What Happens When a Neurosurgeon Needs a Neurosurgeon?

Acoustic Neuromas

Dr. Michael Sisti, Dr. Nasser’s neurosurgeon

When Brazilian neurosurgeon Jose Nasser felt numbness on one side of his face, he hoped it was a minor nerve problem and that it would go away quickly. But he decided to have an MRI done just in case.

The MRI showed that Dr. Nasser had an acoustic neuroma, a tumor that grows near the nerves that handle hearing, balance and facial sensation. And it was large enough that he would need surgery.

As a neurosurgeon, Dr. Nasser was intimately familiar with how serious this tumor could be—and with the risks of surgery to remove it.

Fortunately Dr. Nasser has a friend who happens to be an expert on acoustic neuromasDr. Michael Sisti from the Brain Tumor and Gamma Knife Centers here at Columbia University Medical Center/NewYork-Presbyterian Hospital.

Dr. Sisti and Dr. Nasser met when Dr. Nasser came to Columbia to complete a neurosurgical fellowship. They became close friends. Over time Dr. Sisti came to consider Dr. Nasser part of his extended family, even visiting Dr. Nasser and his family at their home in Brazil.

When Dr. Sisti heard about the tumor he immediately arranged for Dr. Nasser to come to New York for treatment. It was an experience that would profoundly affect both doctors. Dr. Nasser published a memoir about the surgery called The Bridge, and both he and Dr. Sisti shared their story with MedPage Today.

Dr. Sisti told MedPage Today that he was “floored” when he heard about his friend’s tumor. An acoustic neuroma is a rare tumor, “so how likely is it that someone who is a neurosurgeon gets one of these? And how likely is it that you know that neurosurgeon and that his tumor happens to fall in your area of expertise?”

Dr. Sisti said that this type of tumor is treatable, but one risk of surgery is damage to the area of the brain that controls fine motor coordination. Dr. Nasser ran the risk of never being able to practice neurosurgery again.

“Any problem with the surgery would be a huge personal loss, and a professional loss for his country,” Dr. Sisti said.

Not only that, but Dr. Sisti found it challenging to operate on someone he knew. “You care about every patient, of course,” he said. “But it’s particularly intense when you’re that close to someone.”

The operation was successful, and Dr. Nasser has returned to practice in Brazil, now with a new outlook on practicing neurosurgery. “As a doctor, you have one side of the story,” he said. “Having both sides of the story makes all the difference. Now, I practice with love. It’s real, and it matters.”

Dr. Nasser has given permission to share his story, and you can read more about it here.

Learn more about Dr. Sisti at his bio page here.

Posted on Nov 10, 2016 by Department Author
In Acoustic Neuroma, Blog, Brain Tumor Blog, Gamma Knife BlogTags: , , , , ,



How to Pray the Chaplet of the Divine Mercy (using the rosary)


  1. Make the sign of the Cross.
  2. Say the optional Opening Prayer:

You expired, Jesus, but the source of life gushed forth for souls, and the ocean of mercy opened up for the whole world.  O Fount of Life, unfathomable Divine Mercy, envelop the whole world and empty Yourself out upon us (Diary, 1319).  O Blood and Water, which gushed forth from the Heart of Jesus as a fount of mercy for us, I trust in you (three times).

  1. Say the “Our Father.”
  2. Say the “Hail Mary.”
  3. Say the Apostles’ Creed.
  4. Say the “Eternal Father” prayer: (on the bead before each decade): 

Eternal Father, I offer You the Body and Blood, Soul and Divinity of Your dearly beloved Son, Our Lord Jesus Christ, in atonement for our sins and those of the whole world.

  1. Say 10 “For the Sake of His sorrowful Passion” prayer on each bead of a decade:

For the sake of His sorrowful Passion, have mercy on us and on the whole world.

  1. Repeat for four more decades.
  2. At the conclusion of the five decades, on the medallion say the “Holy God” prayer: 

Holy God, Holy Mighty One, Holy Immortal One, have mercy on us and on the whole world.

  1. Say the optional Closing Prayer:

Eternal God, in whom mercy is endless, and the treasury of compassion inexhaustible, look kindly upon us, and increase Your mercy in us, that in difficult moments, we might not despair, nor become despondent, but with great confidence, submit ourselves to Your holy will, which is Love and Mercy Itself. Amen.


The Divine Mercy Novena




Begin on GOOD FRIDAY and continue for 9 days


Jesus asked that the Feast of the Divine Mercy be preceded by a Novena to the Divine Mercy which would begin on Good Friday.  He gave St. Faustina an intention to pray for on each day of the Novena, saving for the last day the most difficult intention of all, the lukewarm and indifferent of whom He said:

“These souls cause Me more suffering than any others; it was from such souls that My soul felt the most revulsion in the Garden of Olives. It was on their account that I said: ‘My Father, if it is possible, let this cup pass Me by.’ The last hope of salvation for them is to flee to My Mercy.”

