Nuance: Being Faithful in the Public Square

What happens when an industry built on burnout, staff shortages, and broken systems begins to lose its very soul? In the modern medical economy, clinics and hospitals have become fast-paced hubs of technical performance, where the deeper meaning of care is easily lost in the shuffle.

Healthcare professionals are suddenly being asked to carry overwhelming physical and emotional workloads, leading many to feel exhausted or disenfranchised. The question is no longer whether our medical systems can cure physical ailments, but what kind of spiritual blindness is being formed in the process.

In this episode of Nuance, host Case Thorp welcomes gastroenterologist, professor, and author Dr. Mark Topazian to explore vocation, perception, and spiritual reality in healthcare. Dr. Topazian pulls back the curtain on the rapid commercialization of medicine and shares how learning to see differently can restore purpose to an already overwhelming job without adding a single thing to a clinician's to-do list. From serving in international missions to taking practical spiritual histories at the bedside, Dr. Topazian explains how to recognize God’s kingdom active in our clinics and hospitals.

Through their discussion, Dr. Topazian helps listeners see how a mature, Christian worldview can withstand the intense pressures of a modern healthcare culture.

🔑 Key Topics Covered in This Episode:

🏥 The Spiritual Blindness in Healthcare: Confronting the idea that clinics and hospitals are spiritually neutral or merely cold, empirical spaces, and establishing why all true healing ultimately points to the kingdom of God.

📜 The Christian History of the Hospital: A look back at how the Christian tradition and a biblical view of human dignity directly birthed the modern hospital system, transforming how society cares for the sick and disabled.

🩺 Burnout vs. Missing Meaning: Redefining clinical burnout not merely as a crisis of workload or long hours, but as a crisis of meaning that can be recovered through attentiveness and true seeing.

📋 The FICA & LORD Frameworks: Practical, non-coercive tools for healthcare workers to take spiritual histories, helping clinicians put on "3D glasses" to care for patients as body, soul, and spirit.

🌍 Global Medicine & Training: A look inside Dr. Topazian's current work in Addis Ababa, Ethiopia, exploring the unique challenges and rewards of training the next generation of specialized physicians in Sub-Saharan Africa.

📚 Episode Resources:

Healing Purpose: Finding Satisfaction in a Healthcare Career by Dr. Mark Topazian - www.ivpress.com/healing-purpose

InterVarsity Press - www.ivpress.com

#podcast #podcastclips #faith #vocation #publicsquare #theology #listen #nuance #listenable #christianpodcast #christianliving #faithandwork 

Nuance is a podcast of The Collaborative where we wrestle together about living our Christian faith in the public square. Nuance invites Christians to pursue the cultural and economic renewal by living out faith through work every facet of public life, including work, political engagement, the arts, philanthropy, and more. 

Each episode, Dr. Case Thorp hosts conversations with Christian thinkers and leaders at the forefront of some of today's most pressing issues around living a public faith.

Visit wecolabor.com for resources, events, and more.

Timestamps
0:00 Spiritual Blindness in Healthcare
1:02 Introducing Dr. Mark Topazian
1:16 Moving to Ethiopia & Training Gastroenterologists
2:51 Introducing "Healing Purpose" & The Crisis of Meaning
3:57 The Realities of Compassion Fatigue & Burnout
6:45 Hospitals are Outposts of God's Kingdom
7:43 The Christian Roots of the Modern Hospital
9:00 Processing Medical Grief: A Gotham Fellowship Story
10:47 Unifying the Scientific and Scriptural Narratives
12:26 The Biblical Concept of Shalom (Holistic Health)
14:11 Putting on "3D Glasses" for Patient Care
15:01 The FICA Framework for Spiritual Histories
16:14 The Science of Faith and Health Outcomes
19:12 Exploring Spiritual Curiosity with the "Nones"
23:41 The LORD Framework & Religious Struggle
27:18 Practicing Good Medicine While Integrating Faith
28:51 Micro-Habits for Busy Clinicians (Lock Screens & Laments)
32:41 The Reality of God in the Operating Room
33:46 Advice for Early-Career Medical Professionals
35:05 The Saline Process Workshop
37:07 Final Encouragement, Episode Resources & Outro

What is Nuance: Being Faithful in the Public Square?

Nuance is a podcast of The Collaborative helping Christians to faithfully live out their faith in their work. We recognize most of life is not lived in black and white but rather lived in the gray, lived in the nuance.

You can find more, including complementary spiritual exercises, at www.collaborativeorlando.com/nuance.

Speaker 1:

There's huge spiritual realities in any health care setting. And I think that it's we can come to think really of our clinics and hospitals and emergency rooms as outposts of God's kingdom because, in fact, all healing is attributable to God.

