Maybe God Doesn't Even Like Miracles That Much.

Reflections from a pediatric chaplain on the irregularity of miracles with help from a Victorian author and an atheist-humanist colleague.

Miracles in medicine: A narrative inquiry exploring extraordinary events in pediatrics.

Background and Aims: Whether miracles are seen as a source of conflict between healthcare teams and families, a foolish or even harmful belief, or a hindrance to system-wide improvements and scientific inquiry, miracles within medicine have long been questioned. We were interested in the perspectives of pediatricians on miracles and how that has informed their care of patients. We also sought to explore the intersection and relationship between the medical sciences, faith, and how we view miracles. Methods: Using narrative inquiry as a research methodology, we had conversations and explored the experiences of physicians who work directly within pediatric clinical care. We used purposeful sampling by emailing several pediatricians whom we felt might have been interested in the project and may have had experiences with perceived medical miracles. All conversations were conducted over Zoom and recorded. Results: We conducted one to three conversations with each participant. During our analysis, we identified two threads. First, participants described miracles mostly as favorable and fortuitous events that invoked a sense of wonder due to contextual factors such as geography, access to resources, time in history but also previous experiences and the expectations of the clinician. Second, there is a complex dynamic within and between the medical sciences and the faith commitments of clinicians and families, especially when facing life-limiting or end-of-life illness. Conclusions: The stories that our participants told not only informed their past experiences and how they remembered them but also their present and future experiences. Exploring the topic of medical miracles allowed us to better understand the social discourses that shape our perceptions of miracles, death, and the role of the physician. These stories offer us hope and possibility in a time when we as a medical community may have lost our sense of wonder and the ability to notice miracles.

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Pentecostal Patients.

People of the Pentecostal faith are a grouping of Protestant Christians. Pentecostals are a growing group not only in the United States, but also worldwide. This article focuses on the Pentecostal beliefs and spiritual practices in North America and their implications in the clinical environment. As the population of this faith group continues to grow, palliative care clinicians will need a basic understanding of the values and practices of Pentecostal spirituality and its potential impact on goals-of-care discussions. This article offers 10 recommendations for clinicians to better understand and support Pentecostal patients and families. These overarching concepts of Pentecostal faith and practices are presented as a point of initiation for further exploration of the support that may be needed, and not as a comprehensive guide.

Disease versus disease: Paolo Zacchia on syphilis and epilepsy.

The lawyer and physician Paolo Zacchia (1584-1659) was the chief physician at the Vatican and an important advisor to the papal court. He is considered a founder of the field of forensic pathology, and the influence of his masterwork, Quaestiones medico-legales, spread throughout Europe. In this essay, we focus on one of Zacchia's consultations, first published posthumously in 1661. Emerging from a cause for beatification, the case features the intriguing medical notion of one disease curing another. Zacchia was to determine if a young man's recovery from epilepsy was miraculous or not. We will briefly review Zacchia's career, examine his argument and the sources on which he based his reasoning in this case, trace the status of the disease-versus-disease notion to the present, and demonstrate that this consultation represents a rare, if not the only example of syphilis being the curative agent - rather than the disease cured.

Alexis Carrel and His Voyage of Discovery: Miracles and the Spirituality of Healing.

In the era of positivism and anticlericalism of France's Belle Époque, scientist Alexis Carrel stood in stark contrast as one preoccupied with his faith and its relation to scientific scrutiny. Despite his early adult agnosticism, he sought proof of the divine and chose verification of the miraculous cures reported from the shrine at Lourdes, France. It so happened that on his first visit there, he encountered a truly remarkable "cure" of a young woman in the terminal stages of tubercular peritonitis. On a return visit, for the second time, he witnessed the restoration of sight to a blind child. Throughout the rest of his life, Carrel was struck by the proximity of the supernatural to corporeal interactions. He ultimately found a place for his faith as a parallel pathway and not in juxtaposition to the scientific. This paper chronicles Carrel's evolution of belief and reconciliation of faith and science.