In her diary, St. Faustina wrote that Jesus told her:

“On each day of the novena you will bring to My heart a different group of souls and you will immerse them in this ocean of My mercy … On each day you will beg My Father, on the strength of My passion, for the graces for these souls.”

The different souls prayed for on each day of the novena are:

DAY 1 (Good Friday)  – All mankind, especially sinners

DAY  2 (Holy Saturday) – The souls of priests and religious

DAY 3 (Easter Sunday)  – All devout and faithful souls

DAY 4 (Easter Monday) – Those who do not believe in Jesus and those who do not yet know Him

DAY  5 (Easter Tuesday) – The souls of separated brethren

DAY  6 (Easter Wednesday) – The meek and humble souls and the souls of children

DAY  7 (Easter Thursday) – The souls who especially venerate and glorify Jesus’ mercy

DAY  8 (Easter Friday) – The souls who are detained in purgatory; 

DAY  9 (Easter Saturday) – The souls who have become lukewarm.

The Chaplet of Divine Mercy may also be offered each day for the day’s intention, but is not strictly necessary to the Novena.


First Day
Today bring to Me all mankind, especially all sinners,

and immerse them in the ocean of My mercy. In this way you will console Me in the bitter grief into which the loss of souls plunges Me.”

Most Merciful Jesus, whose very nature it is to have compassion on us and to forgive us, do not look upon our sins but upon our trust which we place in Your infinite goodness. Receive us all into the abode of Your Most Compassionate Heart, and never let us escape from It. We beg this of You by Your love which unites You to the Father and the Holy Spirit.Eternal Father, turn Your merciful gaze upon all mankind and especially upon poor sinners, all enfolded in the Most Compassionate Heart of Jesus. For the sake of His sorrowful Passion show us Your mercy, that we may praise the omnipotence of Your mercy for ever and ever. Amen.


Second Day
Today bring to Me the Souls of Priests and Religious,

and immerse them in My unfathomable mercy. It was they who gave me strength to endure My bitter Passion. Through them as through channels My mercy flows out upon mankind.”

Most Merciful Jesus, from whom comes all that is good, increase Your grace in men and women consecrated to Your service,* that they may perform worthy works of mercy; and that all who see them may glorify the Father of Mercy who is in heaven.Eternal Father, turn Your merciful gaze upon the company of chosen ones in Your vineyard — upon the souls of priests and religious; and endow them with the strength of Your blessing. For the love of the Heart of Your Son in which they are enfolded, impart to them Your power and light, that they may be able to guide others in the way of salvation and with one voice sing praise to Your boundless mercy for ages without end. Amen.


* In the original text, Saint Faustina uses the pronoun “us” since she was offering this prayer as a consecrated religious sister. The wording adapted here is intended to make the prayer suitable for universal use. 

Third Day
Today bring to Me all Devout and Faithful Souls,

and immerse them in the ocean of My mercy. These souls brought me consolation on the Way of the Cross. They were a drop of consolation in the midst of an ocean of bitterness.” 

Most Merciful Jesus, from the treasury of Your mercy, You impart Your graces in great abundance to each and all. Receive us into the abode of Your Most Compassionate Heart and never let us escape from It. We beg this grace of You by that most wondrous love for the heavenly Father with which Your Heart burns so fiercely.Eternal Father, turn Your merciful gaze upon faithful souls, as upon the inheritance of Your Son. For the sake of His sorrowful Passion, grant them Your blessing and surround them with Your constant protection. Thus may they never fail in love or lose the treasure of the holy faith, but rather, with all the hosts of Angels and Saints, may they glorify Your boundless mercy for endless ages. Amen.


Fourth Day
Today bring to Me those who do not believe in God and those who do not know Me, 

I was thinking also of them during My bitter Passion, and their future zeal comforted My Heart. Immerse them in the ocean of My mercy.”  

Most compassionate Jesus, You are the Light of the whole world. Receive into the abode of Your Most Compassionate Heart the souls of those who do not believe in God and of those who as yet do not know You. Let the rays of Your grace enlighten them that they, too, together with us, may extol Your wonderful mercy; and do not let them escape from the abode which is Your Most Compassionate Heart.Eternal Father, turn Your merciful gaze upon the souls of those who do not believe in You, and of those who as yet do not know You, but who are enclosed in the Most Compassionate Heart of Jesus. Draw them to the light of the Gospel. These souls do not know what great happiness it is to love You. Grant that they, too, may extol the generosity of Your mercy for endless ages. Amen.


*Our Lord’s original words here were “the pagans.” Since the pontificate of Pope John XXIII, the Church has seen fit to replace this term with clearer and more appropriate terminology.


Fifth Day

Today bring to Me the Souls of those who have separated themselves from My Church*,

and immerse them in the ocean of My mercy. During My bitter Passion they tore at My Body and Heart, that is, My Church. As they return to unity with the Church My wounds heal and in this way they alleviate My Passion.”  

