A framed print hangs prominently in Dr. John Torquato's waiting room. It depicts another waiting room — far grander, it has to be said, than the one at the Family Medical Care walk-in clinic in a Spokane Valley Rosauers. A family is seated on a couch. The father, sleeves rolled up on his Oxford shirt, places a reassuring hand on his wife's elbow; she holds their sleeping young son. To their left sits a doctor, a white lab coat over her floral dress, a stethoscope around her neck. Though hers are the only hands that are folded, all the adults have their heads bent in prayer.
Above them, eyes also shut, stands Jesus Christ. His arms are extended in a downward embrace to form the visually satisfying triangular composition found throughout classical painting. It is, moreover, a gesture of comfort and of grace.
The print might not be to everyone's taste, aesthetic or theological, but it invites several questions. What place does faith have in the doctor's office? In what ways do we deify doctors? Is there a greater need for spirituality when our physical selves are most vulnerable, or even a need to address spirituality at all? And for physicians, how does their private faith inform their medical practice?
Dr. Torquato has clearly been contemplating these questions for most of his 51 years, first as a registered nurse in California and later as a physician in Florida and Idaho. In conversation he has the rehearsed, rhetorical flair of an infomercial presenter or self-help guru. Every sentence is assured and cadenced. Every idea flows systematically toward a logical, inevitable conclusion.
Much like Jesus, he prefers to speak in parables, starting with an account of his own father's medical nightmare. A sudden heart attack. A defibrillator — two times, once while fully conscious. A frantic ambulance trip to a bigger facility. A finger-sized catheter in his groin. "People running around in spacesuits while he's naked." Then films of his salvaged arteries. Doctors' stern warnings about his smoking: "Quit or you will die."
The grim punch line? On leaving the hospital, Torquato's father turned to him and said, "I think I need a cigarette."
Torquato momentarily goes silent as he waits for the point to hit home. Where, he continues, is the self-preservation instinct? It's not as if the desire isn't there. He estimates that 95 percent of the 1,000 smokers he sees every year would like to quit, but can't.
There's no shortage of anecdotal examples. The anxious woman who's unwilling to forego one of her 20 cups of coffee per day. The man in his late twenties, roughly 150 pounds overweight, who despite suffering from life-threatening hypertension, high cholesterol and obesity, stubbornly refuses to change his diet.
"He's got this disease that's going to kill him. He knows what to do. But he can't fix it because something about him has kept him from it. Now, what is it?" Torquato says.
To answer that, Torquato compares his training as a registered nurse to medical school. "In nursing, they taught us the four areas of wholeness: physical, mental and emotional, spiritual, and social. In medicine, I got physical and maybe sometimes mental/emotional." The medical profession's wider reluctance to deal with the social, and above all the spiritual, is in his opinion a glaring deficiency. Not only is it at odds with its own teaching, it ignores patients' yearning for more holistic care, as measured by oft-quoted Pew polls and research surveys.
"The data out there show that the majority of Americans believe in a god," he says. "It might not be the same god, but they believe in a god. The majority of Americans pray. The last figure I saw was 75 to 80 percent. Almost 50 percent of Americans pray daily. At least 25 percent want their physician to talk to them about their spiritual lives. And the data show that the people who are tending to their spiritual life live longer."
Where applicable, his preferred treatment is to find physical cures by tapping into the metaphysical. This kind of approach is commonly employed in the first three steps of putatively spiritual 12-step programs like Alcoholics Anonymous: an admission of powerlessness over an addiction, a discovery of a positive power outside of oneself, and a deliberate self-subordination to that power.
Torquato welcomes the comparison. He says he's seen the results of such an approach firsthand, even among the most abject cases at the clinic he works for in Hayden, Idaho.
"I've had people with blood sugar in the 300s down to normal (about 100). Four months. No drugs. How can they have the power to change their lifestyle? Where would they find the strength to continue that? From the kind of supportive environment that comes from a person who's spiritual by themselves. If you leave out the spiritual, I can change your diabetes, and I can change it in four months, but you'll never keep it if you don't have a spiritual foundation."
He says this concept highlights that spirituality isn't at odds with science or medicine, but rather that spirituality is at odds with the convenience we expect of science and medicine. That goes for patient as well as practitioner.
"As a physician, I want to take care of you, but the faster I can get you out of my room, the faster I can take someone else and bill them. It's very unfair, and it fails — outright fails! — when it comes to chronic, lifestyle-related illness. We can put people on drug after drug, and all we've done is made them think that's the way back to normal. Now I've got 14 drugs, and I'm going to take them for the rest of my life with all the side effects they cause, rather than changing my diet, exercising, finding a way to interact. They require time and a purpose bigger than a prescription."
In line with the tenets of his Seventh Day Adventist faith, Torquato shuns compartmentalization. For him, considering the whole, though dauntingly complex, is the only proper way for a physician to diagnose and treat illness.
He readily concedes that atheists and agnostics might balk at the particulars. Some patients have been staunchly opposed to his suggestions and walked out. He bears them no ill will and often tries to help them find a doctor more suited to their needs.
"I don't care who you are," he says. "If you're suffering, God wants you to be well."