Speaker 2:

What if the problem in healthcare is not only burnout, staff shortages, or broken systems, but a blindness, a spiritual blindness? What if meaning has not disappeared from clinics and hospitals, but has simply gone unseen? Well, today, we're exploring vocation, perception, and spiritual reality in health care, why so many clinicians may feel exhausted or disenchanted, and how learning to see differently might restore purpose without adding one more thing on a to do list for an already overwhelming job. Well, friends, welcome to Nuance, where we seek to be faithful in the public square. I'm Case Thorpe, and I'm grateful today to be joined by gastroenterologist, professor, and author, doctor Mark Topazian.

Speaker 2:

Mark, welcome.

Speaker 1:

Thank you. It's an honor to be with you today, Case.

Speaker 2:

Well, and you told me just a moment ago, you're coming to us from Addis Ababa, Ethiopia. How unique. What what brings you to Ethiopia?

Speaker 1:

Well, my wife and I, now over six years ago, just felt the nudge, felt God sort of prompting us to make a change. And we had a background in Ethiopia in Africa. We had lived here in Liberia during our first year of marriage and done a lot of short term work over the years here in Sub Saharan Africa with medical education and research. So it wasn't a completely out of the blue thing. But definitely the Lord prompted us to make a change.

Speaker 1:

And it took us a took us a few years to figure out the where and the how and all of that. But ultimately, we joined SIM USA, which is a nondenominational mission organization, and here we are. My wife teaches in an international Christian school here.

Speaker 2:

Okay.

Speaker 1:

And I teach in two big public hospitals, the only places in this country of a 120,000,000 people where gastroenterologists are trained, you know, that specific specialty. Yeah.

Speaker 2:

And you you how many years did you serve in The States?

Speaker 1:

Well, gee, I worked as a doctor in The US for probably thirty years or so.

Speaker 2:

Okay. Okay.

Speaker 1:

First, after finishing my training, after we lived in Liberia for a year, I taught and practiced and tried to push the boundaries in my field. Yeah. First at Yale, then at Mayo Clinic.

Speaker 2:

K. Well, friends, more about doctor Topazian. He's the author of a new book published by InterVarsity Press entitled Healing Purpose, Finding Satisfaction in a Healthcare Career. Fantastic book and I encourage you to pick it up. A link to the book will be in our show notes.

Speaker 2:

His book explores how healthcare professionals can find deep satisfaction in their work, not by escaping medicine, but by learning to perceive the spiritual realities already present in clinics and hospitals. Marx's work sits at the intersection of theology and formation and lived experience within the modern world of health care. He argues that burnout is often not a crisis of workload, but a crisis of meaning. Meaning that is recovered through attentiveness, presence, and truthful seeing. So let me encourage you, please, like, share, leave a comment.

Speaker 2:

It helps us to spread the word on our work. Maybe there's a doctor or a friend of yours in the medical world that would benefit from this conversation. So, Mark, about your book. It seems to rest on two common instincts. On the one hand, it doesn't romanticize health care, but you also fight against, you refuse the idea that hospitals are spiritually neutral or just clinical kind of spaces.

Speaker 2:

So talk to us more about those two foundational perspectives and and then how those insights led you to write this book.

Speaker 1:

Yeah. Well, I've been at it too long to romanticize health care, which I think was your first point. Because I'm well aware of the realities of working in health care. Yeah. And I know the demands that health care professionals face.

Speaker 1:

And not but not only doctors, but nurses, technologists, therapists, dentists, anyone interacting with patients in health care. The demands are huge. And the potential for burnout and compassion fatigue, as you already mentioned, are huge. When I started in health care, nothing made me happier than making sick people better, and I think that's true for most of us in health care. Mhmm.

Speaker 1:

But interestingly, over time, I think for most of us, that is not enough. And that there's various reasons for that that we could talk about. But over time, the significance of that fades. And there's times when, you know, clinical success becomes an expectation, becomes a routine, becomes a draining demand. So Mhmm.

Speaker 1:

Ultimately, I think that getting our professional satisfaction from making people better it's a great thing to make people better, by the way. It's what I Yeah. Loved. I still love doing it. But if it's the basis for why I do what I do, it's unstable.

Speaker 1:

So I would also I would say that for me personally, as a health care worker, in the long term, as you already said, perceiving the spiritual realities of what's going on around me every day Mhmm. Has become a huge component of satisfaction in a career. So I don't think that clinics and hospitals are spiritually neutral. Mhmm. I forget the word you used.

Speaker 1:

Was that it? Or or spiritually empty?