Most Merciful Jesus, Goodness Itself, You do not refuse light to those who seek it of You. Receive into the abode of Your Most Compassionate Heart the souls of those who have separated themselves from Your Church. Draw them by Your light into the unity of the Church, and do not let them escape from the abode of Your Most Compassionate Heart; but bring it about that they, too, come to glorify the generosity of Your mercy.Eternal Father, turn Your merciful gaze upon the souls of those who have separated themselves from Your Son’s Church, who have squandered Your blessings and misused Your graces by obstinately persisting in their errors. Do not look upon their errors, but upon the love of Your own Son and upon His bitter Passion, which He underwent for their sake, since they, too, are enclosed in His Most Compassionate Heart. Bring it about that they also may glorify Your great mercy for endless ages. Amen.


*Our Lord’s original words here were “heretics and schismatics,” since He spoke to Saint Faustina within the context of her times. As of the Second Vatican Council, Church authorities have seen fit not to use those designations in accordance with the explanation given in the Council’s Decree on Ecumenism (n.3). Every pope since the Council has reaffirmed that usage. Saint Faustina herself, her heart always in harmony with the mind of the Church, most certainly would have agreed. When at one time, because of the decisions of her superiors and father confessor, she was not able to execute Our Lord’s inspirations and orders, she declared: “I will follow Your will insofar as You will permit me to do so through Your representative. O my Jesus ” I give priority to the voice of the Church over the voice with which You speak to me” (497). The Lord confirmed her action and praised her for it.

Sixth Day
Today bring to Me the Meek and Humble Souls and the Souls of  Little Children,

and immerse them in My mercy. These souls most closely resemble My Heart. They strengthened Me during My bitter agony. I saw them as earthly Angels, who will keep vigil at My altars. I pour out upon them whole torrents of grace. I favor humble souls with My confidence.    

Most Merciful Jesus, You yourself have said, “Learn from Me for I am meek and humble of heart.” Receive into the abode of Your Most Compassionate Heart all meek and humble souls and the souls of little children. These souls send all heaven into ecstasy and they are the heavenly Father’s favorites. They are a sweet-smelling bouquet before the throne of God; God Himself takes delight in their fragrance. These souls have a permanent abode in Your Most Compassionate Heart, O Jesus, and they unceasingly sing out a hymn of love and mercy.Eternal Father, turn Your merciful gaze upon meek souls, upon humble souls, and upon little children who are enfolded in the abode which is the Most Compassionate Heart of Jesus. These souls bear the closest resemblance to Your Son. Their fragrance rises from the earth and reaches Your very throne. Father of mercy and of all goodness, I beg You by the love You bear these souls and by the delight You take in them: Bless the whole world, that all souls together may sing out the praises of Your mercy for endless ages. Amen.


Seventh Day

Today bring to Me the Souls who especially venerate and glorify My Mercy*,

and immerse them in My mercy. These souls sorrowed most over my Passion and entered most deeply into My spirit. They are living images of My Compassionate Heart. These souls will shine with a special brightness in the next life. Not one of them will go into the fire of hell. I shall particularly defend each one of them at the hour of death.

Most Merciful Jesus, whose Heart is Love Itself, receive into the abode of Your Most Compassionate Heart the souls of those who particularly extol and venerate the greatness of Your mercy. These souls are mighty with the very power of God Himself. In the midst of all afflictions and adversities they go forward, confident of Your mercy; and united to You, O Jesus, they carry all mankind on their shoulders. These souls will not be judged severely, but Your mercy will embrace them as they depart from this life.Eternal Father, turn Your merciful gaze upon the souls who glorify and venerate Your greatest attribute, that of Your fathomless mercy, and who are enclosed in the Most Compassionate Heart of Jesus. These souls are a living Gospel; their hands are full of deeds of mercy, and their hearts, overflowing with joy, sing a canticle of mercy to You, O Most High! I beg You O God:

Show them Your mercy according to the hope and trust they have placed in You. Let there be accomplished in them the promise of Jesus, who said to them that during their life, but especially at the hour of death, the souls who will venerate this fathomless mercy of His, He, Himself, will defend as His glory. Amen.


*The text leads one to conclude that in the first prayer directed to Jesus, Who is the Redeemer, it is “victim” souls and contemplatives that are being prayed for; those persons, that is, that voluntarily offered themselves to God for the salvation of their neighbor (see Col 1:24; 2 Cor 4:12). This explains their close union with the Savior and the extraordinary efficacy that their invisible activity has for others. In the second prayer, directed to the Father from whom comes “every worthwhile gift and every genuine benefit,”we recommend the “active” souls, who promote devotion to The Divine Mercy and exercise with it all the other works that lend themselves to the spiritual and material uplifting of their brethren.



