The Hand(s) of God

I have recently had the pleasure of participating again in priesthood blessings, an LDS ritual based on New Testament precedent in which believers place olive oil and then their hands on a person’s head before pronouncing a prayerful blessing on the recipient. As I indicated a few years ago, these blessings are a sacred part of my attachment to the LDS Church. These recent experiences, blessings of support in the midst of complex and challenging life circumstances, returned to my mind an episode[1] some years ago in my practice as an ICU physician.

There is a stage in shock (life-threatening impairment of circulation, often related to overwhelming infection) where an individual is dying before your very eyes. Blood pressure is perilously low, heart rate is exceedingly high, the patient is comatose, and every beat of the heart (we call them systoles in our medic-speak, three syllables with the accent on the first) threatens to be the last. These are challenging situations that stretch your capacity as a physician, often late in the night, requiring responses every few minutes if not more frequently. This young man had arrived with a combination of a severe, “double” pneumonia and an accidental aspirin overdose (having heard that tylenol can be fatal in accidental overdose, he had treated his fever and aches with the ancient pain reliever the chemists called acetylsalicylic acid when they bullied it from willow bark and modified it slightly). Every organ system stood in profound disarray, his blood pressure too low to support life despite enormous doses of adrenalin and related compounds that our nurses pushed into his IV catheters. I immediately set to work initiating his life support systems, the sterile plastic tubes that transform the dying individual into a semi-cyborg in the precincts of death. The anatomy of his veins was unusual, so the process took some creativity, while we adjusted the adrenalin infusions on a minute-to-minute basis. As I finished the initiation process, the young man’s wife and parents arrived. I informed them that perhaps 1 in 10 patients survive this degree of illness but that I was fully committed to his possibility of survival. They asked whether they could administer an LDS priesthood blessing to him, and I reflexively told them that I thought theirs was a perfect idea, my mind immersed in juggling the support of the failing organs of this profoundly critically ill patient.

I stepped out of the room, checking laboratory results and arranging for dialysis to begin the process of eliminating acid from his blood (for the cognoscenti, his blood pH was 6.72 when he arrived). As the family left the room, tears in their eyes, I resumed my place at this young man’s side, coordinating with his skilled nurses the administration of the various life support therapies. To my surprise, though he remained profoundly critically ill, his blood pressure had finally reached a level that suggested he just might survive (for the cognoscenti, his mean arterial blood pressure had finally risen from 30mm Hg to 55mm Hg).

I asked his nurse what had happened to change his status, and, among all the other interventions, the nurse told me that she had suddenly suspected that one of the adrenalin infusions (dopamine) had been having an effect on the heart opposite to its intended effect, so she had stopped the infusion. She is no particular friend of Mormonism or religion in general–she finds religious types silly and stifling. And she is a highly skilled critical care nurse with years of experience. As I inspected the ultrasound of this young man’s heart, I could see that the nurse had been right, that under the influence of that particular agent, combined with the fluid loss that occurs in the most severely infected patients, the heart was having difficulty expelling blood smoothly. This nurse’s careful attention (her inspiration?) I believed had made a crucial difference. Of course, we all continued at his bedside from midnight to 5am regardless, slowly making ground as the life support therapies allowed his body to begin to stabilize itself.

Over the course of the next 15 days, this young man slowly awakened and was liberated from life support therapies. Eight days after this liberation, he made it home to his wife and family to finish his convalescence. He returned to work several months later.

I wonder how best to interpret this experience. For his family, a beloved husband/son had returned from the dismal antechambers of premature death after a priesthood blessing. For me, this case was a reminder that having an experienced critical care nurse at your side is a priceless blessing, that sometimes we do not see everything ourselves, that less is sometimes more, that in rare cases the adrenalin infusions we administer to save lives can work against us. I also remember that as desperately as we want to know, we cannot reliably predict the future. Our entemporalment limits our views; the fact that we experience time linearly is a necessary element of our mortality.

