816 North

October 15, 2013

Faith is just what the doctor ordered

From discussing their faith with patients to praying at a dying patient’s bedside, these religious doctors see an interconnectedness between their faith and their work as healers.

By the time Steven Larimore met neurosurgeon William Rosenberg this summer, the 31-year-old cancer patient was in dire need of intervention — from the field of medicine, certainly, but help of a divine nature was fine too.

A year before, Larimore had gone to the emergency room with what he thought was a broken left leg. Within hours, he was diagnosed with cancer: It was in his lungs. The cancer treatment meant that repairing Larimore’s broken leg had to be delayed, leaving him in constant pain.

As it became unbearable, Larimore’s oncologist recommended he see Rosenberg, founder and director of the Center for the Relief of Pain, a service of the Midwest Neuroscience Institute at Research Medical Center.

In Rosenberg, Larrimore found more than a physician offering relief to his pain. He found a fellow man of faith: Rosenberg an Orthodox Jew who observes his religion prominently in his daily life as he practices medicine.

His office is filled with colorful Judaic and medical-themed art. He wears a yarmulke, a small skullcap worn out of reverence for God and an indication of Jewish identity. He freely talks faith with patients who seek such solace. And he’ll pray with patients if asked.

“You could tell he was a very religious man because he wore a yarmulke and by the way he talked,” Larimore said. “I’m a very religious man — I’m a Lutheran — and it really puts me at ease that I have doctors that believe in a higher power.”

During the meeting, Rosenberg laid out two options for Larimore: a pain pump or a special procedure called a percutaneous C1/2 cordotomy, a procedure that goes into the spinal canal and interrupts the pain fibers in the area causing problems. Larimore was comforted by how Rosenberg explained the delicate procedure.

“He said God made the human body so that pain receptors all run on different pathways,” said Larimore, “and it put me at ease that he believes there’s a higher power involved. … Knowing he believed God made us the way he did for a reason was helpful.”

Larimore underwent the procedure a few weeks ago.

“I’m in zero pain … and now I can focus on my cancer treatment and not be in pain,” Larimore said. “I truly feel that someone is looking out for me.”

“He who saves a single life is as if he saved the entire world.”

— Talmud, Tractate Sanhedrin, Chapter 4, Verse 5

Whether it’s doing delicate brain surgery or praying at his synagogue, Rosenberg uses this quote from the Jewish Talmud as a guiding principle for his life.

“I feel like we’re doing the Lord’s work,” said Rosenberg. “I feel like it’s a mission …but I do always have in the front of my mind that I’m not there by myself, and I frequently thank God for the favors he grants me, especially during surgery.

“As they say, there are no atheists in foxholes,” said Rosenberg with a tone of humor in his voice, “or difficult cases.”

The collision of medicine and religion is the stuff of headlines: a doctor who chooses not to perform a particular surgical procedure because of his or her religious beliefs. Or a physician who refrains from using a new experimental technique because it challenges his or her faith’s position on its use to prolong life.

But more often than not, physicians seamlessly bridge the worlds of science and religion, often quietly, sometimes overtly as they live their faith in their approach to medicine.

Rosenberg, with his yarmulke and religiously adorned office, is open in his faith. Hindu Samiran Patel, a pulmonologist who travels between St. Luke’s North and South, relies on his faith as his critically ill patients confront the end of their lives. Life-long Catholic Maria Gomes, an endocrinologist with Shawnee Mission Medical Center, takes time out of her busy practice to pray in the hospital chapel daily.

From discussing their faith with patients to praying at a dying patient’s bedside, these religious doctors see an interconnectedness between their faith and their work as healers.

The blending of religious faith and the science of medicine is often complementary and helpful, said Tarris Rosell, the Rosemary Flanigan Chair at the Center for Practical Bioethics in Kansas City.

“It helps them deal with all the things they encounter in treating patients,” Rosell said.

However, it is a balancing act.

“One of the dilemmas physicians may face is how to be true to their own faith and not violate professional codes. … At the same time, we need to be respectful of physicians and their personal conscience.”

Rosell said the Center for Practical Bioethics is a resource for doctors trying to grapple with their own personal faith and its intersection with their vocation. About 10 years ago, Rosell started a group with some fellow clergy and physicians to discuss these very issues. Pledging confidentiality, the group gathers monthly at Shawnee Mission Medical Center to discuss case issues and how to balance their personal morals and ethics with the patients they are treating. While those who attend the group have changed over the years, Rosell said their opinion of its value remains consistent.

“It acknowledges spirituality and medicine and that they do intersect and can co-exist,” he said. “What I hear most of the time is that they are fully complementary and help to motivate, guide them and be caring and compassionate.”

In this world of uncertainty one thing is crystal clear — these three physicians find their faith a key element in helping to serve their patients. Their common thread is how their personal religious beliefs and practice complement their chosen profession of helping to heal.

“I love what I do,” Rosenberg said. “Being a doctor makes me a better Jew. I feel better on a basic level that the things I do matter and on a higher plane.”