Speaker 2:

Well, you don't romanticize, but you don't romanticize, but likewise, you don't accept that they're just cold clinics with a merely empirical perspective.

Speaker 1:

Well, it's easy to see them that way. Mhmm. Both for the health care worker, who's often focused on technical performance and on the patient. Yeah. But in fact, there's huge spiritual realities in any health care setting.

Speaker 1:

Mhmm. And I think that it's we can come to think really of our clinics and hospitals and emergency rooms as outposts of God's kingdom. Yeah. Because, in fact, all healing is attributable to God. Mhmm.

Speaker 1:

Even if it as it commonly is is through medical technology, it's and knowledge, it's attributable to God. So anyone who is sick and experiences healing is having a close encounter with the kingdom of God. They may be oblivious to that. Their health care provider may be oblivious to that. It's still a reality.

Speaker 1:

And when we as health care workers tune into that, it's it's gives us resources to cope with the stress of our work Mhmm. Especially when things don't go as planned or when there's just way too much work for one person. Mhmm. And it also positions us for longevity. It helps sustain us, and it it even makes us better at our jobs.

Speaker 2:

And and aren't I correct? I mean, the Christian tradition is largely responsible for the institution of a a hospital for hospitality. And I understand in other cultures where humans are not seen as carrying the image of God, they can be more easily thrown away or their suffering ignored. And it was the Christian tradition that said, no. No.

Speaker 2:

We need to lean into this suffering and and seek to remedy it.

Speaker 1:

Yeah. I think you're right, Casey. I'm not a historian. But what I read what what I do read about this, yes, in the Roman Empire. Right?

Speaker 1:

This was hospitals and rudimentary, right, at that time Mhmm. Were largely the creation of Christians. And it's because, as you said, of the view of of a sick person, a disabled person is still has huge value. And and there's plenty of reason to hope and to care in that situation. And I would also say that those early Christians had experienced freedom from slavery to the fear of death.

Speaker 1:

And so sickness and death was not something to be instinctively not something instinctively repulsive.

Speaker 2:

Mhmm. Mhmm. We have a program called the Gotham Fellowship, and it is a it is a seminar for Christ centered professionals to do a deep dive on the gospel and how it applies to one's profession. And before our broadcast, we had talked about Tim Keller and the influence of Redeemer. This is actually one of their programs that we license.

Speaker 2:

Probably had over 90 Gotham fellows now here in Orlando. One of our fellows was a retired pastor who had served at the Lynn Moores Children's Hospital as a chaplain. And there's a major project to finish in the spring of Gotham fellowship, and you you're to look at some struggle areas in your industry and and bring the answers of the gospel to it. He noticed that he, as a hospital chaplain, provided so much care and service to the children who were sick but also to their families. But he realized the medical care professionals, the medical professionals were often left with with no attention or way to process their grief, and it's these nurses and doctors at times that have walked with these patients for years.

Speaker 2:

And it's quite stressful. And so his he created a program to help lean into the medical professionals and it was picked up by Nemours and used in other places. You would resonate with that stress in the medical world.

Speaker 1:

Well, yeah. And I resonate with Gotham and I had mentioned this to you, but my daughter did Gotham.

Speaker 2:

Oh my goodness.

Speaker 1:

Not in your place, but in New York. Fantastic. Yeah. So I've heard a lot of good things about it.

Speaker 2:

Oh, that's And

Speaker 1:

that's a beautiful story you just told of how appreciating a spiritual reality leads to healing and improvement in a professional medical setting. Mhmm. And in my book, well, I guess what I would say is I'm examining one case, health care, of the larger theorem that faith is good for people. It's also good for society Yeah. And for institutions.

Speaker 1:

Yeah. Even where there's no consensus about faith. And I think that people are increasingly thinking this way, and I'm trying to take a detailed look at that in health care, especially how how does that work? How do we make that work for ourselves as health care workers? Mhmm.

Speaker 1:

But but I think that that's it's just one case of a much larger truth.

Speaker 2:

Mhmm. Mhmm. AdventHealth is one of the larger hospital systems here in Florida and in a number of other states, understand. And it's run by the Seventh day Adventists. And they pull no punches in terms of how they have scripture all over their hallways.

Speaker 2:

They have their art's a little interesting, not necessarily my style, but great paintings from scripture. And I really appreciate that as a Christian. And the p in fact, I was at one this morning visiting a woman and patients are often surprised to see such a explicit spiritual approach to medicine. Why do you think hospital systems or medical professionals lean away and and don't readily bring faith in?

Speaker 1:

Well, of course, some have no faith. But actually, I I think surveys show us that most Americans do believe in God Mhmm. And then by some name or other. Mhmm. And that that's true also of most health care professionals.

