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Expanding our definition of ‘spiritual competence’

The first thing I remember as I regained consciousness, lying in a hospital emergency room, was hearing a nurse ask my mom if I was allergic to any foods. With my eyes still closed, I thought to say, “Asparagus,” thinking this might reduce the chances of anyone serving me what was then a dreaded vegetable.

“Asparagus,” repeated the nurse, making a note on my admission form.

And then, with a chuckle and what must have been a great sense of relief to see me alert, Mom said, “He’s not allergic to anything; he just doesn’t like asparagus. Obviously nothing has happened to his sense of humor.”

I was 15 years old and had just been airlifted off the side of a mountain after sliding nearly a thousand feet down an ice- and rock-covered chute. By the time I came to a stop, my body had taken quite a beating. My pelvis was shattered; my leg was broken in two; my face was pretty banged up; and as I would later find out, there was some internal bleeding.

Obviously there was a lot of work to do in order to put me back together. Little did I know, however, that it would be what Mom said about my apparently unscathed sense of humor that would provide the first line of defense against what my doctors predicted would be a long and uncertain recovery.

Being raised as a Christian Scientist, I understood the deeper meaning of Mom’s comment. As far back as I can remember, she had this remarkable ability to see past whatever scrape I’d gotten myself into and detect something of my actual spiritual substance. In fact, it was this spiritual substance that Mom recognized during that brief and seemingly inconsequential exchange with the nurse that helped me to see the very same thing, and in so doing, to alleviate my fear.

This was the start of my healing process.

Nowadays those working in the medical profession might use the term “spiritual competence” to describe what Mom did – a particular set of skills usually associated with chaplains and clergy but now widely accepted by most medical schools in the U.S. as something that can and should be encouraged in doctors and nurses as well, at least to some extent.

Having given presentations on the subject at the last two Stanford Medicine X conferences, I’m aware of the debate over the necessity, appropriateness, and value of folding the study of such competencies into the medical curriculum. I’m also aware, based on personal experience, of the need for a broader definition of the subject itself.

Within a medical context, spiritual competence generally refers to a health care professional’s capacity to take into account something other than a patient’s physical symptoms, sometimes but not always involving questions related to spirituality and religion. “What do I need to know about you as a person to give you the best care possible?” asks Dr. Harvey Chochinov, Director of the Manitoba Palliative Care Research Unit, a question he’s found tends to reveal the “invisible” factors impacting his patients’ health, without crossing any lines of impropriety.

But for me, spiritual competence involves so much more, even the ability to discern, through prayer, my own or another’s genuine individuality as an expression of Spirit itself. It’s this kind of prayer that time and again I’ve found to be an effective means of achieving not only better mental and physical health, but better relationships, a more balanced disposition, and a greater appreciation for the Divine. “True prayer is not asking God for love; it is learning to love, and to include all mankind in one affection,” writes Mary Baker Eddy. “Prayer is the utilization of the love wherewith [God] loves us.”

Of course, there are those who might wonder how this works for someone who is accustomed to relying on prayer in lieu of conventional medicine for his or her health; someone like me who, through no choice of my own, happened to have found myself in a hospital.

Looking back, I don’t recall there being anything but a spirit of cooperation in terms of the hospital staff’s accommodation of my approach to healing – a testament, I think, to their own sense of spiritual competence. While my parents and I respected the concerns and recommendations of my doctors, they in turn respected our religious convictions and preferences to the extent their professional responsibilities permitted.

I remember one afternoon when one of my doctors insisted that I have immediate surgery to repair my pelvis. X-rays showed that the bones weren’t knitting together as well as he had hoped and the plan was to insert a plate. My parents and I asked if, instead of immediate surgery, we might take the rest of the afternoon and evening to pray about the situation. My doctor agreed but said that he would still plan on coming by in the morning to prep for an operation.

The next day, new X-rays were taken which showed significant improvement. Instead of carting me off to the operating room, my doctor made plans for me to be released from the hospital.

There were other healings that took place along the way. On one occasion during an operation to stop my internal bleeding, my doctor ended up finding nothing wrong. As one of the members of the surgical team put it, “Someone must have gotten in there before us.” And within a relatively short time, every scratch and scar on my face had healed over without any medical intervention. I might add that after my initial surgery and throughout my stay in the hospital, I was not given, nor did I require, any pain medication.

Within four months of my returning home, I was leading my high school marching band in a parade. Since that time, nearly 40 years ago, I haven’t suffered any aftereffects and have continued to participate normally in a variety of athletic activities, including long-distance biking.

While I am deeply appreciative of what my doctors did for me, I can’t help but think back to that moment when I first arrived at the hospital when Mom said, in essence, “I see something in you that perhaps you’re having trouble seeing and feeling right now” – that “something” being my innate and indestructible spiritual essence. More than anything else, it was this extraordinary expression of divine insight – of true spiritual competence – that paved the way for healing.

By the way, I would be remiss if I didn’t mention that asparagus is now one of my favorite vegetables – a side effect, I suppose, of God’s great and ironic sense of humor.

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