Faculty Peer Reviewed
The overlap between religion and medicine is ancient. On a recent medical volunteer trip to India I met a medical student who proudly wore a school sweatshirt with the saying: In God we trust. The rest we dominate.
This arrogant approach is probably uncommon, but praying to God for healing–self or intercessory–is not.
Intercessory prayer is a form of prayer conducted by a group or individual who petitions a god on behalf of another individual in need of assistance. Intercessory sessions often occur in highly-developed belief systems, but are also sporadically used by nonreligious people, not only as a tool for healing, but as a coping mechanism for those engaging in the prayer. Occasionally, the affected individual may be included in the intercessory prayer session.
When working as an intern in a hospital, rabbi/physician Abraham Twersky was treating a man who suffered a severe iatrogenic complication during a routine procedure. When Dr. Twersky saw that the man was filled with anxiety and fear, he offered to pray with him. As a result of the prayer session, the man’s attitude changed, his fears diminished, and he was able to cope more positively with what had befallen him. In a remark to the doctor the following day, he said, “I am no longer afraid. The antibiotics worked, but the prayer worked better.” In this story, we find an example of how a patient can perceive prayer to be as efficacious, if not more so, than medical intervention.
Many prospective studies have examined the use of prayer as a coping mechanism and its relationship with the healing process. One randomized, double-blinded, prospective study of coronary care unit (CCU) patients found that intercessory prayer was associated with less adverse health events during the CCU course, but had no affect on length of stay. The 2006 Study of the Therapeutic Effects of Intercessory Prayer (STEP) trial was a multicenter randomized study that stratified patients due to undergo coronary artery bypass graft surgery (CABG) into 3 groups. The first 2 groups either received intercessory prayer or did not, but were blind to their grouping. A third group was aware of receiving prayer by another. Patients aware of receiving prayer had statistically more complications than the unaware groups. While intercessory prayer seems to have little effect on health outcomes, one study found that private self-prayer did make a positive difference in mental optimism. Prayer was found to be associated with increased preoperative positive attitude, which one study suggested leads to a better quality of life as well as faster rate of recovery after coronary artery bypass grafting. Despite the limited and inconclusive evidence in favor of prayer, nationwide polls have shown that 80% of Americans commonly pray for healing.
A fascinating early example of people evoking intercessory prayer in connection with health and illness is the phrase “God bless you,” a term that Kavka asserts is “inseparably [attached] to the sneeze.” Religious or not, take a moment to ask yourself this question: how often do you say “Bless you!” or even “God bless you!” in response to hearing a friend or even stranger engage in sternutation (which Merriam-Webster defines as “the expulsion of air from the lungs through the nose and mouth, most commonly caused by the irritation of the nasal mucosa”). If your answer is not “never,” ask yourself why. Dr. Kavka adds, “No routine comment is invited by someone belching, coughing, groaning, hiccupping, retching, snoring, vomiting, wheezing, or breaking wind, even when these symptoms may portend trouble.” So, why pray for another after they sneeze?
It seems like we humans are programmed to hope and pray for the well being of others after they sneeze. While it is well documented that humans are inherently altruistic–Fehrl & Fischbacher elegantly stated that “evidence indicates that human altruism is a powerful force and is unique in the animal world”–it seems that little benefit would come from hoping for another to recover from a benign sneeze. In order to fully explain why we innately utter niceties after hearing a fellow human blast mucous and disease particles out of their nares, we must understand disease in the context of the past 2 millennia.
The act of sneezing was once considered sacred. The ancient Greeks, for example, thought that the sneeze was a heavenly sign from the Gods. The Greek physician Hippocrates knew the sneeze helped spread pulmonary pathogens, but otherwise thought it to be beneficial in the absence of ongoing disease. The Romans too considered the sneeze to be a sign of good health. Since it arose from the lungs, an organ they considered divine, Romans often greeted the sneeze with the phrase “Live long.”
This all changed during the 14th century, when the bubonic plague killed one-third to one-half of Europe’s population. Plague is caused by Yersinia pestis, a gram-negative ovoid bacillus that is spread by fleas or rodents. Marked lymphadenopathy, often in the inguinal region, is the hallmark of plague. The last stage of disease, however, is characterized by respiratory distress, chest pain, and violent sneezing that causes patients to aerosolize and spread bacteria. The association of the sneeze with death led Pope Gregory VII (reign 1073-85) to decree that the sentence “May God bless you” must be said as a short prayer after one sneezed. Over time, the sneeze was believed to be a way to expel demons from the body.