Speaker 1:

I mean, we have data about that. I think that for evangelicals like myself Mhmm. It's easy to to think that, well, I'm working in a secular health care setting where there is no consensus about faith. And my patient is here not because they're seeking to be converted. They're here because they've got a health problem they want me to help fix.

Speaker 2:

Right.

Speaker 1:

That's why they're here. And so on the one hand, I could try and evangelize my patient, but that's against the ethos of my employer. It's not what my patient wants. So then really, there's nothing going on spiritually here. And the best I can do the only way my faith impacts my work is that I will be an ethical person because, at least in the sense that the the Christian ethic is broadly accepted in health care.

Speaker 1:

Right? I mean, it's it's not a it's it's a secular thing, really, many of the aspects of Christian ethic. I mean, some not. I mean, we could go a long way with that. But in terms of putting my patients' needs first, being honest, following through, all those aspects.

Speaker 1:

But but so I think there's this tendency to either think, well, since I I'm not here to evangelize, and I was taught in an evangelism seminar how to interact with Christians in in an evangelistic way, that's not appropriate where I work. Therefore, my work has no real spiritual element. And the fact of the matter is there's this great middle ground in between those two extremes, but I think a lot of us in health care are unaware of that middle ground.

Speaker 2:

Unaware because, like you say, some are not believers at all. Are there ways in which health care professionals can can naturally come to this awareness if not brought there by a Christian friend? Do you see God working in different

Speaker 1:

There's something spiritual going on at my workplace. Mhmm. Mhmm. Yeah. So, yeah, there are practical ways to do that, but I would back up a step and just before getting to practical ways to do that Mhmm.

Speaker 1:

Give it some underlying integrity. And so I would say that as health care professionals, when we go to school in health care, we learn a whole bunch of facts and principles about health and sickness and healing. And those are scientific facts, and they're very powerful. They're the basis for our competence. And those facts and principles together form a narrative.

Speaker 1:

You know, we learn we really learn are learning a story or a narrative about health, sickness, and healing. Mhmm. And so when we go to work, it's all about that scientific narrative. In fact, scripture also gives us a narrative about health, sickness, and healing. Mhmm.

Speaker 1:

And it's also a very powerful narrative, and it actually doesn't is not in conflict with the scientific narrative. So if we can put those two narratives together and if we can live in that unified story while we're at work, it's not that we're in any way discarding the science. Absolutely not. It's a great thing. It's a gift from God.

Speaker 1:

But but if we can live in that unified narrative of the scientific understanding and the scriptural reality, understanding of reality, then a lot of the little practical steps, the micro habits, they kinda come naturally. So again, in in the book, I'm trying to go through various issues and cases in health care and say, okay. How do those two narratives fit together? And then how does that help you at work connect to what's going on?

Speaker 2:

Tell us more about that biblical narrative of healing.

Speaker 1:

Yeah. So health let's even back up and say, what is a person? So a person is body, soul, and spirit. And we could have a long chat about those terms, I suppose. But Yeah.

Speaker 1:

If we say that that's the case, that we are a body but also a soul and also a spirit, knit sort of inextricably together into one thing, then health is definitely has to do with bodily function, but also with soul and spirit. Mhmm. So if you look at the Bible, the words that are used to describe health, probably the best known and most important of those words, at least in Hebrew, is shalom, which is a word that has a very broad meaning about health. Certainly physical health, but also just well-being. Mhmm.

Speaker 1:

You know? And it encompasses emotional aspects of health, relational aspects of health, resource aspects of health, social aspects of health, spiritual aspects of health. So the whole biblical concept of what a person is and a very broad concept of health underlies the Christian approach to illness and healing. And, you know, it's a biblical concept, shalom, but it's also a very modern concept. There's survey data from The US showing that if you just survey ordinary people in The US and you ask them what is health, over 90% will tell you it's so much more than just not being sick.

Speaker 1:

And they will tell you it's things like being able to work, having friends, having relationships, being happy. So the aspects that are caught up in Shalom, that's still what most people think health is. Sure. But in but in that same survey, they said, well, what does your doctor ask you about or talk to you about? And it was three things.

Speaker 1:

It was test results, medicines, and exercise. So those things are good and very important to talk about. But there's all these other elements to health. Now in a very busy health care practice, you know, you don't have time to take a deep dive into the entire psychological and spiritual history and experience of every patient.

Speaker 2:

Right.

Speaker 1:

But I would say that we see some we see some patients in health care who are really pretty healthy in the shalom sense, in pretty much all aspects of life, but they've developed a physical problem that is needs it to be fixed. Might be as simple as a strep throat. It might be something as serious and complex as a malignancy or a chronic health condition. But what those people need from me is help with that physical problem.