Eighth Day
Today bring to Me the Souls who are in the prison of Purgatory,

and immerse them in the abyss of My mercy. Let the torrents of My Blood cool down their scorching flames. All these souls are greatly loved by Me. They are making retribution to My justice. It is in your power to bring them relief. Draw all the indulgences from the treasury of My Church and offer them on their behalf. Oh, if you only knew the torments they suffer, you would continually offer for them the alms of the spirit and pay off their debt to My justice.”   

Most Merciful Jesus, You Yourself have said  that You desire mercy; so I bring into the abode of Your Most Compassionate Heart the souls in Purgatory, souls who are very dear to You, and yet, who must make retribution to Your justice. May the streams of Blood and Water which gushed forth from Your Heart put out the flames of Purgatory, that there, too, the power of Your mercy may be celebrated.Eternal Father, turn Your merciful gaze upon the souls suffering in Purgatory, who are enfolded in the Most Compassionate Heart of Jesus. I beg You, by the sorrowful Passion of Jesus Your Son, and by all the bitterness with which His most sacred Soul was flooded: Manifest Your mercy to the souls who are under Your just scrutiny. Look upon them in no other way but only through the Wounds of Jesus, Your dearly beloved Son; for we firmly believe that there is no limit to Your goodness and compassion. Amen.

Ninth Day
Today bring to Me the Souls who have become Lukewarm,

and immerse them in the abyss of My mercy. These souls wound My Heart most painfully. My soul suffered the most dreadful loathing in the Garden of Olives because of lukewarm souls. They were the reason I cried out: ‘Father, take this cup away from Me, if it be Your will.’ For them, the last hope of salvation is to run to My mercy.” 

Most compassionate Jesus, You are Compassion Itself. I bring lukewarm souls into the abode of Your Most Compassionate Heart. In this fire of Your pure love, let these tepid souls who, like corpses, filled You with such deep loathing, be once again set aflame. O Most Compassionate Jesus, exercise the omnipotence of Your mercy and draw them into the very ardor of Your love, and bestow upon them the gift of holy love, for nothing is beyond Your power.Eternal Father, turn Your merciful gaze upon lukewarm souls who are nonetheless enfolded in the Most Compassionate Heart of Jesus. Father of Mercy, I beg You by the bitter Passion of Your Son and by His three-hour agony on the Cross: Let them, too, glorify the abyss of Your mercy. Amen. 



Diary, Saint Maria Faustina Kowalska, Divine Mercy in My Soul (c) 1987 Congregation of Marians of the Immaculate Conception, Stockbridge, MA 01263. All rights reserved. Used with permission.






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The Future of Catholics in Healthcare 

Talk given to Catholic and Christian healthcare professionals, and clergy and religious in care ministries, organised by the
Bristol Branch of the Guild of Catholic Doctors. 31 October, 2006.
Clifton Cathedral.  Archbishop Peter Smith of
Cardiff and Bishop Declan Long of
Clifton participated. 

Jim McManusAssistant Director of Health Improvement,Barking & Dagenham Primary Care TrustMember, Healthcare Reference GroupCatholic Bishops’ Conference of
England &

I work in a very deprived borough in outer
East London. Our average income is £13,000. 19% of people have achieved formal qualifications against 39% nationally and 1 in 5 deaths is attributable to smoking, one of the highest in the
UK. Our second language, African French, has changed in 18 months to Lithuanian or Polish and we have large numbers of Kosovan and other refugees and asylum seeks, and 300 families – largely African – living with HIV. Against this background we have experienced £14.9 million in cuts, cuts made from a PCT which breaks even to subside other, wealthier areas who traditionally have managed in deficit. I believe that what I do, I am called to do, as my part in participating in Christ’s ministry and as my apostolate. And I want to share with you this evening some thoughts on the future of Catholics in healthcare.  

While we are also mainly Catholics here this evening, much of what I am going to say will apply equally to our sisters and brothers from other Christian families who are here as part of our gathering. 

There are several reasons why I feel privileged to be here tonight: 

  1. When I was a boy, the parish I went to was privileged to have a Catholic doctor, a Catholic dentist and Catholic nurses. They were valued and honoured as having a vocation for what they did. Needless to say, our parish generated as many vocations to healthcare ministry as it did priesthood or religious life. Speaking to fellow Christians here is a privilege. So speaking to a network of the health professionals I so admired as a boy is a great honour.
  1. There is a wonderful ecclesiology at work here tonight. The celebration of the Eucharist together has led those working in healthcare, with the local Bishop as the focus of unity, to gather round and discuss our vocation and ministry in healthcare, and consider what God would have us do. This is Lumen Gentium the Vatican II constitution on the Church, at work. This provides, I think, a model for the future of work for Catholics and Christians in healthcare ministry to assert the dignity and importance of their role. A worshipping community gathered together as Church, thinks through its role in light of the Gospel and moves out, as Church, to express its diverse charisms.
  1. This ecclesiology at work is a model for the local Church more widely. When the Bishops of
    England &
    Wales had their Ad Limina visit to
    Rome, they were challenge to do more to support visible ministry in healthcare. While some of this can, and should, be done nationally it is the local church which will make the bulk of any sustainable and sustained action see fruit. You have given us a model we can share with others.