As a pulmonary critical care physician in the St. Luke’s Health System, Samiran Patel works with critically ill patients and regularly faces life and death situations. His schedule is hectic as he travels between hospitals treating patients dealing with various lung diseases and disorders.

His Hindu faith helps him face these daily challenges and provides a sense of peace.

“That’s when anyone’s faith makes it smoother,” he said. “Anyone’s physical death is sad and painful, but if you dwell on those feelings you can’t do a better job the next time.”

For Patel, originally from Ahmedabad, India, his Hindu faith calls for seeking the real truth, using the mind, senses, our tendencies and ego in understanding the world.

“We have the intelligence and intuition and they are given to us for a purpose, and that purpose is to know the absolute truth and to know God,” Patel said. “We are manifestations of the consciousness of God.”

Patel reads Bhagavad Gita, derived from the original Hindu scriptures “Vedas”

that help guide one’s life. Dharma is a central concept that is described as righteousness, moral law and duty. If dharma is central in one’s life then you are striving to do what is right. Hindus also believe in reincarnation.

Patel moved to the United States in 1998 after finishing medical school in India.

After completing his residency in 2002, Patel worked as a hospitalist in New Jersey. Patel did additional training to go into pulmonary and critical care work. Married with two children, Patel came to the Kansas City area in 2009.

For Patel, his religious beliefs are intertwined with his mission as a physician.

“Practicing medicine is important and working with human beings is the most important,” Patel said. “In my day-to-day practice I am consciously thinking about it. … The body is an amazing machine created by God.”

His medical knowledge impacts his spiritual beliefs, as well.

“The human body is so complex yet designed so precisely that I don’t think we can ever imagine ourselves creating something like that without copying,” Patel said. “The interactions with the patients and their families help me understand the modes of nature (prakriti). After all, we are all on a spiritual path and we all have our own journey.”

Patel prays three times a day and has a small shrine in his Leawood home, ever mindful of his faith. Patel is also a vegetarian, another tradition in his faith. Patel wears a gold chain with an Aum charm on it.

“It’s a reminder to me that I am a creation of the consciousness of God,” he said.

Patel tries to practice the even-mindedness the Hindu faith calls for in daily life.

“It helps me be the peacemaker and interact with people and connect with them,” he said.

That extends to praying for a dying patient. Patel recalled a 30-year-old patient who was suffering with multiple organ failure. Modern medicine — with all its scientific advances — could do nothing more to prolong life.

“We tried and tried, and the body wouldn’t respond,” Patel said. He and another doctor and staff “gathered around the bed and held hands and we asked God, who is the ultimate one, to oversee him,” Patel said.

“It was a divine, amazing moment praying together for this divine eternal soul,” he said.

Patel’s Hindu faith helps guide him in his work as a physician. He shares his beliefs when friends and colleagues ask about it.

“My duty as a physician is to help my patients heal and feel better,” he said. “I have to treat not only the physical body but the mind.

“My faith basically teaches you how to be a good human being without hurting others,” Patel said.

An endocrinologist and single mother of two teenage children, Maria Gomes of Shawnee leads a busy life. Her Catholic faith is something that helps this native of India cope with the frenetic pace.

“When I’m in the hospital, I start my day in the chapel and then do my rounds,” Gomes said. “It gives me a sense of peace.”

Gomes was raised in Goa, India, although she was born in the United States while her father was doing his surgical residency. Gomes is one of seven children who grew up in a region of the country that is heavily Catholic.

“There’s very little other Christianity in India,” Gomes said in explaining her area. “Goa was a Portuguese colony that brought it in. We have churches that have Mass in English, Portuguese, Konkani and some Latin.”

Gomes family was active at church and said the rosary daily.

“I used to be Mother Mary or Mary Magdalene in the Christmas play each year,” she said.

The medical profession runs in Gomes’ family. In addition to her father, Gomes’ uncle is a physician and her mother has a doctorate in zoology. Of the seven children in her family, three are physicians; one is a pharmacist and one a dentist. Her ex-husband also is a doctor.

Originally, Gomes wanted to be an engineer because she liked math and physics.

“My mom directed me to the (medical) route,” she said. “Women didn’t seem to be going into engineering at that time.”

Gomes attended Goa Medical College and came to the United States in 1987 for her internal medicine residency in Wichita, where her aunt and uncle lived. She did her original studies in anesthesia “but I wanted to work with patients.”

Later, Gomes did her fellowship in endocrinology at Washington University. A stay-at-home mom for a number of years with her son and daughter, Gomes moved to the Kansas City area in 2006 and went into private practice. She joined Shawnee Mission in 2011.

Gomes’ strong Catholic upbringing in India has remained with her. She attends her parish church weekly.

She believes God’s hand is involved in everything, both good and bad situations.

“God has a role to play in every action or role we play in life, and I am conscious of this daily,” she said. “I hope that every time I make a decision that it is based on God’s assisting you.”

