Turning to the Psalms to Understand and Care for the Suffering
Jonathan Wispe, M.D., Neonatology, Pediatrix Medical Group and the Center for Bioethics, The Ohio State University
This paper will offer three major points. First: chronic pain is best understood as a disintegrating condition. Second: an important objective in caring for those in chronic pain is reversing the disintegration. Establishing an empathetic kinship between caregiver and patient fosters this goal. A careful consideration of Psalms 69 and 88 provides a better understanding of the nature and care of chronic suffering. In these Psalms the imagery is brokenness, darkness and hopelessness. The psalmist pleads for understanding and a reason to hope for a better future. Third: the skilled use of empathy in the care of suffering will require changes in medical training.
Chronic pain is disintegrating, damaging the physical, spiritual and emotional aspects of self. Pain also fragments relationships with faith and community. This disintegration is well imaged in Psalms 69 and 88 with the Hebrew word nephesh, a word that is frequently translated as soul or self. However this translation presumes a mind/body dualism that is foreign to ancient Israelite thought. Ancient Israelites saw mind and body as integrated. Thus, in the Psalms nephesh encompasses the entire mind, body and soul and represents a force that supports a will to live. This is apt when considering the breadth and depth of the effects of chronic pain. The suffering associated with pain destroys the nephesh.
This paper is founded on the belief that wholeness can be restored in patients with chronic pain without complete resolution of pain. The Germanic root of “heal” is khailaz that means, “to make whole”. Psalms 69 and 88 provide assurance that wholeness is attainable and offer insights on how to heal. With vivid language and images, the psalmists share their despair and plead for an empathetic understanding from their readers. The psalmists pray for the solace of a comforting relationship with the reader. In medicine, empathy with patients requires the same emotional sharing that the psalmist desires. The clinical objective is an empathetic kinship in which the disintegrating effects of chronic suffering are shared by caregiver and suffer. When achieved, this partnership will be therapeutic, guiding the healing that the psalmist prays for.
Effective use of empathy in the care of patients in pain requires a new emphasis in medical training. Despite evidence to the contrary there is still doubt about the value of empathy in medicine. In part because of this doubt, trainees are not informed about the potential benefits of empathy nor are they prepared to use empathy in practice. The ability of a physician to share in a patient’s emotional point of view needs to be nurtured in medical education. This paper conceives of emotional understanding, empathy, in a spiritual context. However it can also be taught and used secularly.
In conclusion, Psalms 69 and 88 speak powerfully of the devastation of chronic suffering and persuasively about the power of empathy in restoring wholeness, the nephesh, so that a patient can find hope for the future.
Chronic pain is disintegrating, damaging the physical, spiritual and emotional aspects of self. Pain also fragments relationships with faith and community. This disintegration is well imaged in Psalms 69 and 88 with the Hebrew word nephesh, a word that is frequently translated as soul or self. However this translation presumes a mind/body dualism that is foreign to ancient Israelite thought. Ancient Israelites saw mind and body as integrated. Thus, in the Psalms nephesh encompasses the entire mind, body and soul and represents a force that supports a will to live. This is apt when considering the breadth and depth of the effects of chronic pain. The suffering associated with pain destroys the nephesh.
This paper is founded on the belief that wholeness can be restored in patients with chronic pain without complete resolution of pain. The Germanic root of “heal” is khailaz that means, “to make whole”. Psalms 69 and 88 provide assurance that wholeness is attainable and offer insights on how to heal. With vivid language and images, the psalmists share their despair and plead for an empathetic understanding from their readers. The psalmists pray for the solace of a comforting relationship with the reader. In medicine, empathy with patients requires the same emotional sharing that the psalmist desires. The clinical objective is an empathetic kinship in which the disintegrating effects of chronic suffering are shared by caregiver and suffer. When achieved, this partnership will be therapeutic, guiding the healing that the psalmist prays for.
Effective use of empathy in the care of patients in pain requires a new emphasis in medical training. Despite evidence to the contrary there is still doubt about the value of empathy in medicine. In part because of this doubt, trainees are not informed about the potential benefits of empathy nor are they prepared to use empathy in practice. The ability of a physician to share in a patient’s emotional point of view needs to be nurtured in medical education. This paper conceives of emotional understanding, empathy, in a spiritual context. However it can also be taught and used secularly.
In conclusion, Psalms 69 and 88 speak powerfully of the devastation of chronic suffering and persuasively about the power of empathy in restoring wholeness, the nephesh, so that a patient can find hope for the future.