Honoring Black Hopes: How to respond when the family is hoping for a miracle.

Background: Racial and ethnic disparities in end-of-life healthcare can be reduced by showing physicians how to best respond to a documented underlying cause: African American families' hopes for a miracle via divine intervention influence their end-of-life medical decisions, like, for example, making them not want to withdraw ventilatory support in cases of poor neurologic prognosis because they are still hoping for God to intervene.  Methods: Autoethnographic research probing the author's Spiritual Care experience in this context yields a nuanced, 90-second point-of-care spiritual intervention physicians can use to address the religious aspect of African American families who base end-of-life medical decisions on their hopes for a miracle via divine intervention. Autoethnographic analysis is framed by physician-author, Dr. Jessica Zitter's documented journey of grappling with this context. The evolution of Dr. Zitter's responses to miracle-hoping African American families provides a framework for applying autoethnographic analysis to a critical appropriation of the Johns Hopkins "AMEN" communication protocol for families hoping for a miracle.  Results: The common instinct of white physicians to remain neutral, holding miracle-hoping African American families at arm's length, rather than supportively engaging their hopes, is shown to be an intellectual ruse for emotional avoidance. A novel, counterintuitive spiritual intervention for the religious aspect of miracle-hoping African American families is integrated into an existing physician communication protocol for responding to families hoping for a miracle with recommendations for utilization of existing communication technology when necessary.  Conclusion: Properly addressing the religious dimension of African American families hoping for a miracle may help physicians to increase their therapeutic connection with families, decrease their own stress/burnout levels, and eliminate racial and ethnic disparities in end-of-life healthcare. .

Revisiting the Healing Narrative of the Gospel in the COVID-19 Pandemic.

In terms of health issues, Christians often refer to the stories of Jesus' healings in the Gospels as an important spiritual resource. However, theological interpretations vary, depending on the hermeneutical method employed and the contextual factors considered. This article explores such approaches to the Gospels' healing narrative and relates them to the current situation of the COVID-19 pandemic. From the platform of practical theology, five theological approaches to the healing narrative are identified and then analyzed. The results of this study suggest that each approach has a degree of relevance that is worth developing to produce a theological contribution to ongoing mitigation and healing efforts.

Beyond one-way determinism: San Frediano's miracle and climate change in Central and Northern Italy in late antiquity.

Integrating palaeoclimatological proxies and historical records, which is necessary to achieve a more complete understanding of climate impacts on past societies, is a challenging task, often leading to unsatisfactory and even contradictory conclusions. This has until recently been the case for Italy, the heart of the Roman Empire, during the transition between Antiquity and the Middle Ages. In this paper, we present new high-resolution speleothem data from the Apuan Alps (Central Italy). The data document a period of very wet conditions in the sixth c. AD, probably related to synoptic atmospheric conditions similar to a negative phase of the North Atlantic Oscillation. For this century, there also exist a significant number of historical records of extreme hydroclimatic events, previously discarded as anecdotal. We show that this varied evidence reflects the increased frequency of floods and extreme rainfall events in Central and Northern Italy at the time. Moreover, we also show that these unusual hydroclimatic conditions overlapped with the increased presence of "water miracles" in Italian hagiographical accounts and social imagination. The miracles, performed by local Church leaders, strengthened the already growing authority of holy bishops and monks in Italian society during the crucial centuries that followed the "Fall of the Roman Empire". Thus, the combination of natural and historical data allows us to show the degree to which the impact of climate variability on historical societies is determined not by the nature of the climatic phenomena per se, but by the culture and the structure of the society that experienced it. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10584-021-03043-x.

The Saint as Medicator: Medicine and the Miraculous in Fifteenth- and Sixteenth-Century Italy.