In the interests of time and space, I will not belabor the point, but I am interested in how people propose we should navigate the often uncertain realms of divine Providence, the answers to prayers, the miraculous efficacy of priesthood blessings, and the complex tapestry of our relationships to God and to each other. If we can explain a mechanism, is an event no longer miraculous? Is miraculousness a reflection of the perspective of the observer, and if so, does that matter? Can such a perspective further a relationship with God, independent of whether God is perceived to deliver what is requested through prayer or blessing? Though the insightful nurse at the bedside would laugh (goodnaturedly) at the thought that her work had come as a result of a priesthood blessing, I am inclined to let that reading stand, to see in her commitment to a life-saving discipline, in her desire to excel, in her well-honed instincts, the marks of God’s hands.

———-
Happy March Fast Day

[1] As always, I have anonymized the episode to protect patient confidentiality. The fundamental observation that a non-religious nurse made an important change in therapy immediately after a priesthood blessing is true.
[2] I use “adrenalin” to refer to what physicians call “vasoactive medications,” or “vasopressors” and “inotropes” for simplicity. This young man was receiving norepinephrine, dopamine, phenylephrine, and vasopressin when he arrived in my ICU.

Comments

  1. Sam,
    I think your point here gets to the heart of what faith means. Although faith can be a catalyst to action, it is more a decision regarding how to view the world around us. I tend to agree with the idea that understanding makes miracles more miraculous, not less.

  2. I enjoyed starting fast Sunday by reading this faith filled post.

  3. Naismith says:

    Nice that the nurse didn’t get fired for failing to follow the doctor’s written orders.

  4. Naismith, when people are this sick everybody’s often just pitching in side by side. Physician is the final authority, but nurses are often and appropriately participating in this kind of active way. Many people have been saved by the competent involvement of an ICU nurse. (And the nurse did notify me promptly of the change; there was no hint of insubordination, just the collegial nature of care for people who are this sick.)
    John C, as I think you know I tend to view miracles and other religious phenomena relationally, in terms of the relationships they build and expand with God and others. I think this story exemplifies this approach to miracles.

  5. Really nice post

  6. Sam, these sorts of “edge of coincidence” experiences are important to our faith and perception of life. A great story.

  7. Dave P. says:

    Experiences with the priesthood are one of my remaining strong connections with the church today too, being on both the blessing and receiving side I’ve seen and had too much happen to be able to deny it. The greatest example being healing a little girl from her illness while on my mission. What made it have such an impact? She did not speak a word of English yet that is what my companion and I gave the anointing and blessing in.

  8. Proud Daughter of Eve says:

    Not all miracles are the old-fashioned “they laid their hands on her head and shazaam!” Sometimes the miracle is the knowledge, skills and equipment being available. My daughter spend three days at Sick Kid’s hospital last fall with Kawasaki’s Disease. I live in Ontario where we have universal health care in addition to first-world medicine. Does that make her recovery any less miraculous? Not to me. My four-month old could not nurse and had thrown up even the little I’d been able to get into her. My happy, smiley baby was crying constantly and miserably. She could not sleep. She had a reaction to the medicine and had three or four nurses working on her at one point. We expected to be there for a week at least. After only a few days she was given a clean bill of health and today is once again the smiliest baby on the planet.

    Priesthood blessing, skilled medical care… it’s all a miracle.

  9. I am also an ICU nurse. This kind of miracle happens constantly. Nurses call it “Nurse’s Intuition.” Before I became a nurse, I just assumed that meant that an experienced nurse can just sense things because they have all that education and have seen things so many times before. And that’s definitely a part of it. But I was astonished by how overwhelming the spiritual prompting became as I actually started working. If I felt like something was wrong and I needed to go check on something or adjust something, I learned very quickly not to ignore that because it often meant the difference between life and death on these critical patients. I will never forget the time I ignored a strong feeling to go into my patient’s room and check on her. I was in the middle of something with another patient that really needed my attention, so I stuck my head into her room quickly, saw that she was fine, and went back to what I had been doing. If I had actually gone into her room, I could have seen that all was not well. Next thing you know, alarms are going off and doctors and nurses are running into her room. Everything turned out okay, but she could have died. And if I had just listened to that prompting, I could have fixed what was wrong in about two seconds and it would have been fine.

    I have talked to other nurses about this, and they all have had very similar experiences. A lot of it is experience and smarts and just being darn good nurses. But there is definitely something more. I have also pondered sometimes, ‘Why did I get this prompting to do something, and it may have kept this patient alive, but then s/he died a week later anyway because s/he was just really old and sick and it was time to move on anyway?’ I don’t understand it at all.

