I was extremely moved by John Graham’s speech today in class. His stories of the little boys he treated were riveting, and I was astounded by his bravery. I am not sure I would ever be able to act logically and professionally when confronted with a little boy missing half his face, or with an arm dismembered. I appreciated the emphasis he placed on respecting other’s experiences and beliefs. Doctor’s should understand that religion plays an important role in the majority of their patient’s lives. Respect is key, and perhaps something that has been lacking in the modern medical practice, where patients are examined by the doctor in a brief period of minutes, and then left isolated in their beds to wallow in fear. It was obviously a very different time in the history of medicine. I doubt whether in today’s world a patient’s family would ever feel comfortable enough with the doctor to grab his hands and pray with him. Graham understands the power of belief, which is what caused him to up and leave medicine, in the pursuit of his spiritual calling. When he describes the presence at the edge of his bed during his conversion episode, he reminds us that this was his experience, and whether or not we believe it, he does, and it has played an essential role in the direction his life took. If doctor’s are going to truly gain the trust of a patient, they must realize that a patient’s beliefs may not coincide with their own, but it is not their place to question those beliefs. Physicians should try to understand the values patients hold closest to their hearts, which will allow them to form a closer bond, and gain the trust of the patient. I believe that medicine is a partnership between he healer and the healee, and both have responsibilities towards each other; the tighter their bond, the better the expected outcomes.

I was also interested by Graham calling into question the very existence of true atheists. His point being, when most people are confronted with a life or death experience, they pray to anything that can possible help to deliver them from suffering. I agree with this reflection, which could be used as evidence for the inherent spirituality of humans. Human spirituality is also supported by the fact that every civilization in history has had a religion. I believe that both of these points substantiate the existence of a vitalistic life force. At our core, we humans reach out in our moments of need to an intangible, mysterious higher power. In many studies, including those of Koenig, a healthy relationship with the divine has been shown to improve clinical outcomes. John Graham believes in his human spirit, and a divine spirit, and he knows he’s right because it is his belief, and is meaningful to his experience. There are more to human than just cogs and gears, if our lives are guided by a higher power. In John Graham’s case, he proudly states he was guided to become a doctor, guided to become a priest, and presumably guided to the reconcile the two.

I was interested in Prof’s mention of Genesis 34 today, so I looked it up and was shocked by the time I had finished reading the second line. In the story Dinah, the daughter of Leah and Jacob, goes on a trip to “visit the daughters of the land”. On her trip Shechem, the son of Hamor the Hivite and prince of the country, sees her and rapes her. He then falls in love with her and tells his dad he wants to marry her. Hamor and Shechem then travel to Jacob’s house to ask for his daughter’s hand in marriage. Meanwhile, Jacob hears the news that his daughter has been raped and tells his sons when they come in from work in the fields. They’re furious.  Hamor and Shechem arrive after and ask for Jacob’s blessing of Shechem and Dinah, but before Jacob can respond, Dinah’s brothers say that in order for the kingdoms to unite under marriage, every man in their town, including Hamor and Shechem, must be circumcised. Hamor and Shechem happily agree and go back to their city to tell every man he must be circumcised. Every man obeys and is circumcised, but three days after the procedure while all men are still in pain, Dinah’s brothers Levi and Simeon attack the city slaying all of the males and looting the rest of the city while they’re at it. They take Dinah from Shechem’s house and take all of the women and children of the city with them as well. When this happens, Jacob who has been quiet throughout all of this is furious with his sons saying they have set him up for death against the rage of the angry Canaanites and Perizzites. The two brothers simply respond, well was it right for him to turn our sister into a prostitute?

This story is very controversial. It raises the question of who is the bad guy? I did some research and many people, when reviewing this story in the bible, regard Shechem as the good guy. This is a viewpoint of scholar Gerhard von Rad for example, and many other scholars that somewhat marginalizes the rape of Dinah. After the rape, something that was completely shameful in Jerusalem, Shechem falls in love with Dinah and proposes to her attempting to make their relationship holy. Shechem is then tricked by the brothers who take revenge for their sister killing the men and devastating the city.  Who do you see as the bad guy?

Also, why did the sons require the men to be circumcised? Was it simply a plan in order to make them weak and cause pain? Was it a representation of stripping the manliness out of men before they stole their wives and children? Was it used to gain a sense of power over the men? Was it even all of these combined? The story makes it seem as they did this in order to physiologically inhibit the men’s ability to fight back, but I’m sure it had intended psychological impacts on men as well.