Speaker 2:

Right.

Speaker 1:

And the rest of life is, you know, it's pretty well healthy. But there's other people where their their condition is sort of the tip of the iceberg, and there are various factors, stress, lifestyle issues, substance issues, relationship issues, psychological, financial issues that are exacerbating or are inflaming the whole situation. And if I'm able to think of my patients as body, soul, and spirit, if I can actually have put on my three d glasses when I'm looking at my patients Mhmm. Then I'm gonna be able to get an inkling. Wait a minute here.

Speaker 1:

You know, is there more to this picture than meets the eye? And do we need to do a little exploring? And I might not be the one to do all the exploring. I might do I would often do take something called a spiritual history from my patient. That's just sort of a routine for me of a patient intake.

Speaker 1:

But but if there's a serious underlying issue and the waiting room is full of people

Speaker 2:

Right.

Speaker 1:

It's not that I'm gonna become their their psychological counselor or their pastor, but I can tie them into resources, for instance. Or I can do some very simple things that just help them take their next step Mhmm. In their spiritual journey. So

Speaker 2:

Well, you write in your book in chapter three, and I wanted to bring this up, two spiritual history methods. And you have two acronyms here. The first is FICA or FICA, f I c a, and then the other one, LORD, l o r d. And so f is for faith. Is faith or spirituality a part of your life or was it in the past?

Speaker 2:

I, what importance does your faith and belief have in your life? C, are you part of a spiritual or religious community? C for community. And a for

Speaker 1:

well, I don't Addressing care.

Speaker 2:

Addressing care. What role do your beliefs play in your health care decision making? So interesting. I've never come across such a thing.

Speaker 1:

Yeah. So this is broadly accepted in health care as best practice to take a spiritual history from a patient.

Speaker 2:

Okay.

Speaker 1:

This is not something that's Christian, actually. This because if we back up a step, we can say there's very strong scientific evidence that faith matters in health.

Speaker 2:

Do do doctors on the whole agree with that?

Speaker 1:

Well, some many are unaware, but the data is very strong. I mean, it's hard to really argue with it. There's a in terms of an association Mhmm. And you might even say, well, how does a scientist measure faith? And what what scientists have done is to ask people about their religious practices.

Speaker 2:

Okay.

Speaker 1:

And we have large scale epidemiologic studies, which means the study of us think something in a population. We have very large scale studies from multiple cultures and countries around the world showing that people who participate regularly in the life of a spiritual community have, in general, better health outcomes than people who don't. Yeah. So so on the basis of that scientific evidence, not on the basis of any religious teaching, it's considered best practice in health care to learn about your patient's spirituality.

Speaker 2:

Mhmm.

Speaker 1:

So that's where FICA comes from. And in fact, it's considered a cultural competence of a health care provider. And it's not me saying this. This is large secular health care organizations. It's the World Health Organization.

Speaker 1:

It's the American Association of Medical Colleges. Mhmm. It's the Joint Commission which cert which credits hospitals around The United States. They all say we should be taking spiritual history. So FICA is not something and this whole thing is not aimed at conversion.

Speaker 1:

It's aimed at understanding my patient's spiritual situation.

Speaker 2:

Well, once you learn of that situation, do you then write prescriptions for church?

Speaker 1:

Oh, you know, it's gonna depend. So what you do with the info it's really a diagnostic tool, if you will. And the first point is that when you're doing an intake of a patient, you're asking them a whole bunch, a whole series of questions to find about things relevant to their health. And some of them are very personal questions, actually. Sure.

Speaker 1:

But and spirituality is a personal thing to ask about. But you're collecting information. So there's a big step from collecting the information to writing a prescription. That's the first thing to say. So, typically, when I'm taking a spiritual history, if there's a red flag that goes up, I may ask a couple of follow-up questions, but I'm not making any prescription right then.

Speaker 1:

Because then I'm going on to do the rest of my thing with my patient, do a physical exam, look at their past tests, and say, okay. We're dealing with situation x and also with with y and z, and let's make a plan for each of these.

Speaker 2:

Right.

Speaker 1:

And then, you know, I depending on what I've learned from the spiritual history, I might say, and, you know, what about your spirit? How's that doing? And can we can is there anything we can do to get your you know, facing this situation? We need you to be firing on all cylinders. Mhmm.

Speaker 1:

And what about your spirituality? Can that become a resource in this situation? Now where that conversation goes has a lot to do with the interest of the patient case. Yeah. If they're disinterested in spirituality, okay.