    My experiences have totally changed my perspective from “God is hands-off and lets life progress on its own” to “holy smokes, we are being followed around by dozens of angels.” :) But then again, is it just that the environment in the ICU causes us to constantly be questioning ourselves and double checking because if I make a mistake, someone dies? Is it this pressure plus my education and experiences that creates that intuition? I have never had a Mormon patient or even a Mormon coworker so I don’t know what difference priesthood blessings can make. Chaplain prayers are pretty powerful though.

  10. Caring for the ill and infirm can be a profoundly spiritual experience (and just for the record, it can be also be profoundly frustrating!) My professional experience (RN in ambulatory care) has been spent with the chronically ill. On many occasions, I have received promptings regarding my patient’s and their care. I have come away from these experiences with a deepened understanding of the Lord’s love and mercy toward all of his children, and of His involvement and care for even the mundane aspects of our lives.

    My best explanation – When you are in the service of your fellow beings, the Lord magnifies your abilities.

  11. Stephanie says:

    Great post. I, too, prefer to see God’s hand in the miracle.

  12. Andrea R. says:

    This was a beautiful post, thank you so much for sharing it.

    Jenna, I love nurses like you. I have spent a lot of time in the NICU, PICU, and PCU, and I know the difference. Not all nurses have that kind of intuition, and being Mormon has nothing to do with it. You are angels being followed by angels.

  13. KerbearRN says:

    As a former L&D nurse, and now especially as a NICU nurse, I am convinced that Jesus walks the halls of hospitals. I have seen many miracles, some of care or technology, others simply unexplainable. They are all miracles. I have learned that medical science, with it’s finite perspective, does not limit the infinite power of God (and of His earthly arm, the Priesthood). And I have seen the great and Godly inspiration given to those who have taken on the mantle of caregiver– doctors, nurses, RTs, pharmacists, et al. In seeing this, I am profoundly touched and humbled by the tender mercy of our Heavenly Father, working through imperfect vessels. It’s has been one of the great joys of my life to be, in the words of St. Faustina, “the hands of Jesus”.

  14. The prophecy of Joel 2 came to mind as I read this post…

  15. Many experienced psychotherapists, religious or not, recognize what is sometimes called the “Third Force.” Mormons call it the Holy Ghost. The feeling is unmistakable when this force enters the room. The interchange between client and therapist becomes a communication through the Spirit with all its attendant power and efficacy.

  16. Jared T. says:

    Thank you, Sam.

  17. I have a surgeon friend who claims he can tell when a patient has had a priesthood blessing. He says he does better, inspired work.

  18. I really enjoyed this post for a number of reasons. One that might be of lesser significance is that it points out that there are at least a couple of very different definitions of “miracle” that we can choose from. I typically think of a miracle as an act of act of God that is beyond our collective ability to explain. For example, Lazarus was dead but then he wasn’t. That makes for an evolving category of what qualifies as miraculous, since our collective understanding evolves over time. This post might be suggesting a different (and absolute) definition, which is that a miracle is any act of God, whether it’s raising the dead or just speaking to someone. Faith is required to acknowledge the hand of God at either end of the spectrum, but are the miracles a subclass of what He does? I suppose this is an arbitrary semantic choice rather than a theological distinction, but I’m still interested in how people choose to interpret…

  19. I’ve felt myself to be guided, too, many times, particularly after a prayer or blessings. It’s subtle. There’s always another possible explanation for nonbelievers-in-miracles to find. It’s always possible that it’s simply a coincidence. There’s often someone besides God who did their part, too, some skilled, intuitive someone like your ICU nurse. But it’s there just the same, that touch of something outside ourselves that gives us aid, that blesses. I’ve seen it happen to me many times, particularly in my role as a mother.

  20. The Bishops Desk says:

    John 2:1-11. This is the synopsis of the New Testament, given by Mary, the Mother of Jesus, before He began His ministrry. You, LDS Priesthood holders or not, if you would see the miracle, ‘whatsoever He saith unto you, do it.’ But, do it with faith, with real intent, and watch the miracle. In the verses mentioned above, the ‘servants’, by being obedient to the words of the savior, were the only ones present besides Mary, who realized that a miracle had happened.