This article discusses the interlinkage of medicine and the miraculous in the healing actions of living saints, based on the canonisation dossiers of St Francesca Romana (1440-53) and St Francesco di Paola (1512-17). These documents include a large number of miracles performed by saints during their lifetime, and in a large proportion of these cases, the holy person administered some kind of medical substance to an infirm devotee before or while performing the miracle. While the commissioners of canonisation inquests had to determine that the cure was of a miraculous origin, it appears that for the devotees the medical and miraculous acts were an inseparable part of the same continuum. Occasional conflicts arose with medical professionals, but the living saints also collaborated with them. The connection of a medicating saint and a miracle-performing saint is thus an essential aspect of the medical pluralism of late medieval and early modern societies.

Miracles in my time: Reflections of a pediatric respiratory physician.

Miracles, like London buses, just seem to come along. The truth is, there are no miracles, just lots of hard work behind the scenes, minds open to opportunity, serendipity, and possibly a little luck. In my time as a pediatric respiratory physician, I have borne witness to remarkable advances in treatment that have changed patients' fortunes overnight. Examples of these include artificial surfactant replacement for premature newborns, conjugate Haemophilus influenzae type b vaccination, propranolol for infants with subglottic haemangiomas, mandibular distraction for babies with micrognathia, cystic fibrosis transmembrane conductance regulator modulators therapy for patients with cystic fibrosis, and antisense oligonucleotide therapy for infants with spinal muscular atrophy. There are lessons to be learned from reflection upon these life-transforming treatments, and perhaps it is a good time just to pause and wonder.

'Superimposed miracles': an extremely rare case of a septuagenarian with an unrepaired tetralogy of Fallot: a case report.

BACKGROUND: Although the life expectancy of patients with tetralogy of Fallot (TOF) is comparable to that of the general population due to advancements in surgical intervention, if untreated, patients with TOF may die during their childhood. However, it has been anecdotally reported that a small number of patients with unrepaired TOF survived into their senescence. CASE SUMMARY: A 71-year-old man with a history of multiple heart failure admissions was referred to our institute after successful cardiopulmonary arrest resuscitation. Transthoracic echocardiography showed the overriding of the aorta on a large ventricular septal defect and right ventricular hypertrophy, along with severe pulmonary stenosis (PS), all of which indicated unrepaired TOF. Computed tomography revealed a patent Blalock-Taussig shunt, which was constructed at the age of 19 years. Coronary angiography revealed multivessel coronary stenoses. Although radical intracardiac repair was not performed due to his multiple comorbidities, his heart failure symptoms were significantly improved owing to proper medication titration. One year following discharge, the patient was well and enjoyed playing golf. DISCUSSION: Specific anatomical, functional, and haemodynamic characteristics may be required for the long-term survival of patients with TOF. Pulmonary stenosis should be initially mild to guarantee pulmonary flow during childhood and adolescence, and gradual PS exacerbation should be paralleled with systemic-to-pulmonary collateral development or an extracardiac shunt. Moreover, reduced left ventricular compliance may act as a balancing factor against a right-to-left shunt. The presence of all of these special requirements may have contributed to the unusual survival for this patient.

How to Perform miRacles: A Step-by-Step microRNA Detection Protocol Using DNA Nanoswitches.

MicroRNAs are short non-coding RNAs involved in post-transcriptional gene regulation, and are increasingly considered to be biomarkers for numerous biological processes and human diseases. Current techniques used for microRNA detection can be expensive and labor-intensive, and typically require amplification, labeling, or radioactive probes. In this protocol, we describe a DNA nanoswitch-based microRNA detection assay termed  "miRacles": microRNA-activated conditional looping of engineered switches. This method uses conformationally responsive DNA nanoswitches that detect the presence of specific microRNAs with a simple and unambiguous gel-shift assay that can be performed on the benchtop. The assay is low cost, minimalistic, and capable of direct detection of specific microRNAs in unprocessed total RNA samples, with no enzymatic amplification, labeling, or special equipment. The protocol for detection of microRNAs in total RNA can be completed in as little as a few hours, making this assay a compelling alternative to qPCR and Northern blotting. © 2020 by John Wiley & Sons, Inc. Basic Protocol 1: Preparation of DNA nanoswitches Basic Protocol 2: Detection of microRNAs from total RNA samples Support Protocol 1: Optional nanoswitch purification by PEG precipitation Support Protocol 2: Optional nanoswitch purification by liquid chromatography.

