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The most provocative and substantive studies have been those that explored the once taboo topic of the effect prayer has on disease. I have often referred to spirituality as the “S word” in medicine. For too many years, modern medicine has focused on the body as a machine, minimized the impact of the body-mind link and aggressively negated and ignored the impact of the spirit. Fortunately, a few daring physicians and scientists have researched this fascinating arena.

One of the first studies brought to my attention was conducted at the University of California at San Francisco’s Medical School. Dr. Randy Byrd divided a group of 393 seriously ill intensive care unit patients, all with heart diseases. They were divided into 2 groups, and were matched for age, severity and type of disease. Dr. Byrd asked people from different religious traditions, (Catholics, Protestants and Jews) to pray for the people, several times each day. The patients prayed had at least seven people praying for them. This double blind study (the patients and their doctors were unaware if they were being prayed for) had very interesting outcomes. Despite their similarities, the group that was prayed for had fewer serious complications, including cardiac arrests, heart failure, pulmonary edema (fluid in the lungs) and pneumonia. Even more amazing, not one person in the prayed for group died!

A more recent and intriguing study, reported at the American Heart Association’s annual meeting, in 1998, was conducted by Dr. Mitch Krucoff, M.D, another Duke University cardiologist, and produced similar results. Called “Monitor and Actualization of Noetic Trainings (MANTRA),” this double-blind study randomly divided 150 patients into 30-person groups. Three of the groups received relaxation, guided imagery, or touch therapies. The names of the fourth group were inserted in the Western Wall in Jerusalem and given to Buddhist monks in Nepal, Carmelite nuns in Baltimore, and to groups of Moravians and Christian fundamentalists to pray for them by name. The fifth group received only standard medical care.

The patients who were prayed for, compared to the group receiving standard care did 50%-100% better during their hospital stay. The other three groups of patients who received either massage therapy, guided imagery or relaxation, experienced 30%-50% improvement.

While the results of this study was too small to offer statistically significant comparison, the results, “are highly intriguing, and not what most traditional physicians would have expected,” Dr. Krucoff stated. “Our date show beneficial trends. Our goal was to conduct as scientifically rigorous and reasonable a trial as has ever been undertaken to look at what else, besides pills and procedures, might help us treat patients.” A larger trial, with 1500 patients is expected to be conducted at 5 major medical centers in the United States.

MANTRA was designed to use objective physiological measurements, such as continuous EKG monitoring, heart rate, blood pressure, and clinical outcomes, to characterize the effects of spiritual energy in cardiac patients before, during, and after invasive procedures. These findings certainly confound our mechanistic view of the human body. How can prayer from thousands of miles away have a positive impact and promote healing? If we consider ourselves as disconnected human beings, there isn’t a plausible answer.

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Did you know that research studies have determined that more heart attacks occur on Monday morning between 8 a.m. and noon than any other time of the week. This phenomena has never been observed in other animals and led to the conclusion that the meaning of Monday morning for many (going to an unfulfilling job) caused the heart attacks to cluster around that time.

During my first year of practicing medicine, I ran into the granddaughter of one of my patients with coronary artery disease and other chronic illnesses. Her keen observation made me more willing to consider the significant role emotions play in disease states. When I inquired about her grandmother, she replied, “Grandma is fine. She only gets sick when she’s upset.” I was struck by her remarkable insight, as she was only 16 years old.

A University of Chicago researcher, Dr. Susan Kobialka, followed AT&T executives during its national restructuring. It was an extremely stressful time for so many executives, as the number of heart attacks skyrocketed, to the point that a coronary care unit was created at Illinois Bell’s corporate headquarters. But within this group of execs, there were those who thrived in the face of severe adversity. While they share the similar age and ethnicity, they held a different perspective, compared to their counterparts experiencing heart attacks. They possessed a commitment to their job, an amazing sense of challenge and excitement in response to adversity, as well as a critical perception of self-control.

I discovered a very fascinating study that caused me to change my approach to treating diseases in general and heart disease in particular. Stewart Wolf, MD, evaluated many residents of Roseto, Pennsylvania. This town, during the 1960s, had a rate of heart disease that was much lower than the national average. While they smoked cigarettes, ate a high fat diet, and consumed alcohol similar to average Americans, they were somehow protected form heart disease. Of course, most thought it was due to their genes. But its wasn’t. The research determined that their close knit family and community structure somehow protected their hearts from becoming diseased with hardening to the arteries.

Dr. Wolf also predicted that the mortality from heart disease would increase as the town’s citizens became more Americanized, which is exactly what happened when the researchers returned in the mid-1970s. During the 1980s, the researchers predicted that, with the onset of national cholesterol education programs and other public health measures, the incidence of heart disease in Roseto would decrease, as it had nationally. However, when they returned in 1985, they found that, despite decreasing fat intake and smoking rates, the rate of heart disease continued to climb. They concluded that their way of life-the materialism and assimilation of ‘conspicuous consumption’-had prevented the expected decline in heart disease.

One of the most significant bodies of research, conducted by Dr. George Kaplan, M.D., of the University of California Medical School in San Francisco, followed thousands of residents of Alameda County, California, for several years. They found social isolation to be a significant risk factor for all diseases including heart disease. Researchers around the globe have confirmed a link between the lack of social support and the development of heart disease in humans and animals.

Yugoslavian research found that physical risk factors such as smoking are altered by psychological factors that are in fact greater predictors of death.

The traditional Japanese culture is hallmarked by a considerable degree of family and social support. Evidence suggests this is a contributor to the low incidence of heart disease in that country, as well as Japanese-Americans, who like the residents of Roseto, maintain their tradition. In 1993, a study found that patients recovering from heart heart attacks with higher levels of emotional support were far less likely to die within 6 months, compared to those with far less support.

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