I want to discuss tonight the following issues: 

  1. Catholic visibility in healthcare systems
  2. A model for vocation to healthcare ministries
  3. The challenges to this model
  4. What the Church is doing
  5. How we implement our vision

Catholic Visibility in Healthcare SystemsWe all have the experience of finding closet Christians in healthcare systems, wherever we find ourselves.  In some places they are more visible than others. We are very visible in Learning Disability and Elderly Care through the work of religious. We are also increasingly visible in some social enterprises. But in the NHS, though anecdotally we are numerous and widespread, we are not so visible. Chaplains seem to be the most visible group. 

We need some empirical research on this, and it may be part of the charism of social research institutes to deliver this for us. We are convinced anecdotally that Catholics are over-represented in healthcare compared to the numbers in the general population (about 8% national average according to the 2001 Census.) On an individual level this may be anecdotal, but when you get people forming part of diverse social and professional networks all saying that there are lots of Catholics in healthcare, then the issue becomes one which warrants further study, and the frequency of corroboration I think would be enough for us to assert that our perception of this is, scientifically speaking, valid. 

The insight which comes from this is that the NHS and Healthcare in the
UK would not be the same without us.  

There are two important things which should strike us from the readings for the Vigil Mass of All Saints’ Day, which we’ve just celebrated. First, the reading from Revelation which describes “a huge multitude, impossible to count, from every tribe and tongue, and people and nation.”  While this could pass as the foreword to the NHS Directory, it describes I think, the presence of Christians in healthcare, who perform the role of being a leaven in the healthcare system. Without them, this present but sometimes invisible number, exercising their ministry as healthcare professionals, the NHS would just not be the same. We know that, but we need to prove it. 

The second is the reading of the Beatitudes. When I was a divinity undergraduate, ploughing my way through Karl Barth in German, I came across a sermon in which he preached on the Beatitudes, and translated one of them as “How blest are those who know their need of God, for theirs is the Kingdom.” That moved me. And I think it explains the tension in being a Catholic or Christian in healthcare today.  We try to be a leaven in a system which seems to want to despiritualise us, but somehow we need to take heart in knowing our need for God, and sharing that, in the work we do. 

We do add something to healthcare, and that is a conviction that healthcare is about helping people to be truly human. It is about implementing Jesus’ statement “I have come that they might have life, and have it in all its fullness” (John 10:10.)  An emphasis on the person as a spiritual, psychological and physical unity rather than a patient undergoing a procedure is crucial to our role.  We do our work, yes, but we do it with a concern for the Kingdom, and the best possible end for the people we work with.  We do it, therefore, in an eschatological perspective as well as a clinical one. 

A Model for Vocation to Healthcare Ministries 

And here, I believe, is where the issue of a model for vocation comes in.  We often speak about Healthcare ministry as if it meant Chaplaincy. And while Chaplaincy is included within this, our model needs to be much wider than that.  Healthcare ministry is lived out, in the
UK, in a variety of different settings: 

·        It is lived out by NHS staff working in the NHS, doing their role, but with varying approaches to spirituality being acceptable for public expression.·        It is lived out by the parish community. In our area we are trying to get “Faith Health Champions” off the ground, and recently through the mosque we trained people to reflect on health from within their faith. We picked up 9 hitherto undiagnosed cases of Type 2 diabetes in women early enough to intervene and reduce their risk of heart disease and complications. Think what we could do in parishes, and how we could build mental wellbeing through them.·        It is lived out in Chaplaincy. At the moment, because of policy changes, Chaplaincy is where we have some major threats – and opportunities – and so a lot of work has been done. More about this later.·        It is lived out through Christian Health Services (CHS, not NHS) like St John of God, the Little Sisters of the Poor and the homeless primary care service here in
Bristol run by your own Guild Chairman. 

All of these are vocations, all of them show different charisms. The charism of the dentist or occupational therapist, the charism of the physician or surgeon, the charism of the nursing religious.  

So what are the models for our vocations?  Well, I suggest there are at least two, and that these two are really complementary.  The first is provided by the Healthcare Workers’ Charter, a document from the Pontifical Council for Health Pastoral Care.  This document speaks profoundly of living out our vocation to healthcare and our participation in the work of Christ in doing so.   

…the healthcare worker is “the minister of that God who in Scripture is presented as ‘a lover of life’ (Wisdom 11:26). To serve life is to serve God in the person: it is to become “a collaborator with God in restoring health to the sick body” and to give praise and glory to God in the loving acceptance of life, especially if it is weak and ill. 