  21. John Mansfield says:

    People acting as agents for God, even miraculously, is part of the belief of believers, and we are very blessed to be participative in His work. And yet, when I hear “you are the hands of God,” part of my mind remembers Joash defending his son Gideon against those who didn’t like Gideon’s nighttime destruction. God has hands of his own.

  22. A long time ago the 10 year old son of a military orthopedic surgeon broke his knee while riding a bike. The radiologist saw an omnious mass at the fracture site suggesting a malignancy. A Priesthood blessing given by the father before an operation included the promise that the boy would get better and serve a mission and eventually marry in the temple if he lived worthy of it. Since they resided over seas on a miliatry base with limited medical care, the father did the surgery to repair the fracture and based on the blessing he assumed the mass was a benign common bone cyst.

    The suspicious cyst was sent to the AFIP in Washington DC and proved to be a malignant tumor. The proper surgery at that time would have been amputation of the leg to save the boy’s life followed by chemotherapy preferrably at a major medical center in the states. But the corrective surgery coupled with the time lapsed allowed the malignancy to spread and the boy died a few weeks later.

    The father who told me this story never forgave himself. I think the risk is real for devote LDS people to defer or ignore competent medical advice that contradicts a Priesthood blessing expressing wishful thinking.

  23. Mike, assuming something medical and ignoring possibilities is very different than the point of the post. Your point absolutely is valid and important to understand, but it points to someone making assumptions and ignoring proper medical diagnosis – when the blessing itself, based on your description, sounds like it was spot-on if proper treatment had been administered. The blessing doesn’t sound like wishful thinking in the case described; it was the father’s assumption that was wishful thinking.

    That’s an important distinction – even though your point really is important to understand.

  24. My limited experience with cases like this, and with blessings in general, is that God will do just enough to achieve the desired outcome. In this case (probably) a gentle nudge to a nurse to remember something she had previously known and the will to go ahead and try it. In some cases it may require much, much more. We may want to define a “miracle” as only the latter, but it’s all the same to me.

  25. Lovely post, Sam.

    As your title alludes, Mormons are enjoined to take a Providential world-view, in all situations. This is in tension with Mormonism’s claims of spiritual gifts, supplication and blessings. My feelings are that in practice, JS worked as if providence were not evident until the negotiation was over.

  26. J., aren’t spiritual gifts, supplication and blessings manifestations of Providence? I don’t understand what you mean by them being in tension with the Providential world-view.

  27. Mike, the other thing to bear in mind is that our “providential” readings can also be misleading in retrospect. From your description of the case, the boy would likely have died even with early amputation (the devil is always in the details, though, and it is possible that the account you describe is an accurate description of the counterfactual case). The enormous grief and guilt may have caused the father to second guess himself at great length.

    I do agree with your general point that abdicating common sense in the face of a blessing may not be the best thing; it may not even be what God desired.

    I agree with J as well.

  28. john f., the traditional Providential world-view is that God’s hand is indeed manifested in all things. So, for example, if your child gets sick and dies, that was the will of the Lord. In Mormonism, there is the idea that people can intervene into this system through faith and power and rebuke a sickness and forestall death. In such a case does God want the child to die or to be healed? If the child isn’t healed, was it due to lack of faith or lack of power or Providence? Typically, Providence would be independent of our volition. In JS this dynamic plays out repeatedly, and interestingly.

  29. Last paragraph I agree with your conclusions.

    This is a compelling story. I suggest it be published elsewhere.

  30. Sam, a powerful insight and I continue to appreciate the nuances that your mind draws out while contemplating the relationship man has with his Father and God. Causes me to miss the old Elders Quorum and hallway discussions in the LFP Ward.

    J. Stapley, I agree with you that there is a tension at work between man’s faith and Providence but I question whether it is man frustrating God’s intent for the individual rather than being worthy and demonstrating sufficient faith to call down additional blessings.

    I want to tread cautiously here though because I do not believe that man is able to call down what God does not already intend to provide. Further, I believe that God is merciful and will not take an individual before their time or His purposes are fulfilled. The two may not be one and the same though.

