There is a growing recognition in medical education and practice that the spiritual component of human existence must be recognized and addressed. The American College of Physicians has concluded that physicians are obligated to attend to all dimensions of suffering: the physical, psychosocial, spiritual, and existential. Similarly, the Joint Commission on Accreditation of Healthcare Organizations (JAHCO), which accredits hospitals, recognizes that spiritual concerns are often important for patients and that hospitals ...

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In his book The Art of Loving, Eric Fromm wrote that “the deepest need of man is to overcome his separateness, to leave the prison of his aloneness.” In the Bible, after forming Adam from the dust of the ground and breathing into his nostrils the breath of life, God declares that something is missing: “It is not good for the man to be alone.” A number of scientific studies verify that a ...

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In an article entitled Culture, Illness, and Care, medical anthropologist Arthur Kleinman writes about the important distinction between illness and disease.  He defines diseases as “abnormalities in the structure and function of body organs and systems.”  In other words, disease is what is actually physically wrong with the body.  In contrast, illness is what patients experience when they are sick.  This is profoundly influenced by multiple factors such as a person’s culture, social situation, and the ...

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Unlike some of my classmates in medical school, diseases themselves are not something I often feel a passion to study.  I find philosophy, theology, politics, literature, history, psychology, and so many other subjects much more interesting.  But when I see a person suffering and looking for answers and relief, I am motivated to learn all that I can to help. So while the topic of allergies is not something that really ...

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Henry Markram is one of the world’s leading neuroscientists.  After a brilliant career of influential research, he has been charged with leading Europe’s Human Brain Project, a $1.3 billion project that aims to build a supercomputer model of the brain.  But Markram is also the father of a boy with autism.  And that has changed everything. Maia Szalavitz’s poignant article The Boy Whose Brain Could Unlock Autism chronicles Markram’s personal and scientific ...

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The pediatrician Margaret Mohrmann tells the story of caring for a young girl in the ICU who developed a devastating case of meningitis. One day when she came to check on her patient, the girl’s mother asked Mohrmann why her daughter had become sick. As Mohrmann began to explain what meningitis is and how it is transmitted, it quickly became clear to her she was missing the meaning of ...

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23andMe is a personal genomics and biotechnology company which for $99 conducts a comprehensive analysis of your DNA.  In recent days, the Food and Drug Administration (FDA) instructed 23andMe to halt sales of its main product.  The FDA’s problem with 23andMe does not seem to be the accuracy of their testing methods. The FDA’s concern is apparently that the company has not met all of the complex regulatory requirements demanded by the type ...

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About two weeks ago, my wife looked over at me in disgust as I spit a large volume of saliva into a plastic test tube just before we went to bed.  I had recently received a testing kit from a company called 23andMe, which for $99 conducts a comprehensive analysis of your DNA. I first learned about this kind of thing a few years ago reading Francis Collins’ book, "The Language of ...

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Ever since the days of William Osler, annual physical examinations with one’s doctor have been an accepted and expected part of health care.  But recently the practice has come under some criticism.  Given the dearth of studies showing that physicals lower the risk of death and hospitalization, some experts and organizations state that the annual physical should be abandoned. I appreciate the effort here to question tradition and to consider if ...

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I wonder how my younger son’s autism has affected the kind of dad I am. Playing with any young child can sometimes be taxing work, but one with autism presents unique challenges.  He or she might pay little, if any attention to your efforts to engage, leaving you feeling like you’re giving and receiving nothing in return. Trying to speak to the child can seem like just talking to yourself -- ...

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There is a lot of talk these days about changing our health care system from “pay for volume” to “pay for value.”  The idea is that we currently reimbursement doctors and hospitals according to the number of services delivered rather than how well they make us.  This perverse system of incentives results in runaway health care spending that doesn’t necessarily result in a more healthy citizenry. There is certainly truth in ...

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At the end of medical school, when it was time to choose my specialty, I was torn between psychiatry and internal medicine.  Psychiatry seemed most suited to my interests and aptitudes.  Focusing on the mind and mental illness bridged my interest in the big questions of human existence and the practice of medicine.  On the other hand, it was hard to see how being a psychiatrist would fit with the ...

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I recently attended a meeting in which a public intellectual spoke with boundless enthusiasm about the wonderful future medical technology will inevitably deliver to human beings. His lecture went something like this: “Since the dawn of civilization, we humans have sought to transcend the limits of our condition.   While we’ve long worked at this enterprise of empowerment, the arrival of the scientific method has radically accelerated the pace of change. With ...

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After finishing medical school and my residency in internal medicine, I undertook an additional year of training in a field called palliative care.  Patients who notice my background sometimes ask me what exactly palliative care means.  It’s really a simple concept.  Palliative care is helping people with a serious illness have the best possible quality of life.  It’s enabling sick patients to make the most of the time they have left ...

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My wife recently read me her journal entry from the day our younger son turned two years old.  She had written quizzically that he had still not spoken any words despite a good deal of speech therapy.  For months previous to that birthday, he had also been engaging in repetitive, obsessive behaviors.  He walked circuits around the couch with total concentration, oblivious to the rest of his surroundings.  If you ...

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The recent revelation of the NSA’s top-secret mass surveillance program by Edward Snowden has spotlighted the benefits and burdens of our increasingly digitally connected world.  According to President Obama, monitoring our phone calls, emails, and web activity has helped thwart dozens of terrorist attacks.  But the idea of the government keeping track of what had hitherto seemed private raises the specter of an Orwellian world in which everyone is under ...

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