God in the exam room

My profession does not allow me the luxury of suffering fools, but neither does it allow me the luxury of always being blunt in my beliefs.

Readers may have noticed a slight tendency toward snarkiness, especially when dealing with woo. I refuse to pull punches when it comes to people peddling quackery. Religion is different.

In my work, my religious beliefs (or lack of them) are irrelevant, and I don’t intend to “confess” to either belief or non-belief to my patients. Being a physician is not the same as being an academic scientist. As a bench scientist, your cell cultures don’t really care who you are—not so with patients. Patients are acutely interested in their doctors–their marital status, if they have kids, where they grew up. I spend quite a bit of time just chatting with my patients. Mrs. S. always likes to see the latest pictures of my daughter, and I oblige her.

Not that I don’t enjoy showing off my kid, but there is a greater purpose to these activities. Patients who know you and like you are more likely to trust you and follow your advice. That’s why I usually go along with whatever my patients say regarding religion. That’s not a cop-out, it’s real medicine.

People are different from primers and test tubes. They require comfort and trust. I never mock (or even contradict) their religious beliefs (I save that for cafe arguments). Telling a cancer patient that God is a fairy tale is not only wrong, it’s cruel.

Patients believe, and nothing a doctor says is going to change that. Yes, sometimes these beliefs get in the way of good medical care, but more often they are benign, strongly attached to the patient, and their removal would cause more harm than good. Primum non nocere.

There are lots of things in this world that I don’t believe in—fairies, God, good Chinese food in the Midwest—but my patients can believe whatever helps them get by (except the Chinese food thing). It’s my job to heal, not evangelize.

That being said, whenever my patients show me the latest bottle of get-well potion they’ve purchased, I gently explain why it won’t do them much good. I won’t take God away from a patient, but I’ll happily separate them from Gary Null.