Biomedicine is in the business of doing ceremonial things unceremoniously. As clinicians, we bear witness to solemn life milestones of patients and families including birth and death. However, we often fail to bear witness to the joy and sorrow that manifests during these events. In keeping our safe, scientific distance, we may become inured to the human need for ritual to mark the passing of any solemn milestone.
In caring for thousands of seriously ill patients, I have yet to meet a family with no rituals. Every family– the deeply religious, the atheist, the agnostic, the non-religious spiritual– all have some type of ritual they practice to honor a life milestone.
Rituals take a wide array of shapes. In fact, most rituals are not really based on religion but can often be a repetitive act that is deeply personal and gives them a sense of control during times of heightened emotion.
I once took care of a wonderful lady named Judy who was often hospitalized due to complications related to breast cancer. Judy would bring a large box of Godiva chocolates to the hospital staff anytime she had a procedure or test and got bad news. That was her ritual. When I asked her about it, she said ” I feel sorry for the doctors because it must be very hard to constantly give bad news to patients like me. I see them squirming, avoiding eye contact, and looking sad when they give me bad news about a test result. I want to take care of you all so you feel appreciated”.
VJ Periyakoil, MD