Belief in the miracles of Lourdes: A voxel-based morphometry study.

BACKGROUND: It has been shown that particular religious beliefs and practices are associated with brain function and structure. The present voxel-based morphometry study investigated the correlation between the belief in the miracles of Lourdes (a major Catholic pilgrimage site) and gray matter volume in specific brain regions associated with theory of mind (ToM). METHOD: Structural brain data from 84 women (mean age: 25 years; no current somatic illness; 80% Roman-Catholic) were correlated with self-report measures on belief in miracles, religious-spiritual well-being, and psychological problems. Selected brain regions of the ToM network included the temporoparietal junction (TPJ), hippocampus, amygdala, and medial prefrontal cortex (MPFC). RESULTS: The belief in the miracles of Lourdes was positively correlated with general religiousness and with feelings of connectedness; there was no association with psychological problems. Belief in miracles of Lourdes correlated positively with TPJ volume and negatively with MPFC volume. CONCLUSION: Belief in the miracles was associated with brain volume in regions involved in mentalizing and self-control.

A morte e os milagres de frei Fabiano de Cristo: conexões entre crenças religiosas e cura de doenças no Rio de Janeiro setecentista / The death and the miracles of brother Fabian of Christ: connections between religious beliefs and healing in eighteenth-century Rio de Janeiro

Resumo Com base nos relatos de caráter hagiográfico elaborados sobre frei Fabiano de Cristo e em testemunhos deixados por fiéis após a morte do religioso, o artigo analisa as representações em torno da morte do servo de Deus e estuda as conexões existentes entre o culto aos santos e a cura de doenças no Rio de Janeiro em meados do século XVIII. Nesse contexto era marcada a indistinção entre saberes médicos e crenças religiosas. Partindo desse pressuposto, o zeloso desempenho do religioso franciscano, durante décadas, da função de enfermeiro do Convento de Santo Antônio do Rio de Janeiro permitiu que alguns fiéis o identificassem como santo após a sua morte.

Abstract Based on accounts of a hagiographic nature on brother Fabian of Christ and witness reports by the faithful after his death, this article analyzes the representations surrounding the death of the servant of god and studies the connections between the veneration of saints and healing practices in Rio de Janeiro in the mid-eighteenth century. At this time, there was a notable lack of distinction between medical knowledge and religious belief. As such, the zealous acts of the Franciscan friar over a period of decades in his work as infermarian at the Convent of Saint Anthony of Rio de Janeiro led some of the faithful to identify him as a saint after his death.

Tracing the Boundaries of the Natural: Medicine and the Inquiry on Miracles in Early Modern Canonization Trials.

Between the seventeenth and eighteenth centuries, the inquiry on miracles in the canonization process reveals a fundamental cooperation between medicine and religion. During the last stage of the trials, theologians, lawyers, and physicians concurred with refined reports to accomplish full analysis of the alleged miracles. The promoter of the faith had the task of doubting the supposed miracle healing on juridical, medical and theological grounds; the lawyer supporting the cause responded to any inconsistency in witnesses' depositions; the physician had the task of finding any natural causes which could lead to a natural recovery of the subject. The interplay of these tripartite disciplines underlies early modern probation of supposed miracles. In this paper I will examine the institutional and cultural consequences of the demand for evidence in canonization trials: on the one hand, the increasing role of medical experts in the assessment of miracles and the friction between them and the other members of the committee; on the other hand, the rise of a new method of inquiry in the legal arena.

Madness, Medicine and Miracle in Twelfth-Century England.

This monograph provides a fresh perspective on how madness was defined and diagnosed as a condition of the mind in the Middle Ages and what effects it was thought to have on sufferers. Records of miracles that were believed to have been performed by saints reveal details of illnesses and injuries that afflicted medieval people. In the twelfth century, such records became increasingly medicalized and naturalized as the monks who recorded them gained access to Greek and Arabic medical material, newly translated into Latin. Nonetheless, by exploring nuances and patterns across the cults of five English saints, this book shows that hagiographical representations of madness were shaped as much by the individual circumstances of their recording as they were by new medical and theological standards.