Why was this story put in the bible in the first place? Is God justifying revenge in the case of family? The brothers could have easily said no to the marriage of Dinah and Shechem, but instead they decide to take everything from Harom and Schehem including their lives, somewhat symbolizing the rape of Dinah, taking her physically and mentally. Was the writer attempting to give notice to women’s rights and the need to stand up for them? Do you have any other ideas to give substance to this story?

Here is the link of Genesis 34 online:

https://www.lds.org/scriptures/ot/gen/34?lang=eng

Much of class today centered around discussion of whether a belief in a god, or higher power correlates with diminished stress in life. Life would be care free, if one believed that a guardian angel or benevolent spirit was looking after them. A person can withstand most stress with the philosophy that, at the end of the day, everything is going to turn out alright. Following a recommendation made in class, I researched the book of Job, to understand a Christian perspective on God’s relation to us. The story of Job, describes god’s most devout follower, who was wealthy, and happy. Satan took notice of Job, and one day challenged God to a test of Job’s faith. He asserted that if Job’s life was made miserable he would reject god, and cure gods name. And so Satan killed Job’s sons, and took his fortune, and livestock, leaving him with nothing. However,  Job remained strong, and stated “Naked came I out of my mother’s womb, and naked shall I return thither: the Lord gave, and the Lord hath taken away; blessed be the name of the Lord”. Yet Satan was not satisfied with this outcome, and bet God that Job would relent if  his body was tortured, and so Job broke out in horrendously painful boils, and his wife told him to curse the name of the lord and die. Yet, Job remained strong, and said, “What? shall we receive good at the hand of God, and shall we not receive evil?” The rest of the book of Job is a philosophic discourse on God’s reasons for punishing Job. In the final section Job’s wealth and family are returned to him. God makes a number of speeches that indirectly answer the question of why he allowed Job to be punished. His answer is basically that he is mighty, and his methods are not to be questioned because we cannot understand them. He describes all of his very important jobs in the universe that Job cannot understand, such as controlling the Leviathan and the Behemoth. In my view Genesis, and the old testament are a terrible place to look for stress relief, as god appears fickle in nature, and capricious. In the modern mechanistic world of western medicine, I believe there is more stress relief to be found in truly understanding how the machinery of our immune system works to fight disease, rather than looking for stress relief from a higher being that is little understood, and has been the source of argument for 1000’s of years. People feel the most stress when they are presented with a problem or affliction that they do not understand and thus cannot act to fix. Thus, at a time before the development of modern science, god represented a relief device: an explanation for diseases that could not be understood mechanistically. The patient could then actively work to improve his condition by praying and repenting for his sins.

Personally, I would not put my faith in a god that gambles with the devil, using the lives of his believers as the chips. That sounds considerably more stressful to me. I believe that the stress relief received from religion comes from the community and congregation. The coming together of a group would perhaps be equally good for lowering blood pressure, or increasing mortality. I would like to see studies on the power of friendship.

I also read Genesis 34, about the rape of Dinah; however, I failed to see how it was relevant to the class discussion. It relates the story of Jacob’s daughter, who was strolling across her father’s land, when she was seen by a Canaanite prince, who lusted after her, and raped her. The Prince’s father approached Jacob’s sons, asking for the girl to be bound in marriage with his son. He agreed to pay any price to rectify the wrong, so the brothers demanded that the men from his city all become circumcised. A few days after the circumcision, when all the men were still recovering, two of Jacob’s sons swept through the city, killing every man, and looting all of their wealth. Jacob was angry at them for creating enemies of the Canaanites, however his sons replied, “Should he have treated our sister like a prostitute?”.

I guess retribution is a common theme in both these stories; however, both also contain an exceptional amount of deceit, which is a major stressor. Perhaps the new testament would be a better place to look for stress relief.

As Prof mentioned in class, there are parts of the Bible, particularly in the Old Testament, that portray very different stories and ideas than we normally associate with the Bible. For those of you who haven’t read Genesis 34 I will provide a brief summary. Here is the link if you want to read the full story though:
http://www.biblegateway.com/passage/?search=Genesis+34

Genesis 34 is the story of Dinah and the Shechemites. Dinah, the daughter of Jacob, is raped by Shechem, the son of the Hivite ruler of the region. Shechem falls in love with Dinah, and goes to Jacob and Dinah’s brothers with the hopes of marrying her. Jacob does little to object, but Dinah’s brothers are furious and decide to trick Shechem and avenge their sister. They agree to let Shechem marry Dinah on the condition that Shechem and his father have all of their men circumcised. Two days after all of the men are circumcised and are still recovering, two of Dinah’s brothers attack the city and kill all of the men. They proceed to sack the city and take Dinah away. When Jacob expresses dismay at the brother’s actions and fear of repercussions, the brothers reply “should we have treated our sister like a prostitute?” What is more, in Genesis 35, it is stated that God protects the family from neighboring towns as they flee.