The therapeutic ministry of healthcare workers is a sharing in the pastoral and evangelizing work of the Church. Service to life becomes a ministry of salvation that is, a message that implements the redeeming love of Christ. Doctors, nurses, other healthcare workers, and voluntary assistants are called to be the living image of Christ and of his Church in loving the sick and the suffering”: witnesses to “the gospel of life”.[1]

Healing – spiritual, physical and psychological – has always been central to the mission of the Church. Healthcare workers of all kinds and charisms contribute their gifts to making this happen. As
St Paul says, “there are many kinds of gifts, but the same spirit.” See what you do as a charism, a gift, to play your part in the healing mission of the Church. 

The second model, which I think is entirely complementary to the first, derives from our baptism.  Our vocation to work for the health of others comes from our baptism into Christ and into the people of God. This is then sustained by the sacramental life of the Church – especially Eucharist and Confirmation – and expressed in our participation in bringing about God’s Kingdom. Our diverse charisms and ministries arising from these are all signs of the Body of Christ at work (back to Lumen Gentium again.) 

None of these models minimise the fact that modern healthcare is a difficult, and even hostile place to be a person of faith. It is supremely ironic that the National Institute for Health and Clinical Excellence recommends the importance of spiritual care in guidance on palliative care for cancer patients, just at a time when spirituality is becoming a dirty word in many workplaces in the NHS. 

But we do have resources to deal with this. I spoke earlier of the model of an ecclesiology. The local Church explicitly valuing, supporting, praying for and standing by us is a huge resource.  Networking with each other in an atmosphere of faith is another.  

But there are resources too, in the health sciences. As a psychologist and consultant in public health I am interested in The Lifecourse chronic illness, and chronic wellbeing, are best seen at population and individual level across the whole of our life. As Christians we call this our pilgrimage or discipleship.  Health is an essential part of this, and by seeing health in context of life pilgrimage we can be better at caring for the whole person across their lifespan, even if we only see them rarely. 

Another resource is the Biopsychosocial model of health[2], much beloved of health psychologists. This model seeks to emphasise the unity of the human person and states that our physical, psychological and social health all affect each other, and our spiritual health will too.  We know from research on stress biology and stress pathways that this stands up empirically.  As Christians we have a term for this, it’s called Right Relationship with God, ourselves and our neighbour, and Jesus taught us this in giving us the Great Commandment that we should “Love the Lord thy God, and thy neighbour as thyself.” 
We cannot escape the social dimension of health, or the Lifecourse dimension of health. As Christians, our perspective on life, disability and life-threatening illness, seen in eschatological perspective, shot through by hope and sustained through sacraments suits us perfectly to work in healthcare. So let us celebrate this. 

The trouble is, we’re not good about making ourselves visible. Claire Short MP once said Catholic Social Teaching was the Church’s best kept secret. Well, our commitment to healthcare is probably an even better kept one. 

The Challenges to this ModelThe current policy climate within the NHS has not helped with this visibility. There are challenges to our model from current
UK policy, and for the Church itself. 

Taking UK policy, we are at a time when the caring, sharing language of policy documents values spirituality in writing[3],[4]but seems to be embarrassed by it in practice, wanting to control it and reduce it to something performance manageable.  I have empathy with this concern. I also think that this is just part of a wider trend, but that there is a way round it. 

We face challenges in the NHS about authentic spirituality. Defining it, teaching it and understanding it is hugely problematic[5]. Spirituality exists in the NHS Knowledge and Skills Framework[6] but you will seek a definition of it in vain. By spirituality here I mean a set of values informed by our particular faith tradition which help and sustain us through engaging with patients and the other work we do.  British policy on diversity, and particular on faith diversity, has gone wrong somewhere, largely because it has been shaped by people who do not understand the meaning of the phrase “multi-faith.”  Multi-faith is most emphatically not a one size fits all, de-traditionalised, bland “concern for the other person” which is a vague extension of some kind of talking therapy.  It is, or ought to be, a valuing of each faith by people who are secure in their own faith, and the creation of a healthcare environment where people can express their faith as it is without fear, and with encouragement, as being a part of their vocation to healthcare ministry. For Christians, spirituality must always be in divine perspective, seen through the lens of what God has done for us in Jesus Christ. That doesn’t mean we can’t enjoy “quiet time” in a work setting. It doesn’t mean we cannot respect Muslim, Hindu or Jain colleagues and patients. Quite the reverse – being secure in our faith means we understand why others need to be in theirs. 

Refusing to allow people to wear the cross or express that they are Christians is not creating a multi-faith environment. It is creating a secular and de-spiritualised one. It is also, arguably, a contravention of the rights you have under the law[7].  Respecting people of no belief and their rights does not mean you have no right to have respect for yours. It’s also arguable that refusing to allow someone to wear a cross (even under their uniform), unless it could be justified and applied universally to all jewellery for infection control reasons, would not meet the test of reasonable and proportionate applied by the law[8]

Devotees of systems theory will suggest that the response of large scale systems on pluralisation is to try to reduce the cost of it to the system[9], and thus reducing cost always seems to default to reducing complexity.  In the NHS this means we talk about valuing spirituality yet handle our clinical governance work to the extent where we have a one size doesn’t fit anyone approach with the bulk of work needed to cope with people’s needs handed to the front-line clinician and Dept of Spiritual Care replacing choice of chaplain. This whole line of development runs entirely contrary to the NHS’s own stated policy on patient choice and staff wellbeing, and spirituality itself. 