Speaker 1:

I mean, but when people are sick, they tend to become interested in spirituality. No. Seriously.

Speaker 2:

That's not

Speaker 1:

the rule.

Speaker 2:

It's true. Life becomes very real.

Speaker 1:

So when you say write a prescription, if it's in the sense of coercion, no, absolutely not at all. Mhmm. Mhmm. That's not my my role. If it's is it what can we do to sort of bring enhance the spiritual resources in your life and get spirituality to be part of part of our solution here, something we can use to help you get where you wanna go.

Speaker 1:

And, you know, I don't know if you're aware with of the book Faith for the Curious, but this whole idea that the nones in our country, you know, the people without religious affiliation. Mhmm. Not n o e Mhmm.

Speaker 2:

To explain, this is when someone does a religious survey options and the one at the end is none, n o n e. So they pick that because they have none or no affiliation.

Speaker 1:

Exactly. So there are there's about a 100,000,000 nones in The United States now. It's a big demographic. Yeah. And, of course, they're not all the same, but but but what marks many nuns is a certain level of spiritual curiosity.

Speaker 1:

You know? There's something up there, and I can't don't know quite know what it is. There may well be often a wariness about traditional religion. But there's also an openness to this, you know, there's something there beyond the physical. Right.

Speaker 1:

We stand as Christians tend to spend a lot of time focused on spiritual nihilists who say there is no God. There is no spiritual reality. In fact, all of metaphysics is really just an imagination and a falsehood, but they make up only about 9% of America. Wow. And there's you got this big huge group of nones.

Speaker 1:

So with nones, and this is not me. I've learned this from work of others, you know, they're tend they're not really looking for a sage on the stage. Mhmm. They're not looking for answers. They're looking for fellow travelers.

Speaker 1:

They're looking for a journey towards spirituality and and better spirituality. So, you know, the traditional evangelical evangelism model doesn't fit well with that. That's gonna be frustrating. But in health care, not so much because many nuns, they're less interested in doctrine, and they're more interested in practical issues. Like, how can spirituality help me And right what happens to me when I die?

Speaker 1:

Yeah. And these are very practical questions. So to say, for a patient who's interested and wants to explore and maybe has some background, you know, to say something like, tell me about a person whose spirituality you really admire. Or to say, tell me about your experience with God. Have you ever felt God nudging you or directing you?

Speaker 1:

I mean, this is a question. It's not a proposition. But it's amazing what comes out and how some of these conversations can blossom. I'm just saying Mhmm. Why don't you know, would you be interested in practicing gratitude?

Speaker 1:

Because you actually have scientific evidence that helps help. And faith many faiths tell us that too. Mhmm. Or prescribing you talked about prescribing, saying, why don't you try reading Psalm 23 every day, every morning this week and just see what that does for you? Mhmm.

Speaker 1:

I mean, it's not an argument about doctrine. Right? It's about what will help. So I'm starting to get off the track here, Kase.

Speaker 2:

No. No.

Speaker 1:

But but but but writing a prescription, it's much more of a conversation, I would say. Mhmm. Sometimes it includes recommending things.

Speaker 2:

Yeah. Well, in the other method that you have here in chapter three, it's an acronym, l o r d, developed by doctor Walt Larimore. And one of the questions under r, which is wanting to know about your religious right? Religious struggle. One of the questions here that just got me, has this illness or situation caused you to question God's love for you?

Speaker 1:

Wow. Yeah. So this is a very important phenomena called religious struggle. In the nursing literature, it's called spiritual distress. And as best I can make out, these are really the same things.

Speaker 1:

And some reach researchers at Duke actually, some years ago now, studied this in a group of adult patients with chronic health conditions. And Mhmm. They asked them three questions. Do you think that God has abandoned you? Do you think that God doesn't love you, or do you think the devil made this happen to you?

Speaker 1:

So if the patient answered yes to any one of those three questions, these researchers said, okay, well, that's religious struggle. And then they compared the group with religious struggle to a matched control group that answered no to all those questions. And the group with religious struggle, they followed them, they had higher two year mortality than the group that didn't have religious struggle. Wow. So, you know, that's a big deal.

Speaker 1:

Mortality is a very hard what we call a hard outcome at health care. I mean, that's really important. And so this is science. Again, I'm not quoting Well scripture to you now. I'm quoting science saying, woah.

Speaker 1:

This this spiritual thing of religious struggle is a factor in patients' health outcomes, serious health outcomes. So it's very medically appropriate to find out if your patient is struggling, yeah, is dealing with religious struggle or spiritual distress. And then, if they are, to think about, well, what what could we do to help with that? You know? Because it's very common that people are asking themselves, why me?