The endocrinologist will share her personal faith beliefs “if they’re interested … and have similar beliefs,” she said.

“I feel for everyone who is following good choices that it doesn’t matter what faith you follow,” Gomes said.

William Rosenberg grew into his Judaism. He was raised in southern California in a Reform Jewish family.

“I was always a pain to my parents,” said the soft-spoken man. “I always asked if you believe in the Book why aren’t we following it?”

Rosenberg faced a significant loss at the age of 15 when his father died; just a year later he graduated from high school.

Always musical as a child, Rosenberg spent his youth playing a variety of instruments and singing; he also was a ballroom and folk dancer. He almost went to Bulgaria to become a member of a professional folk-dancing troupe.

Instead, during college Rosenberg went to Israel and spent his sophomore year at Tel Aviv University. He returned to the states to finish his undergraduate work and then went to med school. It was during those years in Boston that he met his wife through an Israeli folk dance group and decided to become more observant in his Jewish practice.

“It was 20 to 30 years of gradual transition,” said Rosenberg.

The Harvard medical school grad came to the Kansas City area 11 years ago with his wife and two daughters.

While the Orthodox Jewish community is a small percentage of the 20,000 Jewish people in the metro area, Rosenberg calls it home. He lives in Kansas City’s eruv, located in central Overland Park. It is a special area designated to allow certain activities to take place during the Jewish Sabbath. Rosenberg keeps strict kosher and does not generally eat meals outside of his home. He wears his yarmulke to work daily.

“I felt it made a visible representation of Judaism, a constant reminder that there’s something higher than me,” Rosenberg said. “I have had people who are curious about it. It makes them feel good. …I’ve even had a few people call me “Father,’” he said with a chuckle.

His Research Medical Center office is filled with colorful Judaic and medical-themed art, including Maimonides’ Prayer for Physicians. Maimonides was a Jewish philosopher and physician who is considered the leading intellectual figure of medieval Judaism.

“In Thine Eternal Providence Thou hast chosen me to watch over the life and health of Thy creatures,” the prayer states. “I am now about to apply myself to the duties of my profession. Support me, Almighty God, in these great labors that they may benefit mankind, for without Thy help not even the least thing will succeed.”

Rosenberg is mindful of those words.

“It’s good to be reminded that there’s something higher than me,” Rosenberg said. “In medicine, there’s a lot that doesn’t work. If medicine isn’t an ego check, it should be.”

Being a man of faith makes him a better doctor, Rosenberg said.

“The fundamental respect for all living beings is a fundamental tenet of Judaism,” he said. “What greater thing can one do than help another human being?”

If he has to attend a meeting or event where food is served that is not kosher, “I’ll just do cold sushi,” Rosenberg said.

While commanded to not work on the Sabbath (for Jews, that’s Friday at sundown until Saturday at sundown) or drive a car or answer a phone or pager, Rosenberg has done so — and without guilt.

“If it has to do with someone’s health and well-being, I’m obligated to care for them,” he said. “It’s my duty. There’s no compromise.

“I’ve even asked my rabbi once if I should wear my kipah (yarmulke) to the hospital and he said, ‘Absolutely,’ because I’m doing what I should be doing.”

Rosenberg has even come to the aid of his patients during Jewish High Holidays.

“It was Yom Kippur once and I spent the day operating on a patient,” Rosenberg said.

Yom Kippur, the Day of Atonement, is considered the holiest Jewish holiday with Jews spending the day fasting and in prayer at synagogue.

“I did ask the rabbi about fasting and he advised me to get sustenance to be able to operate and not to endanger the patient,” he said.

The doctor tries to daven — pray — daily and attends Sabbath services on a regular basis. He studies the Torah (a scroll that contains the first five books of the Old Testament), which he believes provides the blueprint for how people should conduct their lives.

“I use it as a litmus test for what I should and shouldn’t be and do,” Rosenberg said. “It’s what guides life.”

From time to time, patients will ask Rosenberg to join them in prayer before a procedure.

“It may not be my specific prayer, but it’s aimed at the same place,” Rosenberg said. “I stand with them. … They’re the ones in the needy situation.”

About four years ago, Rosenberg went through a personal “reinvention,” as he calls it, changing his medical focus to the treatment of pain with a patient-centered focus. He was particularly interested in helping cancer patients.

Rosenberg embraced his religious background as part of his latest endeavor as medical director of the Center for the Relief of Pain, a service of the Midwest Neuroscience Institute at Research. The mission of the center is managing complex pain and improving patients’ quality of life. The center has a staff of five; all are active in their different faith communities, he said.

“I view treating pain as a calling. … We open the tool box and see what we can do,” Rosenberg said. “We look at the pros and cons and you, the patient, decide. … We believe in being aggressive.”

Ever present is his view of patients, a perspective he credits to his Jewish beliefs.

“I meet my patients on a level as one of a brother or sister and helping them like family,” he said.

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