The God Delusion

Last time I was on call at the VA, we were called at 5:30am for a rapid response on a patient with lymphoma that had compressed his spinal cord and made him a paraplegic in a matter of weeks. Just that morning his family had made him a DNR. When we saw him he was relatively unresponsive but would respond to touch and shake his head when we asked if he was in pain. The nurse told me that his wife was coming back soon with other family members and that after 58 years she had finally convinced her husband to be baptized that morning. We stabilized his blood pressure and went to rounds. Later that morning I found out the patient had died, but first he had woken up just long enough to be baptized.

I'm glad for the patient's wife and family that they can get comfort from the thought that he was saved in his last moments of life. I wonder how the patient himself felt and if he got any comfort thinking he was going to God. At least he was surrounded by his family. Not that there's any harm in a little water splashed on your head if you don't believe it's anything but water...though some people could certain take offense, and with good reason. It reminded me of a recent interview I saw with Christopher Hitchens where he says that any future remarks that make it sound as though he had found religion would not truly be from him, but would rather represent the ravings of a dying man. Stick with your principles to the end. I'm hoping to finish reading "The God Delusion" as soon as I have a little free time (you know, when I've finished my sub-I, pediatric residency applications, research project, and "The Girl Who Played With Fire").

I've never been quite as militantly atheistic as Christopher Hitchens, I belong more to the school of everyone's free to believe whatever they want. Having said that (which I can't say without thinking of Curb Your Enthusiasm), I find it impossible to relate to anyone with strong religious beliefs. I certainly respect faith and think that good things can come out of it, but at some underlying level our world views are just completely irreconcilable. I'm not going to go out and name the second chapter of a book "Religion Kills", but at least from my observations in the hospital, may be in can. We had one patient who had been in the hospital for about a week with meningitis and thrombocytopenia. His platelet level was 4000 (anything under 150,000 is too low). With platelets that low if you hit your head on a cabinet or trip and fall you have going to bleed into you brain and die, no question. He was in the middle of his treatment but just got fed up with being in the hospital and decided to leave against medical advice. Our attending did everything he could to talk him in to staying, but the patient had decided that he was in God's hands and through the power of prayer he would be healed and if not then it was meant to be. He left. We've tried to follow-up with him since, but he lives alone and no one picked up the phone at his house. Hopefully he's still alive. He was deemed competent so he's allowed to make all his own medical decisions, even if they are delusional. Of course, in psychiatry delusions are defined as fixed beliefs that are certainly and definitely false, but not beliefs that are ordinarily accepted by other members of the person's culture or subculture. Any way of thinking that needs a qualification like that should give one pause.