Speaker 1:

If they have a serious or chronic health condition. And there's a lot of unfortunate answers to that question, and one of them is religious struggle and say, God has abandoned me, or God no longer loves me, and he's punishing me with this illness, or the devil's in control here, and the devil made this happen. Well, you know, that's not actually a biblical understanding Mhmm. In any of those things of of sickness. And but it happens.

Speaker 1:

You know, the the Duke's doctor researcher says said that 15 of American patients have religious struggle. But when you ask chaplains and they do a study, they say it's more like fifty percent. Wow. Yeah. So Yeah.

Speaker 2:

Yeah. Well, I always chuckle when a media report comes out that, oh, science has discovered many of the statistics you just said and we we know those things to be true already from a faith perspective. And when science discovers, oh, well, maybe God does have some truth in in ways of doing things out there. Now your book So

Speaker 1:

I guess, let me just say that that I'm sorry to interrupt. I No. No. Go think that one of the important things I wanna say is that, for instance, when I take a spiritual history from my patient, I'm not straying from the core competence of my profession. Mhmm.

Speaker 1:

It's not like somehow I've taken off my white coat and I put on a preacher's robe or something. No. I'm being a doctor, and I'm taking spiritual history because that's good medicine. Yeah. And when I'm trying to encourage my patient's spiritual health with some sort of prescription or joint decision about something to try, I'm working towards their health.

Speaker 2:

Mhmm.

Speaker 1:

Mhmm. So for the health care professionals who might be listening to this, I want I really wanted to mention that. This is and it's good for me too because those two narratives, the scientific and the spiritual, they're coming right together. And the flip side of that is I'm aware that I've become more aware that God is present and that he's in charge and that he's working here. And I don't may not know what he's working.

Speaker 1:

I don't know what outcomes he has in mind. Right. But he's here. And that's a huge thing. So connecting to that god's presence, there's lots of microhabits that help us get there, but one of them is something like taking a spiritual history.

Speaker 2:

Mhmm. Mhmm. I really appreciate the way in which you have so beautifully integrated your faith and work, which is such a passion of ours at the collaborative.

Speaker 1:

On my best days, Kase. On my best days.

Speaker 2:

Maybe I should interview your wife. Well, speak to those clinicians that may be listening. What habits of perception and attentiveness could help someone get a bigger view of what God's doing somewhere in this situation.

Speaker 1:

Yeah. So so much of it for me has to has to do with being able to connect you to God's presence in real time. Mhmm. And I've definitely been in the place in my life where, you know, I was a spiritual I'm a spiritual person thinking about God at home and at church, and I'm a scientist at work. And it's a big step for some of us to start saying, wait a minute.

Speaker 1:

Of course, if you said, is God in the hospital? Well, God's everywhere. I guess he's in the hospital. But to connect to that reality can make a big difference. And so I think that I've already used this word, but micro habits I think are important.

Speaker 1:

And as best I know, a man named BJ Fogg first used that term. And he meant by it small habits that are relatively easy to adopt and that make a small shift in our outlook and behavior. So, you know, if you said, I'm gonna read the Bible, the whole Bible. Woah. That's a big there's a lot of pages there, and it's not all easy reading.

Speaker 1:

But if you said I'm gonna read a chapter a day, well, that I can manage.

Speaker 2:

It's manageable. Mhmm.

Speaker 1:

And, you know, it might take me three years or whatever to get through, but that's a microhabit is the small bit that I can do day in, day out. So what microhabits connect us to God's presence at work? Well, it's gonna depend, and a lot of health care workers have figured some of this out already. One thing is just a reminder. You know, how often do you look at your phone when you're at work?

Speaker 1:

I would say that I would bet that most people look at their phone at least three or four times a day. Some sometimes it's three or four times an hour. For sure. And so if on your phone lock screen, there's a verse, that's helpful. I mean, what I love is Psalm is it Psalm 22?

Speaker 1:

The Lord is the stronghold of my life. I mean, it doesn't take a lot of reading to get that hint. Login password to connect to a computer network. If you can use a a login password that reminds you God is present, a verse, a word, or a phrase, and that you Short have prayers at recurring moments. For me, it's often when washing my hands between patients.

Speaker 1:

I mean, health care. Right? Mhmm. If I was a teacher or public servant in another role or a businessman, it wouldn't be washing my hands between patients. It'd be something else.

Speaker 1:

I know surgeons who every time they're scrubbing for surgery, they're praying. And it's just a habit, and it happens. See, in medicine, we sometimes see sad situations. And being able to pray a lament, the biblical form of lament, and to be able to do it in ten seconds because you don't have a lot of time silently can be hugely restorative. Mhmm.

