Lost in a Faithless Age

When doctors don't have all the answers, is there anyplace else to turn?

By LUCETTE LAGNADO

June 20, 2005

THE JOURNAL REPORT: PERSONAL HEALTH

 

Essay

By LUCETTE LAGNADO

Staff Reporter of THE WALL STREET JOURNAL

June 20, 2005; Page R7

"Do you believe in miracles?" I asked a friend of mine one recent Saturday morning. The man, an affable, down-to-earth developer, seemed startled by my question. He eyed me quizzically, both amused and worried. Mostly worried.

Yet, this fanciful, seemingly arcane question has been uppermost in my mind of late, as I've begun to ponder the limits of science and health care. Is there anyplace to turn when those limits are reached? Merely questioning the supremacy of medicine and the scientific establishment is discomfiting, and discussing a return to faith, prayer and even -- yes -- the possibility of a miracle can be almost taboo. Or worse than that, hokey.

Those of us who were raised in the West are taught at an early age to revere rigorous scientific thought, and to cast a wary eye on inchoate notions involving mysterious higher forces. The only deity many people revere is their specialist, while hospitals have replaced churches as houses of worship.

Modern medical centers and laboratories even look like churches, or rather, cathedrals, with their outsized architecture, the small fortunes they cost to build, and the awe they trigger. No matter the mistakes they can make, the dismal cure rates for some diseases, the hype around drugs and treatments that can turn out to be painful and pricey and ineffective.

No matter the heartbreak so many of us have felt at these "leading" institutions, and in the hands of "top" doctors when they had no more answers to offer us or our loved ones. It can be so jarring when the men and women we're programmed to see as superhuman turn out to be only too human, and they can't offer any more solutions. There are no more clinical trials for the tumor. There is no relief for the chronic pain. What then? That was the question I was seeking to answer: What then?

* * *

As a little girl in Cairo, Egypt, where I was born and spent my early childhood, I had a very different belief system -- one where prayer and faith played as important a role as doctors and institutions. There was no conflict, real or imagined, between science and religion, between seeking concrete treatments and praying for supernatural intervention. The two ideally worked hand in hand. People there who were sick were as likely to visit a shrine as a hospital, where they would seek the counsel of a rabbi, priest or imam, as earnestly as they consulted a physician.

My father taught me to respect doctors, and to look up to them. He always addressed them deferentially, and I took my cue from him. Yet I also understood -- perhaps better than my American friends would, years later -- that physicians were limited, possibly flawed, and that the tools at their disposal didn't always work.

I learned, in short, that I couldn't depend on them for all the answers.

Now, to be sure, a physician in 2005 New York may have a lot more to work with than his Cairene counterpart did some four decades ago -- or even now for that matter -- but a fundamental truth remains: The technology and medicines are still imperfect even here in the West, where we boast about our "advanced" facilities and our "miracle" drugs.

What I learned from the start was to put my faith in a higher power as well as in medicine -- to believe that somewhere in the intersection of God and modern science, relief could come. When I became ill as a 6-year-old in Egypt, my parents hedged their bets. They instantly sought out medical solutions. I was dragged to countless doctors and specialists. Most seemed stumped, unable to advise what to do. That is when my mom and dad started taking me on pilgrimages to an equally dizzying number of synagogues and shrines, hoping that our prayers at these holy places would produce a miracle -- the miracle the doctors couldn't deliver.

The last stop was to an ancient shrine where, legend had it, I had to fall asleep so that Maimonides, the esteemed 12th-century rabbi and doctor, would visit me in a dream and heal me. I did, in fact, get better -- and to this day, I am not sure if it was because of my trips to specialists, or my stop at the shrine, or neither, or both.

* * *

Thoughts of my Cairo childhood, its mystical and religious overlays, returned to haunt me recently as I've worked on a memoir of my father. He was a man who, for much of his life, was hopelessly dependent on the medical establishment for his survival -- first the hospitals and doctors of Egypt, after he suffered a bad fall and needed surgeries and months of hospitalizations to repair his injured leg and hip, and later the clinics and hospitals of America, where we settled. Though he always seemed to be in need of doctors to relieve the pain that never went away, he also had a deep instinctual distrust of them.

As I probed my father's life, I found myself increasingly drawn to his world -- the world that I had abandoned -- of "old" Cairo, with its profound sense of faith, its belief in miracles. And the more I was drawn, the more in conflict I've felt with my own adopted world, which casts a cold eye on such supposedly primitive, unscientific methods and beliefs.

Miracles, my friends ask?

My American sister-in-law doesn't even seem to take the question seriously. "Placebos," she declared, when I asked her about believing in the unseen and explaining the unexplainable. In her mind, faith and the belief in miracles to cure illness were nothing more than sugar pills.

The American medical system too often fails too many, she said, but that needn't dictate a return to primitive, unscientific beliefs.

I wished that my father were here to answer her. I imagined him waving the little red prayer book that never left his side, and telling her that religions that sustained so many for so long couldn't be dissected and dismissed in such a peremptory fashion. Because what my dad trusted to an unwavering degree, more than the legions of doctors he consulted and the endless medical facilities where he was a patient, were his prayers.

I never saw him without his tattered red prayer book in hand. Even when he was desperately ill, a thin, lonely figure lost in a sea of beds in a New York hospital, where he was shuffled from room to room, from ward to ward. Or even when he was seated in his wheelchair at the end of the hall, forgotten, in his hopelessly cold nursing home. He found comfort and safety in his little red book, and the chants and incantations they contained that he muttered to himself again and again.