But what is happening here is not just a system reducing cost. It is a social movement. Lieven Boeve, writing in the current issue of the Bulletin of the European Society for Catholic Theology[10] charts the rise of not just a secularisation of our services and systems, but a de-traditionalisation where any tradition is not valued. This, ironically, is happening at the same time that people are feeling there is “something more” to the world. This leads to a model of pluralisation which is based on a “one size fits all” approach. This will create inter-religious and racial tensions, not reduce them. And when this is expressed in a system such as the NHS, under the guidance of managing diversity, it actually runs counter to what most psychological evidence about managing diversity would actually suggest[11],[12],[13]

So, this public policy challenge brings a challenge to the Church. We need to make sure we take formation of our healthcare ministers seriously. Valuing them, encouraging them to network and share and support each other, and providing resources to reflect theologically and ethically on their work are crucial.  

The Church also needs to speak publicly at national and local level to policy makers about the importance of authentic spirituality. But to do that we need empirical research to give policymakers on why it is important.   

What the Church is Doing  

There is action for the Church to take at local and national level. To quote Bishop Tom Williams, the Chair of the Healthcare Reference Group, we need to address this through “galvanising, not organising.”  In other words, we will not achieve what we need through setting up large national systems – even if we had the funds – but through creating an environment where people can exercise their distinctive charism. 

Some of this undoubtedly is national, but most sustained work (such as setting up Catholic or Christian Social Enterprises for primary and secondary care using forthcoming DH monies[14] ) will be done at local level.  

What we can do at national level is speak to policymakers, and create and disseminate resources for local use. In response to issues and needs identified by healthcare workers and Catholic chaplains, a Healthcare Reference Group, chaired by Bishop Tom Williams, was brought together. This group currently has a strategy in draft which is aimed to help the Church address the issues I have outlined above.

At national level we have sought to address the crisis in Chaplaincy by producing a good practice guide and a handbook for Bishops’ Advisers (the person who advises each bishop on healthcare chaplaincy issues). These will be published by Easter.   A leadership toolkit to train chaplains on leadership within the NHS to help ensure authentic Christian spirituality is valued is already in development.  

A guide to the role of the Church in major incidents has already been produced in response to the 7/7 bombings[15] and work on preparing the church for a ‘flu pandemic is underway.   

We will also shortly be publishing a guide for healthcare staff on the pastoral needs, and care, of Catholic patients.  
Further publications will include a Catholic Theology of Healthcare, and we hope a book where Catholics in Healthcare share their stories in a way which shows others they are not alone in their struggles. 

We have held two national seminars, networking Catholics in Healthcare, and will launch a website and e-network next year.  

We will also market our position and influence the Department of Health and NHS Chief Executives and Non Executive Directors.  

At local level, these resources can be used for formation, and you can do influencing too. The local Church can claim its networks, or collaboratives in NHS speak, as an important aspect of continuing development and clinical governance for Christians in healthcare.  

How We Implement This A national body, which does everything it does on a voluntary basis (because there is no funding) can only achieve so much. So we have focused on what is proper for a national level. 

We will be dependent on people exercising their charism. And here are some examples: 

  1. If you are a researcher, empirical research can help demonstrate the importance of spirituality in healthcare. There is already a body of evidence which we can use[16],[17]. While much evidence may not, as the recent NICE work on palliative care found, meet the standard of randomised controlled trials, it does sit within a properly critically appraised quantitative paradigm and can, if we approach evidence synthesis suitably. But we need to localise this for a
    UK context and also by each discipline. Evidence in palliative care may not be readily agreed by thoracic surgeons, for example. That said, evidence in psychology may have to be more readily translatable for an audience in occupational therapy or nursing.
  1. If you are a PCT or Trust Chair, Chief Executive, Non Executive Director or Senior Manager, you can use the Clinical Governance and Diversity Agenda to do something which will help. Gloucester PCT’s Chair has shared with us the PCT’s prayer groups and e-mail list. Prayer is becoming a valued word, not a dirty word, in this setting.
  1. If you are a healthcare worker, you can quietly assert how your faith is an asset to your role – your charism – in clinical governance terms.
  1. If you are a local Church you can form networks, bring people together, speak to the NHS locally, and explicitly celebrate the healing ministry of the Church.

On one level, what we are all engaged in is nothing less than an exercise in public theology in a climate of secularisation and de-traditionalisation.  On another we are just challenging sloppy thinking about diversity and “multi-faith” which has become too ingrained in the system and too uncritically pushed. On another level, we are trying to take the vocation to healthcare seriously and make sure that healthcare workers feel supported in this.  We invite you to join us, putting your charism to this.

