Relentless & Fascinating: Patients' big end-of-life questions & their impact on health care professionals
Doctor, Will You Pray for Me? Medicine, Chaplains, and Healing the Whole Person
Robert L. Klitzman, MD
Oxford University Press, 2024
Hardcover, 328 pp
ISBN 978-0-19-775084-1
MSRP: $35 USD, £22.99
Also available as: eBook, Oxford Scholarship Online
Robert L. Klitzman’s most interesting book, in essence, focusses on the often tricky but essential relationship between medicine and spirituality. Cicely Saunders' conception and shaping of the "Total Pain" model is already widely documented1,2 and although this manuscript does not unpack this directly—or even concentrate completely on medicine, spiritualty, and the end of life—the thoughts, stories, and experiences that are shared relate to it absolutely and are full of it.
When we are all faced with illness, the matter of our mortality, and the meaning of life, what we might call "the big questions" indeed come to the fore. Such questions, which include "Why me?" and "What have I done in my life to deserve this?", shake us to our core in the pages of this book as we travel through a wide variety of intimate encounters and views. Through varied and fascinating example after example, Klitzman hits these questions head on by sharing real and lived accounts of individuals facing some of the most vulnerable times of their lives, as well as those of physicians and chaplains who, in the midst of dealing with the unknown, can also be rendered powerless or questioning their place.
He is not afraid to expose the many tensions that often exist between medicine and spirituality, the strengths and weaknesses of each discipline, and the struggles and incentives that all of us clinicians face in our daily work when treading the often uncomfortable line between the distance that professional regulation demands and the depth of intimacy needed to regularly and relentlessly meet vulnerable people where they truly are. I commend him for this absolutely.
How patients and professionals construct hope as part of their professional stories and personal experiences is a critical focus of this book. We read how hope can positively affect the human spirit and begin to satisfy the longing for meaning that each of us carries throughout our lives, into illness, and on into death and bereavement. I was struck by the diversity of views that Klitzman delves into: a variety of religious beliefs as well as atheism and agnosticism are all expertly addressed.
It is impossible to mention in full the highlights and experiences encountered within this book or even one particular element for special mention or examination, as every part is so relevant. However, I was struck particularly by Chapter 15's exploration of "Spiritual care versus psychotherapy." It has always been clear to me that the patient chooses the person to tell their story to and to ask their questions of, rather than the professional. And like Klitzman, many of us will find the crossovers between the different professions, and the varying regulations and personalities within them, particularly fascinating. Although these are addressed in part, I would have valued more of Klitzman’s insight into working with a wider variety of professionals and even volunteers in the health care arena, focusing on both the challenges and richness that these interwoven vocations can bring to each other when working with the complexity of being human.
This is an important book focusing on enormously relevant things and I thoroughly recommend it to those of us who struggle to make meaning of the myriad encounters we all have daily within our workplaces, both with patients and other professionals. I hope that the limitation seemingly expressed by the book’s title, Doctor, Will You Pray for Me?, will not prevent a wider range of health care professionals and others reading this very valuable text. So many of us can learn from Klitzman’s vast experience of dealing with the pressures of regulated professional distance when regularly facing the central challenges of being human, which insist that we step into the reality of a more creative intimacy as we struggle to be of help to those who ask the big questions whilst living through the most vulnerable time of their lives.
References
1. Clark D. Cicely Saunders—Founder of the Hospice Movement: Selected Letters 1959-1999. 2002; OUP Oxford (New York).
2. Hartley N. End of Life Care: A Guide for therapists, Artists and Arts Therapists. 2013; Jessica Kingsley (London).
Reviewed in January, 2025.
Nigel Hartley, MBE FRSA MA BMus(Hons) DipGM DipNRMTh, is Chief Executive Officer of the Mountbatten Hospice Group, Hampshire and Isle of Wight, United Kingdom.