Unlike Dr. Torquato, Dr. Jared Wyrick's religious leanings are not conspicuous. There are no Creationist coloring books in his waiting room, no pictures of horses underscored by quotes from Isaiah. On the wall of his tiny corner office in the Rockwood Heart and Vascular Center at Northpointe is a black-and-white photo of sunlight beaming through trees. Behind him are his children's drawings of Gumby and a fisherman. Little here proclaims that he's a self-professed "devout Christian, born and raised" who does not take his faith lightly. "I try to say it is my life."
Wyrick, 36, is also less polished in his speech. When discussing his faith and its influence on his practice, his sentences are unruly concatenations of clauses: a preface, then a statement, followed by qualifications, loopbacks, asides, caveats, revisions. He frequently disrupts a thought to identify himself as being "flawed," a "sinner" and a "meager human." Before quoting Scripture, he warns that he might flub it; afterward, he routinely apologizes. "I'm not trying to preach at you."
The hesitancy might seem unusual, even undesirable, in a cardiologist. We tend to look to doctors, and highly trained specialists like Wyrick in particular, to be unflappable monuments of confidence, since our well-being depends on the precision of their diagnosis and their recommended course of action. The slightest hint of doubt opens the possibility of error, and error is not easy to forgive when lives are at stake.
Yet confidence doesn't equate to infallibility. Nancy G. Brinker, who founded Susan G. Komen for the Cure in honor of her late sister's struggle with breast cancer, has written publicly of their tragically misplaced trust in physicians who brimmed with self-confidence. In Wyrick's case, what seems like self-doubt is something closer to humility, a key component of his religious faith.
"It's an awkward topic to talk about, humility. As soon as you say you're there, you're not. What's the old joke? 'I'm the humblest person in the world,'" he chuckles. "One of my jokes is that God calls it heartburn to confuse and humble cardiologists."
Without a pause, he adds, "That usually draws a laugh."
For Wyrick, the Biblical reminders of his own shortcomings are what keep him on his toes. "C.S. Lewis always said that pride is the worst sin, because you can track every other sin to that. I am someone who's just used by the Lord," he says. "I realize that I am flawed, and that gets back to what makes me, I hope, a little better doctor — and I don't mean that in a bragging way. My accountability to God is something maybe patients don't notice, though I do hope they notice the fruits of it."
As a heart specialist, Wyrick frequently conducts end-of-life counseling. He says that his Christian views on death — namely, that eternal life in Heaven follows this one on Earth — often provide comfort to patients, though he's careful not to foist his religious beliefs on those who wouldn't welcome them.
Nor should his beliefs suggest that he looks upon death with any kind of perverse joy. When Wyrick recalls his own mother's death from cancer two years ago, there's every indication that the emotional sting is still fresh, regardless of the unflagging strength of his convictions.
"Death is a huge thing. Boy, as I found out on March 22, 2012, it's very painful to lose someone. I've dedicated my life to physical medicine, and obviously my goal is to help people live as long as possible. I take that very seriously." Despite his concept of this physical life as being distinct from an afterlife, Wyrick doesn't view religion and medicine as mutually exclusive. Quite the opposite.
"I see science as being propped up by Christianity and such," he says. "I look at things and see the beauty of design and artistry. I don't want to digress or get into arguments I'm not smart enough to win, but I see, for example, the beauty of the human heart. As a Christian, I see the Lord as the great physician. And I try to take my patients as a whole person."
At the University of Chicago, a whole program has formed around this recurring idea of the "whole person" and the overlapping aspects of medicine and religion that are a part of Torquato's and Wyrick's daily medical practices.
"Our society tends to sometimes look very pragmatically and reductionistically and instrumentally at many things, including ourselves, and we can run into problems when we think there is a technological solution for everything in human experience," says Dr. Dan Sulmasy, who directs the university's Program on Medicine and Religion. "When someone is having trouble sleeping, we're immediately thinking it might be insomnia and that it can be addressed by a pill, rather than the fact that they might be having trouble in their relationships."
"I've described in my own literature a bio-psychosocial-spiritual model of medicine," he says, echoing Torquato's emphasis on the four pillars of his nursing training. "We've done a poor job of integrating the 'psycho' and the 'social' into medicine, and we've done an even poorer job of integrating the spiritual. People are not simply their bodies, and when they're ill, it's a spiritual event that shakes them by the soul. Healing in a deeper sense is more than just fixing their heart rhythm."
This enlightenment, so to speak, goes in the other direction too. "People are beginning to recognize that physicians are not just scientists. They are spiritual beings who have pledged to help other spiritual beings who are sick. For that reason, physicians must also cultivate a spiritual life," Sulmasy says. "More medical schools are teaching this, and there's more literature on this subject."
What Sulmasy terms a newfound "groundswell of interest" in spirituality within the medical profession makes physicians like Torquato and Wyrick appear positively cutting-edge. Their age-old religious beliefs, far from casting them in an atavistic light, are re-emerging as a means of addressing the shortcomings of modern medicine.
"To heal a person, one must first be a person," Sulmasy says, quoting the Jewish philosopher Abraham Heschel. "I think patients and physicians are both beginning to recognize that."♦