When Religion and Medicine Clash: Non-beneficial Treatments and Hope for a Miracle.

Patient and family demands for the initiation or continuation of life-sustaining medically non-beneficial treatments continues to be a major issue. This is especially relevant in intensive care units, but is also a challenge in other settings, most notably with cardiopulmonary resuscitation. Differences of opinion between physicians and patients/families about what are appropriate interventions in specific clinical situations are often fraught with highly strained emotions, and perhaps none more so when the family bases their desires on religious belief. In this essay, I discuss non-beneficial treatments in light of these sorts of disputes, when there is a clash between the nominally secular world of fact- and evidence-based medicine and the faith-based world of hope for a miraculous cure. I ask the question whether religious belief can justify providing treatment that has either no or a vanishly small chance of restoring meaningful function. I conclude that non-beneficial therapy by its very definition cannot be helpful, and indeed is often harmful, to patients and hence cannot be justified no matter what the source or kind of reasons used to support its use. Therefore, doctors may legitimately refuse to provide such treatments, so long as they do so for acceptable clinical reasons. They must also offer alternatives, including second (and third) opinions, as well the option of transferring the care of the patient to a more accommodating physician or institution.

Exploring the vagueness of Religion & Spirituality in complex pediatric decision-making: a qualitative study.

BACKGROUND: Medical advances have led to new challenges in decision-making for parents of seriously ill children. Many parents say religion and spirituality (R&S) influence their decisions, but the mechanism and outcomes of this influence are unknown. Health care providers (HCPs) often feel unprepared to discuss R&S with parents or address conflicts between R&S beliefs and clinical recommendations. Our study sought to illuminate the influence of R&S on parental decision-making and explore how HCPs interact with parents for whom R&S are important. METHODS: A longitudinal, qualitative, descriptive design was used to (1) identify R&S factors affecting parental decision-making, (2) observe changes in R&S themes over time, and (3) learn about HCP perspectives on parental R&S. The study sample included 16 cases featuring children with complex life-threatening conditions. The length of study for each case varied, ranging in duration from 8 to 531 days (median = 380, mean = 324, SD = 174). Data from each case included medical records and sets of interviews conducted at least monthly with mothers (n = 16), fathers (n = 12), and HCPs (n = 108). Thematic analysis was performed on 363 narrative interviews to identify R&S themes and content related to decision-making. RESULTS: Parents from 13 cases reported R&S directly influenced decision-making. Most HCPs were unaware of this influence. Fifteen R&S themes appeared in parent and HCP transcripts. Themes most often associated with decision-making were Hope & Faith, God is in Control, Miracles, and Prayer. Despite instability in the child's condition, these themes remained consistently relevant across the trajectory of illness. R&S influenced decisions about treatment initiation, procedures, and life-sustaining therapy, but the variance in effect of R&S on parents' choices ultimately depended upon other medical & non-medical factors. CONCLUSIONS: Parents consider R&S fundamental to decision-making, but apply R&S concepts in vague ways, suggesting R&S impact how decisions are made more than what decisions are made. Lack of clarity in parental expressions of R&S does not necessarily indicate insincerity or underestimation of the seriousness of the child's prognosis; R&S can be applied to decision-making in both functional and dysfunctional ways. We present three models of how religious and spiritual vagueness functions in parental decision-making and suggest clinical applications.

A new twist to the No Miracles Argument for the success of science.

J. D. Trout has recently developed a new defense of scientific realism, a new version of the No Miracles Argument. I critically evaluate Trout's novel defense of realism. I argue that Trout's argument for scientific realism and the related explanation for the success of science are self-defeating. In the process of arguing against the traditional realist strategies for explaining the success of science, he inadvertently undermines his own argument.