    And so if a child dies in spite of a blessing that might say otherwise, I would say it is most likely that he who gave the blessing was not in tune with Spirit and the Lord’s intent. Elder Oaks addressed this question in his General Conference talk last year where he stated first that faith is an essential and often underestimated requirement for healing. Quoting President Kimball he explains that faith of the individual being blessed and that of their family is more important than that of the individual administering the blessing. “Thy faith hath made thee whole.”

    Elder Oaks continues by explaining that it is not the words of the blessing, such as for instance the father claiming his son would be healed, but instead the anointing, sealing, faith and the will of the Lord that are the critical parts of the blessing. As he says, “If faith is sufficient and if the Lord wills it, the afflicted person will be healed or blessed whether the officiator speaks those words or not.” But he also very pointedly expanded on D&C 42:48 in stating that our faith and prayers and blessings cannot produce a result contrary to God’s will.

    This has been my experience as a priesthood holder called upon to bless someone in a time of desperate need. Sometimes the words flow because I am strongly connected through the Spirit to the will of the Lord. Other times I walk away dissatisfied with the words of the blessing and not certain of what I have stated but filled with a desire to pray in faith that the Lord’s will be fulfilled.

    My wife has often asked me, why did God take our first pregnancy, why could our faith and prayers have not made the outcome different? He could have healed the fetus who was suffering from Trisomy 13. After 10 years of searching with that question, I have come to the conclusion that it was God’s will and I am comfortable that the blessing and inspirations we received at the time were in tune with God’s will on that matter.

    And in closing comment to Sam’s last paragraph, I think it is too easy to look and say, “Here’s an explanation that shows it was a human hand or intellect that saved this individual’s life.” Yes that may be the case, but does God not call us to act as servants for Him? Why is it not possible for Him to make use of the tools available to solve a problem rather than applying some divine power that is unexplainable? I think we look beyond the mark if we believe miracles require mystical measures.

  31. Alain, I think this is where it is difficult for Mormons to talk about Providence. I is hard to recognize the hand of the Lord in all things if you think God is ambivalent on things that seem so important. It is also easy to see why traditional Christians were so married to cessationism and viewed such activities by Mormons pejoratively (e.g., magic). It is helpful to read Oaks as a negotiation within the Providential world-view and not necessary a statement on the beliefs of early Mormons.

  32. Alain and J, in my Mormon Scholars Testify entry I try to open up space for another approach to Providentialism, one that is more about relationships with God and others than it is about deconstructing any particular occurrence.
    Alain, I sometimes feel quite nostalgic for LPW, and I am sad to hear of your bereavement and its proximate cause. God bless.

  33. I agree, Sam. That is a helpful view.

  34. “If we can explain a mechanism, is an event no longer miraculous?”
    I would say yes and no, depending on the miracle. For example, if we were to understand the how of Christ walking on water I would say in a way it is no longer miraculous, if only in that I understood how it was being done- since a component of miracles like this seems to be that we do not perceive how they’re done. What to us seems impossible is suddenly possible.
    For something like modern medicine and medical techniques, I would say that they are miraculous in a way. Of course, we understand how these things work (ha, well, with medical technology at least some of us understand), but we only understand and possess them because God brought them to us. In other words, God inspires mankind and shows them truth (although I believe seeking out the truth is key here). Every good things comes from God, so to an extent I believe we can consider the advent of modern advances miraculous, in that their being brought to light was done by our Creator.

    “Is miraculousness a reflection of the perspective of the observer?”
    If we were to include God among the observers, then the answer is a resounding yes.

    “Can such a perspective further a relationship with God, independent of whether God is perceived to deliver what is requested through prayer or blessing?”

    I think the important thing to keep in mind with all things good that come to us, miracles or not (whether they appear miraculous or not) is that we remember to express gratitude to God for these blessings. The hand of the Lord is definitely in every good thing we receive (although sometimes the good may not be immediately recognizable), and it’s important to recognize that in sincere prayer. That will be one powerful relationship strengthener in your communications with Heavenly Father when it comes to these miraculous sorts of blessings, among other things, more so than acknowledging whether or not something is miraculous, which hasn’t seemed that important in the grand scheme of things to me (which is not to say that this thread is frivolous, that’s not what I mean at all). I just think its importance does not rival the importance of expressing real gratitude for these sorts of things, acknowledging that they’re from God. After all, when Christ asked about the lepers He had healed, He wasn’t concerned about whether or not they considered His healings miraculous, but was concerned about whether or not they were grateful with the incredibly precious gift of a life extension they had received from their God.