And here are my four buzzwords for Catholic and other Christians in healthcare ministry.  Here is how we move from being the Church spoken of in Lumen Gentium to the Church at work in Gaudium et Spes:  

  • Visible – we need to be visible at national and local level. The current model of national and local work sits well with the ecclesiology of subsidiarity and Vatican II. So let’s get moving and be visible. What can you do towards this, exercising your charism?
  • Valued – we need to explicitly and publicly value our health and the ministry of all those engaged in healthcare.  What can you do towards this, exercising your charism?
  • Vocation – we must celebrate and emphasise publicly and in formation, and especially to the NHS, that healthcare ministry is a vocation of dignity.  What can you do towards this, exercising your charism?
  • Veracity – what we do must be true and authentic. Based in experience and evidence, and honest to those we work with and care for. What can you do towards this, exercising your charism?

Without living through these four “Vs”, or four tests, we are not, as a Church, authentically being Church in the sense of delivering our ministry. Moreover, we will not ensure that the NHS remains true to its fundamental values; values which, as Christians, we have shaped and signed up to across the years. “Galvanising, not Organising.” 

Thank you. 


[1] Pontifical Commission for Health Pastoral Care (1995) Charter for Healthcare Workers.
Rome: Pontifical Commission for Health Pastoral Care.
[2] Engel, GL  (1977)  ‘The need for a new medical model: a challenge for biomedicine’  Science, Vol 196, Issue 4286, 129-136 (1978) ‘The biopsychosocial model and the education of health professionals’.Ann N Y Acad Sci. 1978 Jun 21;310:169-87. For a review of its use in literature on healthcare utilisation see http://herkules.oulu.fi/isbn9514264460/html/chapter2.html [3] McSherry W, Cash K, Ross L. (2004) Meaning of spirituality: implications for nursing practice. J Clin Nurs. 2004 Nov;13(8):934-41. See also comments in J Clin Nurs. 2005 Nov;14(10):1268-9; discussion 1270 and J Clin Nurs. 2006 Jan;15(1):117-8.[4] Genevieve Enid Kyarimpa and Jean-Claude Garcia-Zamor. (2006) The Quest for Public Service Ethics: Individual Conscience and Organizational Constraints. Public Money and Management 26:1, 31-38

[5] McManus, J (2006) Spirituality and Health Nursing Management Vol 13  No 6, 24-25. See also Baldacchino D.; Draper P (2001) ‘Spiritual coping strategies: a review of the nursing research literature’. Journal of Advanced Nursing, Volume 34, pp. 833-841. See also McSherry, W and Ross, L (2002) ‘Dilemmas of spiritual assessment: considerations for nursing practice’. Journal of Advanced Nursing, Volume 38, Number 5,  pp. 479-488

[6] Dept of Health (2004) The NHS Knowledge and Skills Framework and the Development Review Process. London : Department of Health

[7] Employment Equality (Religion or Belief) Regulations 2003, SI 2003/1660 which came into effect on 2 December 2003.

[8] Hallsbury’s Laws of
England (2005), 4th Edition, Volume 16a, 538.

[9] Doherty, T L and Herne, T (2004) Managing Public Services. London : Routledge

[10] Boeve, Lieven (2005) La theologie comme conscience critique en Europe. Le defi de l’apophatisme culturel. Bulletin ET (16) 1, 37-60.

[11] Stockdale, M.S and
Crosby, F.J (Eds) (2005) The Psychology and Management of Workplace Diversity.
Oxford: Blackwell. See also Boyle, MV and Healy, J (2003) Balancing Mysterium and Onus: Doing Spiritual Work within an Emotion-Laden Organizational Context. Organization, Vol. 10, No. 2, 351-373 See Also M. P. e Cunha, A. Rego, and T. D’Oliveira Organizational Spiritualities: An Ideology-Based Typology Business Society, June 1, 2006; 45(2): 211 – 234.

[12] Dent, E.B. Higgins, E.M and Wharff, D.M. (2004) Accessed at Spirituality and Leadership: An Empirical Review of Definitions, Distinctions, and Embedded Assumptions http://www.uncp.edu/home/dente/LQPaper.pdf on 29th October 2006.

[13] Garcia-Zamor, Jean-Claude (2003) Workplace Spirituality and Organizational Performance.Public AdministrationReview 63 (3), 355-363.

[14] See the new Social Enterprise Network for the NHS. http://www.networks.nhs.uk/networks.php?pid=155. Accessed on 7 November 2006

[15] Accessible at www.catholic-ew.org.uk/citizenship/documents/ReflectionChurchResponseMajorIncidents-JimMcManus-2.11.05.pdf 

[16] C. Daniel Batson, Patricia Schoenrade and W. Larry Ventis (1993) Religion and the Individual. Oxford
University Press.
[17] Koenig, H, McCullough, M and Larson, D (2001) Handbook of Religion and Health. Oxford
University Press.