Drexel University College of Medicine, Philadelphia, Pennsylvania, United States (Spring 2010)
“You act like you are waiting to die!” Sophie explains that this accusation comes in many forms from friends and members of her church.
“Why don’t you go to the health spa? Give up those medications. What you need are good, nutritious foods, vitamins, and minerals. There is a spa in West Virginia that has an eighteen-day cleansing program.”
Sophie cringes. “I don’t have $3000 to pay for such an extravagance,” she laments.
“My sister-in law had breast cancer,” Sophie continues, “She was 36 years old. She changed her diet. She ate fresh fruits and whole-grain foods for months. She didn’t give in to the doctors; she trusted the Lord and ate well.” Sophie then whispers words that I don’t hear. I ask her to repeat what she just said.
“She died. My sister-in-law died. The diet didn’t save her.”
Sophie, a pastoral counseling client, is often bedridden for days after her treatment. During those days, church visitors arrive with prepared meals and ample advice. One visitor, while sitting at the kitchen table, criticizes and says, “You have the wrong kind of juicer. This juicer is too fast. 3500 RPM is too fast. It kills enzymes. You need to buy a new blender — one that runs at 1700 RPM.”
Another church member passionately testifies to the need for Sophie to submit to the will of God. She argues that Sophie’s illness is a sign of disobedience to God. “Kneel,” she admonishes, “Pray! Exercise! And eat well!”
Sophie feels blamed for her illness, for not eating right.
“There are two sets of laws in the universe, the spiritual laws and the health laws, and you can’t defy either set. You violate either or both sets of laws and you reap the fallout,” the church’s health minister warns, “There is no getting around the effects of what you eat. The law is merciless. If you eat too much food, you get fat. If you eat too much fatty food, you get heart disease. No longer in harmony with the law, you get sick.”
Another friend encourages, “The journey is not easy, Sophie. But move forward, Christian soldier! Don’t eat those unclean foods; they will harm your body. No meat or fish. Eat raw food! Listen to Jesus. Obey God’s health laws. Glorify God in your body.”
Sophie says, “In conversations like these, I try to think of all the people who eat well and who still die. I know a person with rectal cancer and another with breast cancer. They ate well, and they didn’t want to die. But they died just the same.”
Sophie is tired of oatmeal patties, which, when she eats them, cause bloating and excruciating pain. She vomits after almost every meal. She eats these gifts given to her from her visitors. She doesn’t want to wait for death. She wants to fight, live in harmony with God’s holy laws and secure a better chance for healing, in spirit, if not in body. She is afraid to share her feelings of confusion and, now when needed most, refuses visits as a way to hide from disapproval. She prays for God’s forgiveness.
Sophie hears their voices:
“Eat like you believe!”
“Stop heart disease.”
Sophie seeks the support of a pastoral counselor despite warnings from her pastor that she will be banished from her church community. Sophie is trapped between the rigid, fundamentalist teachings of her religious community and a desire to experience God’s love. She desires prayer, not proselytizing, as she nears the end of her life. She wants to believe that God loves her. Illness, chronic suffering, and the realization that medicine has nothing more to offer has intensified a growing conflict with her faith of many years. But, there is no time to honor Sophie’s questioning and searching for answers, nor is there time to alter her belief that she is the cause for her illness.
Now, Sophie is dying. She wants to die well, without guilt or blame, in neither physical nor emotional pain, surrounded by the love of others. She wants to believe that God’s love, even for the sinner, will never end. Instead she spends her last days in turmoil, haunted by persistent messages of failure from friends and church members. She regrets the times she indulged in the joys of eating. She laments her occasional enjoyment of fast food and exuberance for sweets. She wonders with great seriousness if resisting those pleasures would have prevented her cancer, would have saved her life.
REV. FLORENCE GELO, DMin, NCPsyA has over twenty-five years experience working with patients receiving palliative care as a former hospital and hospice chaplain. She is also a pastoral psychotherapist in private practice specializing in chronic and life threatening illness. She has special expertise in cultural and religious diversity and medical decision making at the end of life. As Associate Professor of Family, Community and Preventive Medicine at Drexel University College of Medicine (DUCOM), Dr. Gelo teaches courses in death and dying, whole person care, religion, and medicine to undergraduate medical students. As the Behavioral Science Coordinator of DUCOM’s Residency Program in Family Medicine, she lectures on end-of life topics. She is the recipient of funding to establish a religion, spirituality, and medicine curriculum and co-recipient of a grant from the George Washington Institute for Spirituality and Health for work in medicine and spirituality with family medicine residents.