Speaker 1:

Mhmm. And the whole business of lament is something I try to get into in the book because I think it took me a long time to even understand that. Mhmm. Scripture memory, it's amazing how if you start memorizing verses can just pop into your mind. And I tell a personal story about that in in the book.

Speaker 1:

So, I mean, there's just some ideas. But there's lots of micro habits that can that can help us connect to God's presence at work.

Speaker 2:

Mentioned the the Advent Health Hospital, and there is a painting to the right of the elevator doors. So it's you you don't miss it. And it is a painting of a doctor in the blue gown with the mask, and he has operating tools, his his scalpel, standing over an operating table with someone laying there and just right up behind him along his touching his shoulders is Jesus, reaching his hand around and putting it on top of the doctor's hand with the scalpel. And it's a really captivating thought and it it confronts you quite clearly.

Speaker 1:

Yeah. And I would say that that is a reality all the time in health care. Mhmm. Whether the doctor has any clue about it or not. But that if the doctor can clue into that's what's happening here

Speaker 2:

Mhmm.

Speaker 1:

Then it's so good for the doctor and or the nurse or the therapist. And it's also good for the patient. Yeah.

Speaker 2:

So last question. For someone listening that might be earlier in their medical career, what sort of advice or encouragement would you offer them?

Speaker 1:

I would say it's so great if you can figure all this stuff out early on because it took me way too long to get where I am now. And too often, this sort of division between science and spirituality, too often, it keeps us from even investigating how these two things come together. Mhmm. Or really understanding how how faith can benefit us in our workplaces as well as our patients. So I would say investigate what we've been talking about and make it part of who you are.

Speaker 1:

And then the other thing I would say, actually, is that if you want to do a deeper dive into integrating faith into your patient interactions in a completely non coercive way with permission, sensitivity, respect in a way that's completely oriented towards the patient's health, then think about taking a seminar called Sailing Process, which is a ten hour workshop that is entirely about the practical matters of integrating faith into your patient interactions in a way that's intentionally appropriate in medicine.

Speaker 2:

Is that like a boat sailing?

Speaker 1:

No. I'm sorry. Medical term, saline, s a l I n e. Oh, okay. We use that solution.

Speaker 1:

We use an intravenous fluid solution called normal saline.

Speaker 2:

Okay.

Speaker 1:

So it's a catchy thing for health care people. So saline process is a is a a quick word about this. It was really the brainchild of two people, including Walt Larimore, whose name you all also mentioned, incredible person, and Mhmm. And a guy named Bill Peel. And they developed this.

Speaker 1:

It was developed in The US. It kind of settled down here. It's went international. It's taught in over 70 countries around the world. There's been tens and tens of thousands of health care workers around the world trained in this, and it's now back in The USA.

Speaker 1:

Both Nurses Christian Fellowship and the Christian Medical and Dental Associations both sponsor saline process workshops

Speaker 2:

Oh, that's in

Speaker 1:

various communities. And so that's another resource. And if you're a clinical year student or you're a resident trainee fellow or you're new in practice, you know, I help lead these workshops. I'm a sailing process trainer and only became one once we moved here. And I can tell you for some of the people who take it, it completely changes their professional life.

Speaker 2:

Right.

Speaker 1:

It's like, this is so great. You know? And they find huge purpose. And and many of us through the years figure out bits and pieces about how to integrate faith into patient and your action in a appropriate way. But this ten hour workshop gives you a conceptual framework and a bunch of practical tools.

Speaker 1:

And so, yeah, since you asked, I would add that.

Speaker 2:

Yeah. We'll put a link to that in our notes for anyone that's interested. Well, Mark, thank you so much. I appreciate your time.

Speaker 1:

Yeah. I appreciate the chance to talk to you, Case. It's fun to talk about that stuff.

Speaker 2:

Oh, fantastic. Well, friends, go out and get his book, Healing Purpose, Finding Satisfaction in a Healthcare Career, published by InterVarsity Press. So Mark's gonna be with us for one more episode next week. I have sought out a number of doctors that I know, and I've asked them to craft questions for next week to make things quite practical. Thank you for inviting us into your day.

Speaker 2:

If this conversation clarified or steadied your thinking, I encourage you, share it with a colleague. Maybe share it with your own doctors and start up a a conversation about the Lord. Leave us a review if you can. Like our episodes. It really helps.

Speaker 2:

Go to our website, wecolabor.com. Drop us your email, and we'll send you zeitgeist, our latest journal on faith, work, and culture. Many thanks to the Stein Foundation for supporting today's episode. I'm Case Thorpe, and God's blessings on you.