He prayed even when the deck was stacked against him, he prayed when doctors had given up and his own family wasn't able to do much and I felt completely helpless. I think he never stopped hoping for that heavenly miracle, especially when earthly solutions seemed to have disappeared.

It is not that he refused care, or turned away doctors. He had no choice but to depend on them all the time -- because of the fractures that had never healed, and the symptoms of Parkinson's that made his hands tremble, and a heart condition, and, ultimately, some signs of Alzheimer's, though I always felt that heartbreak and disillusionment with the new world after Cairo were as much to blame for his confusion and memory loss as any clinical diagnosis.

Until he could no longer do so, until he was literally unconscious, he prayed, and waited for the divine intervention that would rescue him from his situation.

* * *

I was raised mostly here in America, and the lessons I learned my first six years as I sat next to my dad at a Cairo synagogue, or traveled with my mom to a distant shrine, began to fade. Instead, as I grew up and assimilated into my new world, as all immigrants must, I abandoned much of the magical belief system that had been such an all-embracing part of my childhood.

I stopped believing in miracles and enchantments. It was all a world I'd left behind, and if I spoke about it, it was in an amused, superior tone, designed to entertain my American friends.

I continued to pray, of course, but I did it less fervently, and more by rote.

I continued to believe in a higher power, in God, but perhaps with less feeling, less passion.

Working as a reporter, I began to cover the American health system, and became immersed in its wonders and enchantments. I believed in "miracle drugs" and was sure of their limitless possibilities. My desk was papered with press releases announcing new technologies, new therapies, new approaches to old treatments.

The illusion was of constant motion and progress.

Now there was magic we could all believe in -- the grand, kaleidoscopic world of major drug companies, and major medical centers.

Everything made it easy to believe in the new religion of modern medicine. Even when these drugs didn't live up to their promise, there were rarely major announcements, and when patients fared poorly, institutions didn't trumpet the setbacks. And of course, it was so much easier to view the dazzling hospital buildings being built, the laboratories sprouting up, the research institutions acquiring more and more real estate, from the safe vantage point of an observer, rather than a patient -- or a patient's daughter.

Gradually, though, I began to wonder whether I was worshiping too blindly. I tried to force myself to look at a situation through a patient's eyes -- and, eventually, through my father's eyes. The hospital room that seems so modern and efficient to a reporter walking around with a public-relations specialist can be awfully cold and scary to the person forced to spend a night in it. The doctor who is so articulate and knowledgeable in his laboratory can be intimidating and dismissive when dealing with an ailing person who doesn't understand medical jargon.

I'd heard too many stories of doctors who look to patients as guinea pigs to try promising treatments, and when the treatments fail, they move on to another patient, another guinea pig. Suddenly I found myself remembering my dead 12th-century mystic and physician at the Cairo shrine, and how kind he was supposed to be, even in a dream.

* * *

When I returned to Egypt in April for my first visit since I'd left as a child, I had no desire to explore the Pyramids or the Sphinx. What I wanted to see were the shrines -- the holy sites I had been taken to as a little girl in the throes of my own medical crisis. I wanted to immerse myself in this world that I had left behind, and that had been so profoundly meaningful to my parents, and that had become progressively lost to me.

It seemed desperately important to seek out societies that held out different kinds of hopes, that weren't beholden to technology, yet also weren't rebelling against it.

They were all there, my shrines and synagogues -- older, more frayed, far more damaged than I'd remembered them, or half-remembered them.

I decided to say prayers in each one of them. Oddly, I found myself thinking not of that time I was a child and ailing in Egypt, but when I was a teenager and sick in America.

The symptoms were worrisome, and though we were in New York, there didn't seem many options for an immigrant family without money or contacts or knowledge of the medical system.

I felt as dizzy and scared as the 6-year-old I'd once been. And there weren't even shrines in New York I could turn to for comfort.

Hand in hand with my parents, I began making the rounds -- to this doctor and that, this specialist and that one, from one hospital to another. Whoever would see me, I saw. We finally found the ideal doctor -- someone willing to care for me, even ready to promise that I would be well again.

Burton Lee was a doctor at the world-renowned Memorial Sloan-Kettering Cancer Center in New York, and though he was fanciful, he wasn't the least bit mystical in his approach. He was cool and crisp and scientific in setting out the course of my treatment. But he also managed an amazing feat: He was reassuring and utterly humane, even as he spouted science with a voice of learning and precision. He vowed to me that I would be well again.

One morning, some weeks later, I woke up to a knock on the door. It was my father, and he had brought home a guest -- an elderly rabbi with a severe hunchback, who walked with a cane. The rabbi approached me, put his hand on my head, and began to chant prayers -- Hebrew prayers, Arabic prayers.

I couldn't understand a word. I sat silently through the incantations and closed my eyes. When he was through, the holy man vowed that I would be well again. I noticed that my father was smiling for the first time since the onset of my illness.

To this day I am not sure what worked: Dr. Lee, my American doctor, and his meticulous ministering, or the heartfelt chants of the aged Levantine rabbi.

I can hear my father chuckling: Of course a miracle had taken place, he would say, but he'd remind me that miracles can come in a thousand shapes and forms. They don't have to be Cecil B. DeMille-style partings of the Red Sea. In my case the miracle could well have been finding my American physician.

Ms. Lagnado, a senior special writer in The Wall Street Journal's New York bureau, is working on a memoir of her father for Ecco/HarperCollins.

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