Saying “God bless you” after one sneezes is now a common practice. In the Seinfeld episode “The Good Samaritan,” Jerry pokes fun at the “God bless you” reflex, and recommends that the compliment “You are so good looking!” would be more meaningful to the sneezer. Jerry, it seems, took the secular approach to the sneeze.
Regardless of the ailment, treating the whole person and not just the disease is necessary for the healing process. The medical literature will continue to debate the objective implications of prayer on health and recovery. The use of intercessory prayer or spiritual intervention as an adjuvant therapy to medical intervention seems to contribute in many situations to the patient’s well being and should not be easily dismissed. So whether you find yourself standing next to a sneezing stranger or helping a loved one cope with a debilitating illness, do whatever you can to make them feel better. Your words may just make the extra difference.
Commentary by Dr. Michael Tanner
The Cochrane Database authors reviewed 10 studies of intercessionary prayer involving 7646 patients and wrote, “These findings are equivocal and, although some of the results of individual studies suggest a positive effect of individual prayer, the majority do not and the evidence does not support a recommendation either in favour or against the use of intercessory prayer.” They conclude, somewhat contemptuously, “We are not convinced that further trials of this intervention should be undertaken and would prefer to see any resources available for such a trial used to investigate other questions in health care.” Yet, while walking the halls of Bellevue over the years I have overheard many group prayer sessions in full swing and been amazed by the energy emanating from the patient’s room. My first reaction: “Stay out of there: these people are taking a different approach to the case.” My second: “Might help, can’t hurt.”
Alon Mass is a 4th year medical student at NYU Langone Medical Center
Peer reviewed by Michael Tanner, MD, Executive Editor, Clinical Correlations
- Roberts L, Ahmed I, Hall S, Davison A. Intercessory prayer for the alleviation of ill health. Cochrane Database Syst Rev. 2009;(2):CD000368. http://www.ncbi.nlm.nih.gov/pubmed/19370557
- Twersky AJ. Do Unto Others: How Good Deeds Can Change Your Life. Kansas City, MO: Andrews Mcmeel Publishing; 1997:127.
- Harris WS, Gowda M, Kolb JW, et al. A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit. Arch Intern Med. 1999;159(19):2273-8. http://www.ncbi.nlm.nih.gov/pubmed/10547166
- Benson H, Dusek JA, Sherwood JB, et al. Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: a multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer. Am Heart J. 2006;151(4):934-942. http://www.ncbi.nlm.nih.gov/pubmed/16569567
- Ai AL, Peterson C, Bolling SF, Koenig H. Private prayer and optimism in middle-aged and older patients awaiting cardiac surgery. Gerontologist. 2002;42(1):70-81. http://www.ncbi.nlm.nih.gov/pubmed/11815701
- Scheier MF, Matthews KA, Owens JF, et al. Dispositional optimism and recovery from coronary artery bypass surgery: the beneficial effects on physical and psychological well-being. J Pers Soc Psychol. 1989;57(6):1024-1040.
- CBS poll: prayer can heal. CBS News website. February 11, 2009. Accessed September 23,2010. http://www.cbsnews.com/stories/1998/04/29/opinion/main8285.shtml.
- Kavka SJ. The sneeze—blissful or baneful? JAMA. 1983;249(17):2304-2305. http://jama.ama-assn.org/content/249/17/2304.refsassn.org/content/249/17/2304.refs
- Songu M, Cingi C. Sneeze reflex: facts and fiction. Ther Adv Respir Dis. 2009;3(3):131-141. http://www.medscape.com/viewarticle/714420
- Fehrl E, Fischbacher, U. The nature of human altruism. Nature. 2003;425:785-791. http://www.nature.com/nature/journal/v425/n6960/full/nature02043.html
- Cobbs CG, Chansolme DH. Plague. Dermatol Clin. 2004;22(3):303-312.
- “The Good Samaritan.” Seinfeld. NBC television. New York. March 4, 1992. http://www.youtube.com/watch?v=Oq-1CtCPUyo