I was initially puzzled by the lesson that this story seems to convey. Rape is clearly condemned by God in this case, but does that mean that massacre and looting are endorsed as acceptable repercussions? This seems to go against many of the other morals in the Bible, most importantly the Ten Commandments which state “though shalt not kill.” In addition, the Old Testament and the New Testament represent God in very different ways. The Old Testament God is vengeful and harsh, while the New Testament God tends to be forgiving and loving towards his people. What accounts for these glaring discrepancies between different parts of the same religious text, and how can they still represent one cohesive set of religious views?

While reading the bible, it is important to keep in mind how the Bible came to exist. The theory of divine authorship asserts that the various books in the Bible were the word of God transmitted through and written by a human prophet. The 39 books chosen to be part of the Torah and Old Testament, and the 27 books chosen to comprise the New Testament are only the 66 most universally accepted books out of many more circulated writings. This full list wasn’t officially set forth until over three hundred years after the death of Christ. Although the list resulted from centuries of religious reflection, it is clear that some books were purposefully chosen and some were deliberately excluded. Whether or not you believe in the idea of divine authorship, this fact alone shows that the Bible may not be as representative of the whole of Christian writings as we often perceive it. It is also important to note the long time span between when the Old Testament and New Testament writings were authored. This could account for the dissimilarities in the portrayal of God in these two sections.

Although faith plays a large role in how you interpret religious writings, I think that evaluating how these writings came to exist is important to consider just as is evaluating your sources in scholarly works.

http://www.biblica.com/en-us/bible/bible-faqs/how-were-the-books-of-the-bible-chosen/

In his lecture on Friday Dr. Chaoul discussed the paradoxical nature of cancer. Faced with a reminder of their own mortality and possible death, cancer patients often find meaning and satisfaction in their lives where before they had none. Many find this meaning in a religious context, but this phenomenon extends beyond the boundaries of just spirituality.

Mechanistically, this could be explained as an adaptive mental adjustment that combats stress and depression that occur after a cancer diagnosis. As Dr. Chaoul and Dr. Cohen discussed, stress and depression have been shown to inhibit immune function and can contribute to the metastasis of cancer. However, this does not explain why so many people find meaning through religion and faith. A vitalistic explanation for this phenomenon could be that perhaps this renewed spirituality is preparing cancer patients for what is to come after death as they near the end of their life in this world.

As a result of this phenomenon, doctors have begun trying to guide cancer patients through steps with which people may find meaning in their lives after diagnosis. I found several articles that describe stories of individuals who have benefited from this meaning-centered therapy. This new form of psychotherapy aims to ease the emotional suffering that many patients experience during traditional chemotherapy and radiation treatments. Unlike other forms of integrative medicine we discussed such as massage, meditation, or acupuncture, this meaning-centered treatment aims to induce a naturally occurring mental adjustment that many patients may eventually reach. By guiding patients through a series of mental reflections and exercises, cancer patients can achieve a greater appreciation for their past, give meaning to their life while living with cancer, and have a greater acceptance of the future.

One article ends on another paradox, “You’d think that once people have found this new meaning in life, they wouldn’t want to let it go. But knowing their life has meaning and that it will continue beyond them seems to lessen that white-knuckle grip on life and give them a sense of peace.” It is with this attitude that doctors hope to help treat the emotional effects of cancer and prepare patients for whatever will come.

http://online.wsj.com/news/articles/SB10001424052970203547904574276434196118914

http://www.mskcc.org/blog/new-form-psychotherapy-might-ease-emotional-suffering-terminally-ill-patients

Muscles, deep dissection. Dissection of the mouth, mandible divided and reflected to show palate and tongue. Male figure, in vivo, anterior view.

http://link.library.utoronto.ca/anatomia/application/digobject.cfm?PlateNum=RBAI003-0014&book_id=RBAI003&plate_id=0014&size=0&query=Muscles.&browsetype=Title&startrow=1

On completing this course students should

• Distinguish between allopathic, traditional, and alternative medicines and be able to state benefits and limitations of each
• Have a basic understanding of the history of medicine
• Understand religious dimensions of various spiritual healing practices and examine how these might influence patients to make medical decisions
• Understand what is meant by an integrative approach to religion, medicine, and healing
• Understand the reasons for the growing importance of humanities training in medical schools and medical environments
• Understand the shift in the philosophical baseline from vitalism to mechanism in The Enlightenment, and the implications of that shift on relationships among religion, medicine and the state.
• Be able to analyze  the tension between mechanism and vitalism as applied to a variety of ideas and narratives.