Hektoen International

A Journal of Medical Humanities

Healing: A word that connects or separates patients from their doctors

Fergus Shanahan
Cork, Ireland

“He is cured by faith who is sick of fate.”
James Joyce (Finnegans Wake, 482)1

Like a vase, healing has infinite possibilities when broken patients are restored to wholeness. (adapted with permission from Shanahan F and Gowers L, Listen to your Microbes, Liberties Press, Dublin 2023)

In Brian Friel’s play Faith Healer, Francis “Frank” Hardy has self-doubts.2 Is his power to heal diminishing? Is it real, autosuggestion, or chance? Does it require faith? People who come to see Frank are desperate, but whether they are seeking a cure or confirmation that they are incurable is unclear. Perhaps they just need to meet their own kind. Frank is sure of one thing: “I always knew when nothing was going to happen….but occasionally, just occasionally, the miracle would happen.”

What are we to think of traditional faith healers like Frank? Doubt and skepticism are accentuated in Faith Healer, as three versions of Frank’s story are told with inconsistencies and discrepancies. In the end, there is truth and reality in each telling. Frank considers faith healing to be “a craft without an apprenticeship, a ministry without responsibility, a vocation without a ministry,” but if he concedes that he is a charlatan, he thinks his occasional gift might disappear forever. He needs to believe, just as those who seek to be healed need to believe.

Self-doubt separates Frank from the self-assured modern medic supported by guidelines, algorithms, and evidence-based everything. However, for most of the ills tormenting Frank’s patients, there is no evidence base. His audience is made up of people for whom modern medicine has been insufficient or has failed. Integral to Frank’s performance is human touch, laying on hands, whereas human contact has disappeared from many doctor-patient interactions.3 Frank acts alone. He deals with people directly, while his scientifically trained counterparts are surrounded by teams of specialists. In other respects, Frank Hardy and the modern medic have much in common. Both deal with mystery and both deal with uncertainty, each trading on the basis of belief and trust. Placebo and nocebo operate in both cases. However, Frank knows he is a performance artist, whereas modern medics seldom concede that performance and acting are part of their skill.3,4 Like all accomplished performers, Frank is acutely sensitive to the subtle body language of his audience. He is conscious of the “strained face” and “burning eyes” of the one who is “sick with bitterness” and for whom he knows he can do nothing. While Frank’s act never changes, the modern medic evolves continually, shaped by science, with diminishing time for the comforts of caring and healing.5,6

Once was a time when healing seemed uncomplicated. Now it is a slippery concept that eludes rigorous definition. If it were synonymous with restoration of health, it might be more accurately termed healthing. A return to wholeness or whatever reduces or transcends suffering does not capture the essence of how one heals.7,8 Nor does it clarify who is doing the healing. Is it something bestowed by a care-giver? Or is it an active process recruited from within the patient?

Health professionals are comfortable being described as carers, but seldom consider themselves healers—healing is something a patient does. Clinicians usually restrict the term “healing” to describe physical recovery from visible lesions of disease, surgery, or trauma; whereas patients seek total healing—spiritual and mental, as well physical. Patients seek an escape from illness—the lived experience of disease. Their ambition is broader than that of the disease-focused clinician, because illness often persists after overt disease has subsided.

The human condition is not static; it involves continual hurt, brokenness, and healing. Like a vessel that can be broken and repaired in an infinite number of ways, the experience of healing is personal, with infinite possibilities when broken patients are restored to wholeness. Healing is an active process in all living material. Time and nature are ingredients for healing, but time alone is insufficient. In a rebuke of clichéd banalities, Emily Dickinson asserted that “time never did assuage…Time is a test of trouble/But not a remedy.”9 Healing is made possible because of continual renewal, repair, and remodeling in all tissues—a process baked into the function of the human genome and involving mind and body inseparably. We become aware of healing following a major crisis, but it is continually active and not simply called upon after the onset of disease or trauma. Healing coexists with active disease. Healing is often imperfect. It may scar or deform. Mental and physical healing are probably similar, but the former receives less attention because it is invisible.

When traditional faith healers invoke supernatural power, they are treated with skepticism, but Friel’s fictional healer deals with something that is natural. For him, the potential to heal resides within the one who seeks healing. Most clinicians have stories of occasional patients who beat adverse odds with miraculous outcomes. When these are dismissed as statistical chance, there is a missed opportunity to explore their causes, including variance in natural human capacity for healing.

Anyone can follow guidelines and dispense evidence-based therapy, but if that is all modern medicine aspires to, who needs doctors? Faith healers know that when there is no cure, much can still be done to relieve suffering. The boundaries of science-based medicine and traditional faith healing overlap, but medicine’s ambivalence toward healing leaves a gap—a gap frequently filled by peddlers of pseudoscience, most of whom are unencumbered with Frank Hardy’s insight and self-doubt. Unless medical science seeks to understand the inner capacity for healing, healing will be another word that distances patients from their doctors.

References

  1. Joyce, James. Finnegans Wake. First published 1939. London: Penguin Classics edition, 2000.
  2. Friel, Brian. Faith Healer. Gallery Books, Oldcastle, 1991
  3. Shanahan, F. The Language of Illness. Dublin. Liberties Press, 2020.
  4. Whorwell PJ, Shanahan F. “In the performing art of medicine: the doctor as actor.” QJM 2016;109:159-60.
  5. Sajja A, Puchalski C. “Healing in modern medicine.” Ann Palliat Med 2017;6(3):206-210.
  6. Lown, Bernard. The Lost Art of Healing. Ballantine Books, New York, 1996.
  7. Egnew TR. “The meaning of healing. Transcending suffering.” Ann Fam Med 2005;3:255-262.
  8. Cassell, Eric J. The Nature of Suffering and the Goals of Medicine. 2nd edition, Oxford University Press, 2004
  9. Dickinson, Emily. “They say that ‘Time assuages.’” In: Vendler H. Dickinson. Selected Poems and Commentaries. The Bellknap Press, Harvard University Press Cambridge, 2010.

FERGUS SHANAHAN is a gastroenterologist and emeritus professor of medicine at University College Cork. He loves people, words, and microbes. Recent books for a lay audience include The Language of Illness (2020) and Listen to your Microbes (with co-author Laura Gowers, 2023), both published by Liberties Press, Dublin.

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