    "Early in my training, I entered a room to assess a critically ill patient, and the mother grabbed my hands and pleaded for me to pray for her dying child," Kaye writes. "I remember standing there, frozen and sweating, my clammy fingers entwined with hers."

    But while Kaye felt anxious and uncomfortable, she quickly realized "the most meaningful way that I could provide care for this patient and family was to join them in prayer."

    Despite feeling "like a fraud" during the prayer, Kaye learned that, when"[c]aring for a patient or family—whether laying hands on a chest to listen to a beating heart or laying palm against palm in prayer—these moments of connection were sacred," she writes.  

    That lesson, she writes, has stayed with her throughout her career: "I will never forget the expression on the mother's face, the feeling of love surrounding the bedside, the togetherness, the strength incurred from sharing an impossible burden."

    The experience, Kaye writes, has enabled her to "stand still in my discomfort and to recognize diversity of faith as an integral aspect of medical care, decision-making, and therapeutic alliance building for our patients and families." She adds, "Sharing in grief, being present, helping patients leave legacies and families create memories—I felt connected to something powerful and much greater than myself."

    Families, fellow doctors respond to Kaye's essay

    Since the essay was published last month, Kaye in an interview with the Deseret News, said she's received hundreds of emails from providers and parents who appreciated her message.

    "I have never in my life received an outpouring of messages like I have in the last week, hundreds of messages from strangers," she said. "Many people share stories of grief and loss that are deeply personal, and wish to engage in a dialogue about how to navigate faith in the context of almost indescribable grief and loss."

    Kaye said she's also heard from colleagues at other hospitals who have been sending her essay around "to spark dialogue during clinical rounds and during teaching didactics with trainees." That news gives her hope because she believes there is a need for medical professionals to pause and acknowledge what they're thinking and feeling.

    "[I]f nothing else I really hope that this piece offers people in medicine and beyond the time and space and permission to pause, to do self-reflection, and then to share those reflections with one another in solidarity," Kaye said. "That's my hope" (Kaye, JAMA, 2/18; Graham, Deseret News, 3/4).

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