Tuesday, March 9, 2010

A Spiritual History

Be wise in the way you act toward outsiders; make the most of every opportunity. Let your conversation be always full of grace, seasoned with salt, so that you may know how to answer everyone. Col 4:5,6.

He hobbled into the examining room on a cane, covered by a complex mixture of old clothes protecting him from the winter cold. I was seeing him for the first time and my initial impression was that he was polite, uneducated and very poor. My questions took us through his present and past history, bringing a description of his illness gradually into focus. He spoke more intelligently than I had expected from my first impression, but his speech was slightly slurred from an old stroke. I moved through his social history: lives alone, divorced, unemployed---consistent with my first impression. When I asked him about his religious faith, he replied that he was a Baptist Christian. Then he added, “I have a Masters of Divinity degree from New Orleans Baptist Seminary. For awhile I served for the Home Mission Board as a church planter in Philadelphia.” My understanding of this man and how I would work with him through his illness was changed.

I am frequently surprised when I ask my patients about their faith history. Many folks whom I suspect to be stalwart church goers have no religious faith at all. Others who seem unlikely to be interested in faith matters are sacrificial servants of our Lord. Such knowledge changes the way I understand their journey through their illness; it changes the way I can speak to them about their fears and needs; it changes the manner in which I seek to share my own faith stories with them.

I understand the importance of a spiritual history, and yet, I still hesitate when it comes to asking the questions---like I’m a stranger invading the patient’s personal space. Pity me if I let my insecurity prevent me from gaining a better understanding of my patient’s support system and a better picture of my place in God’s plan for his/her life.

There are many methods published in peer reviewed literature for taking a good spiritual history. I would recommend, and I personally use, a revision of the method described by Dr. Gene Rudd in his chapter, Testimony, in Practice by the Book, available through CMDA

Is faith in God important to you?
How are you involved in your faith community?
Is there anything we need to know about your beliefs that might affect your healthcare

Sometimes we never get past the first question; but I always learn, and am often surprised that my perception of a patient’s faith may be totally wrong. Not asking the questions would lead me toward less than adequate patient care and less than adequate cooperation with God’s Spirit as He wishes to work in my patient’s life.

Dear God,
Help me to be consistent in asking my patients about their faith. Sometimes it doesn’t seem necessary for their physical care plan, but let me not forget that it is always important for my work with You in their spiritual care plan. Amen

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