  35. Great post. I am certain a miracle is from the perspective of the observer. While I would say the scenario you shared has the hand of God in it—or rather I would call it a miracle—I recognize it has a scientific explanation. I believe ultimately everything has a scientific explanation, even if we don’t understand that explanation yet. Faith is always a choice, attributing good to God, or attributing the improbable to God is always a choice. Mostly, I think with all the scientific knowledge we have now miracles have become called such based on probability rather than scientific understanding. I think either way it can further our relationship with God. It’s all a matter or framing, and reframing what part(s) of the event was miraculous. Was it the nurse being prompted? Was it that such a knowledgeable nurse was working that night? Was it other experiences the nurse had that led up to this moment?

  36. waterspout says:

    “You need not, unless you choose, believe in a causal connection between the prayers and the recovery.
    The question then arises, ‘What sort of evidence would prove the efficacy of prayer?’ The thing we pray for may happen, but how can you ever know it was not going to
    happen anyway? Even if the thing were indisputably miraculous it would not follow that the miracle had occurred because of your prayers. The answer surely is that a compulsive empirical Proof such as we have in the sciences can never be attained.” (C.S. Lewis, The Efficacy of Prayer)

    Lewis’s essay is a great read to complement this post.

    Thank you for the post Sam MB.

  37. Great post Sam.

    It got me thinking about a memorable mission experience I had in Peru. My first area was a little sleepy fishing village on the northern coast the country. The branch had three active priesthood holders, five if you count the missionaries.

    The Elder’s quorums president, Hno. Medina invited us over one morning because he had a special request. I remember sitting in his humble, yet clean and organized living room where I noticed he had several bags packed in the corner. Trying to hold back the tears, he told us he was going to Lima because his most recent visit to the doctor revealed cancer in the lungs. He asked us to give him a blessing. My senior companion said he would anoint I would give the blessing. I remember being extremely nervous. In the blessing I said he would be healed of any sickness and that he would return home to his family and lead a long and happy life. It was a very spiritual (emotional) moment and everyone present was crying. We hugged and said goodbye.

    A week later, he called and invited us to his home. As we entered his home, he practically jump into our arms and hugged us with such enthusiasm and joy. After he gathered himself he said that a miracle had occurred. His x-rays that had previously showed cancerous spots had disappeared. He was given a clean bill of health and sent home. A miracle had occurred. I have to admit, I was felt humbled and blessed to have taken part in such event.

    I have seldom recounted that experience because I felt it was too sacred to share and I didn’t want to come across as one who had anything to do with the miracle itself. In my mind, it was brother Medina’s faith and the power of God who did all the heavy lifting.

    How do I view this experience today, now that I doubt that god even exist?

    I now tend to believe the following possibilities:

    He never had cancer. He was misdiagnosed by an incompetent doctor or they mix up his x-rays with someone who had cancer. Mix ups occur all the time in hospitals. If babies get switched around accidentaly, why not X-rays?

    Or;

    He had cancer. The first doctor was right in is diagnosis, but the second doctor was incompetent and failed to confirm the proper diagnosis. His cancer ridden x-rays could have been mixed up with the X-ray of a healthy patient. The cancer may have spread 2-3 years later and he died. I don’t know.

    The third option would be, if you believe in an interventionist God, that he was healed of his cancer in a miraculous manner.

    If a miracle occurs, God gets all the credit. However, if no miracle occurs, He get none of the blame. We dutifully chalk it up to “it was His will, they have a another mission to complete in spirit world, or they lacked sufficient faith.

    I tend to believe priesthood blessings have a placebo effect on the person receiving blessing and to a certain extent, the person giving the blessing. If the desired outcome occurs, faith and belief are further galvanized. If the desired outcome does not occur, it is viewed as test of one’s faith or not God’s will.

    I choose to place my trust in medical professionals, however competent or incompetent they may be, and leave it to others to pray for miracles.

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