Spirituality and Health: Interview with C. Everett Koop

Printed 2002: C.July 1998- Everett Koop, a pediatric surgeon with an international reputation in public health, is best known for his service as Surgeon General of the United States from 1981-1989. Dr. Koop elevated the position to one of considerable public policy influence and was awarded the Presidential Medal of Freedom in 1995 for his efforts. In a medical career that has spanned many decades, Dr. Koop established pediatric surgery as a surgical specialty and performed thousands of operations for children. The author of more than 230 articles and books, he has received dozens of honorary doctorates. Dr. Koop continues to educate the public about health issues, and serves as senior scholar of the C. Everett Koop Institute at Dartmouth College, Hanover, NH, USA.

Dr. Koop recently spoke about the issue of spirituality in medicine with Dan Kauffman, an editor on the National Institute for Healthcare Research newsletter staff. We are pleased to have this work shared with Science & Spirit readers.

Q. Can you give us a historical perspective on the relationship between spirituality and medicine?

A. In my lifetime, I've seen medicine's attitude toward spirituality come full circle. When I first went into medicine – which was 60 years ago – the understanding that we had as young physicians was that the really artful physician would use anything that was part of the patient's armamentarium to help that patient come through any kind of a crisis, and move toward healing. So, if faith was one of those things, you used it. Then, by the late 1950's and 1960's, it became absolutely taboo in hospital practice to even talk about faith because there was a backlash of people saying these doctors and nurses are just proselytizing patients to their way of belief. What is happening now, however, is that mind-body medicine is so much in the public eye and having so much attention paid to it by physicians, that it has welcomed back the spirituality, faith, and prayer principle once again.

Q. How important is the faith of the patient in medical care?

A. I think the faith of the patient is a very important factor in medical care because people of faith have several attitudes that people without faith do not. One is that they tend to believe in the sovereignty of God, so that whatever happens to them is part of God's plan for them. Secondly, most people who claim to be deeply spiritual have great faith in a life hereafter. When they face a tough problem like open-heart surgery or brain surgery, they enter it with a much different approach and with greater peace of mind than the person who doesn't have anything else to lean on. I think that all of these things are beneficial to patients and the smart doctor uses them when he can.

Q. Have you incorporated faith into your medical practice?

A. During World War II there was a saying among the troops that there were no atheists in foxholes. I used to say there were no atheists among the parents of my dying children. So, when we had a really sick kid and I had to do major surgery on him, I would frequently say to the parents: "I want you to know that if I thought I was the only person responsible for your child's recovery, I would not dare go into that operating room. I do believe that there is a God which orders our lives, and I just want you to know that I am acting as his steward on this occasion." It's amazing how many people would come back later and say, "You know, when you said that the day before the operation, we lost all our fear of surgery." I think patients in distress really like to know that their physician isn't just a materialist. That I wasn't relying on technical ability alone was a source of comfort to them.

Q. Are religious people healthier?

A. I think in many ways they are healthier, because there are many religious people who consider that the stewardship of their body is important. I was interviewed about the Oxman Study from Dartmouth by the religion editor for the American Broadcasting Corporation (ABC) Evening News program. I made the point that this study demonstrated in a very clear-cut manner that all the patients who died on the operating table were in the group which said they had no spirituality at all. The patients who said they were very spiritual were in the group that had the best outcomes at six months and one year later. But it is important not to get into the place where research tries to prove faith, because faith is the evidence of things not seen. There is a point beyond which you cannot go in proving faith and proving prayer. You have to remember that both are very personal things, and whether it is divine intervention or whether it is mind-body medicine that gets you better, you will never really be sure.

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