SALT LAKE CITY — Dr. Erica Kaye was raised in a secular Jewish home and went to medical school in one of the least religious states in the nation.
So she was unprepared, when working as a pediatric oncologist in the South, for the first time that a mother asked her to pray for a critically ill child.
“I remember standing there, frozen and sweating, my clammy fingers entwined with hers,” Kaye, 37, wrote recently for the Journal of the American Medical Association. “In that moment, I realized an uncomfortable truth: the most meaningful way that I could provide care for this patient and family was to join them in prayer.”
The experience, and Kaye’s response, is recounted in a widely circulated essay published Feb. 18 in JAMA’s popular weekly feature “A Piece of My Mind.” Since then, the essay has been circulated at health care facilities around the nation, and Kaye has received hundreds of emails from medical providers and parents who were moved by her message, which is that hope and love are powerful paths toward spirituality, and that compassion and meaningful connection with others can help us connect with the sacred.
As a Harvard-trained physician board certified in three specialties — pediatrics, oncology and hospice and palliative medicine — Kaye works with seriously ill children and their families. She has found that, despite her initial discomfort, praying with patients can help create a connection that is transformational, and that “love is a mysterious force with properties that neither medicine nor science can explain.”
“Now when patients and families ask me to pray with them, I no longer feel like an imposter: I take their hands without apprehension; I whisper, ‘Amen,’ in the anguished pauses; I sing ‘Amazing Grace’ over the ventilator hum; I see indescribable suffering, and I find faith in bearing witness, caring and connecting,” she wrote.
In a conversation with the Deseret News, Kaye, who has two daughters and works for St. Jude Children’s Research Hospital in Memphis, Tennessee, explained how becoming a mother helped to clarify what she believes and why the essay struck a chord with other physicians, even some who have no religious faith. The conversation has been edited for clarity and length.
Deseret News: Your first experience praying with a patient took place several years ago. What made you decide to write on this topic now?
Dr. Erica Kaye: The seed was planted about a year ago because a spiritual leader within my faith community, which is Jewish, asked me to reflect and share my thoughts about what faith meant to me to the larger congregation. I’m not a particularly religious person, in the context of subscribing to the rules and tenets of organized religion, per se, but I have always felt deeply spiritual. And it was the first time anyone ever asked me to describe what that meant in words. It was a very challenging exercise, and I grew through that experience.
The other piece is that, in relatively recently becoming a mother, I have thought more in the last couple of years about how it’s important for me to be able to verbalize what I think and feel and believe in order to have meaningful conversations with my children. Not necessarily to tell them what they should think, but to give them a language with which to explore their wonder and their thought processes and develop their own personal faith journeys. Those two sentinel events — motherhood and a gentle call to reflect by someone else — made me start putting pen to paper, and as I did so, I started realizing that what I thought was a deep well of lack of understanding could actually be reframed as something that I very much believe in and can apply, not just in my faith journey but in my daily clinical practice.
DN: How do you navigate the inherent hope of prayer with clinical diagnoses that may not be hopeful at all. Have you ever felt concern that you were giving people hope by praying with them when hope was not appropriate?
EK: That question is at the heart of much existential stress for many clinical providers because there is a fear of giving false hope. I don’t discount that fear because I recognize and appreciate the critical importance of honest and transparent communication. When we share information with patients and with families, we gift them the opportunity to make decisions that align with their values, and so it is exquisitely important that we be as compassionately honest as we can be, particularly with topics as sensitive and high stakes as survival.
At the same time, I think that there is always a basis for hope. What I like to say to families is, “What are you hoping for?” And most families hope for a cure and hope for a miracle, and I say, “I share that hope with you, and this is the medical information that we know.”
In the same voice, we can say, “We don’t have interventions that can cure your child; in my experience, we have not seen cure possible in this specific disease or time or place.” And for a family for whom faith or miracles is an important part of their resilience, we can still share in their hope for a miracle, irrespective of our personal faith backgrounds, and that draws back to what I think is the greatest power, which is bearing witness and connection and sharing love.
The other thing I will say is, “What else are you hoping for?” Because many families, although their first hope is for a miracle, will also say in the next breath say, “I’m hoping for my child to be comfortable, I’m hoping for my child to die at home, I’m hoping for us to be together as a family.” And if you give people opportunities to explore “what else are you hoping for?,” you realize this hope is not denial. It’s not a lack of prognostic awareness. It is a normative coping mechanism. It’s the resilience needed to get out of bed every morning. Why wouldn’t we partner in that hope with them, while also giving them opportunities to reframe what they’re hoping for?
DN: How has the essay been received?
EK: I have published many papers in my career, some in impactful journals, many that I hope have helped shape and advance the science. I have never in my life received an outpouring of messages like I have in the last week, hundreds of messages from strangers. Many people share stories of grief and loss that are deeply personal, and wish to engage in a dialogue about how to navigate faith in the context of almost indescribable grief and loss.
I got an email from the editor-in-chief of the journal saying, “Wow, you’ve really struck a chord.” And I responded that this is a gift that is beautiful and heavy. It is profoundly humbling and inspiring that strangers entrust their stories and their own faith journeys to me. I feel privileged and I feel it is important to respond personally and meaningfully to each, but I may be doing so for the next 10 years of my life.
I put my girls to bed about 7:30 at night, and from 7:30 to 11:30, I just answer emails. My husband tried to take the computer away the other night because almost every email makes me cry. They are such vulnerable, authentic, beautiful stories of difficult lived experiences, and I read the emails and I re-read them and I grieve with these strangers. But I mean that truly: It is a gift. And it is a beautiful gift, though albeit a heavy one, and it is my honor to have a small part in people’s faith journeys.
DN: Some of the comments posted online were from physicians who identified as agnostic or atheist and yet said they were deeply moved by your words. Did this surprise you?
EK: This was probably the single most fascinating aspect of the response to this piece. It’s very profound to recognize that the visceral response to this essay is universally felt across people who identify as atheists, agnostic, secular or devoutly religious. I heard from people who are Christian, Jewish, Muslim, Hindu and devoutly religious, to people who are self-described as atheists and still share wonder and curiosity and are asking questions just like any of us.
DN: Is there a void in medical training when it comes to encounters like the one you described? Does the response to your essay show that there aren’t sufficient opportunities for this conversation to take place?
EK: I don’t think the topic is inherently taboo, not in my experience. To the contrary, I think in recent years, there is an increasing awareness of interfacing with spirituality as a topic and as a pillar of support to patients and families. But I will say, I think that in many ways, medicine and science are taught as objective and clinical and fact-based, and inadvertently that can sometimes create a false dichotomy between fact-based science and the wonder inherent to faith and spirituality. Subconsciously, that dichotomy may teach us that they are mutually exclusive, when I think it couldn’t be further from the truth.
I don’t recall receiving formal didactics on how to navigate the intersection of faith and medicine personally, but I have had wonderful role models across the trajectory of my training. But I would imagine that role modeling is minimal for many people, and you really have to seek it out.
DN: What effect is your essay having in health care settings?
EK: I am receiving feedback from colleagues at other academic centers who are circulating the paper and using it to spark dialogue during clinical rounds and during teaching didactics with trainees. And that makes me so hopeful because I think what’s needed is the recognition of the value of pausing — because that alone, just the pause to say, what are you thinking, how are you feeling — that in and of itself provides critical role modeling for trainees who are trying to figure out what they believe and how they wish to navigate faith within their personal, clinical practice.
And so if nothing else I really hope that this piece offers people in medicine and beyond the time and space and permission to pause, to do self-reflection and then to share those reflections with one another in solidarity. That’s my hope.