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Revd Peter Yuichi Clark, Spirituality for Physicians Part 1: What is Spirituality? - Duration: 15:32.
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Hello, I'm Reverend Peter Yuichi Clark, I'm director of Spiritual Care Services at
UCSF Medical Center and UCSF Benioff Children's Hospitals.
And I'm here to talk with you today about spirituality for physicians.
This is Part 1 of a four part lecture on the topic.
And each part is organized around a central question.
The question for
Part 1 is, What is Spirituality, Anyway, and Why Does It Matter?
Which is a really good question to ask.
Hopefully by the time we finish with this presentation,
you'll be convinced like I am that spirituality is very important and
that you should care about it as you care for your patients.
So let's start with a little cartoon.
This is by Lee Lorenz and it comes from the New Yorker.
And the Grim Reaper is at the door and the wife says, it's the closure fairy.
And the reason why I picked this cartoon is because oftentimes chaplains are seen
as the angels of death when we walk into patients' rooms.
They think that we're there to simply break bad news, or that the other
reason we come to the patient's room is because they're at the end of life.
And it is true that we do a lot of that but we go to see patients in all kinds of
situations, and we're there to address their spiritual and
emotional needs, at any point of their lives, not just at the end of life.
And you may be thinking that, you know, I don't want
to talk about spiritual issues because I'm afraid the patient might think that I'm
telling them something about what's going to happen to them with their prognosis.
And I hope that you'll feel like you don't have to worry about that.
The patients really want to talk with you and
with all of us about their spiritual issues and concerns.
Because it is so very important to so many of them.
Which gets us to a commonly used phrase, especially here on the west coast,
about people saying, oh, I'm not religious, but I am spiritual.
And there's actually a lot of truth in that statement because for
many people, they do express a sense of spirituality, but they
may not feel a formal affiliation with any kind of religious group or movement.
But that begs a question for us, what is spirituality anyway?
Well, the first thing to think about is that spirituality comes from
the Latin word for breath.
And if you think about breath, there's no way that we can have our life without it.
And spirituality is in the same way as breath,
in that spirituality pervades all of our existence, all of our lives.
And it is vitally important, even for
people who don't have any formal religious affiliation.
So, one definition that I like to use for
spirituality comes from the consensus committee talking about palliative care
and the importance of paying attention to spiritual needs in palliative care.
And the definition that I like to use is, spirituality is the aspect of humanity
that refers to the way individuals seek and express meaning and purpose.
And the way they experience their connectedness to the moment, to self,
to others, to nature, and do the significant or sacred.
Now, you'll notice that the words meaning and
purpose and connectedness are highlighted in this definition, and I think that those
are the two really important aspects of spirituality, in that it doesn't matter
what religion you might practice, you may have no religious faith that you profess.
But all of us have a sense of meaning and purpose that guides our lives.
And all of us, regardless of how introverted we are, or
how extroverted we are, we have a sense of connectedness to others.
We have a sense of connectedness to the world around us.
And we have a sense of connectedness to something or someone bigger or
higher or deeper than ourselves and we may have a name for
that significant alternate reality, or we may not.
But we all have this sense of connectedness to something more powerful,
stronger or more meaningful than ourselves,
that helps to give us a sense of purpose and meaning and so, in that sense,
all of us are spiritual, even if not all of us would claim to be religious.
Now, having said that, most of our patients have a very strong connection or
tie to a sense of religion or a belief in God, or
some form of transcendent reality, however they might name it.
For example, the Gallup Poll back in 2011 said that at least 92%
of the US public consistently described themselves as believing in God.
That's a pretty high percentage.
And 81% of those people said that religion is either very important to their lives or
fairly important to their lives.
So again, a very significant proportion of the patients we see, here in the hospital,
are going to have some kind of tie or claim to a religious faith.
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Now to look at it from a different perspective,
the Pugh forum did a study of the U.S. religious landscape back in 2008.
And they found that in the United States,
five out of six people nationally had a religious affiliation that they claimed.
The majority of them were Christians, but still,
even if you included in a number of other more minority or
under-represented faith groups, it came out to about five of six people in the US.
Now in the state of California, the percentage is a little bit lower,
it's more like 80%, four out five people state wide.
But even so, at 80%,
that's quite a few people that we have to pay attention to the spiritual needs for.
So while many of our patients in their families and
loved ones want to pay attention to their spiritual needs and
feel a strong connection to their religious faith.
The axiom is that physicians as a whole are less likely to believe in God,
less likely to practice a specific religion, and
less likely to hold much stock in spiritual things.
And some of this may be due to the inclinations that physicians have to
pay attention to the scientific.
It may be a sense of not having it as a strong part of one's growing up.
It doesn't matter.
And it also isn't true that all physicians don't feel a connection to
religion at all.
But it seems as a whole, that physicians tend not to pay
attention to religion as strongly as other factors in their lives.
Certain studies have shown that a number of trends in this regard.
For instance, physicians seem twice as likely not to rely on God or religion for
a sense of coping, particularly with major stressors or crises in their own lives.
They're twice as likely to see themselves as spiritual but not religious.
Similar to the axiom that I talked about a little bite earlier.
They're more likely to claim an underrepresented faith,
if they are religious.
And what I mean by that is that those physicians who
do explicitly confess a religious faith, tend not to be Christian.
They might be more inclined to be Muslim or Sikh or Jewish.
And less likely to have an affiliation with a Christian denomination.
Physicians are more likely to rank lower than other healthcare givers in terms of
the degree of religiosity that they practice compared to social workers,
nurses, and of course chaplains.
Now, I should define religiosity quickly here, spirituality is the larger term,
the umbrella term that I offered for you a little bit earlier in this video.
Religion is a subcategory of spirituality.
In that religion is a particular way in which people can express their
spiritual lives.
Now, religiosity refers to the degree or
amount of religious practice that a person has.
So you can have a person who is practising a high degree of religiosity.
And that person might be going to religious services every week,
might be engaging in regular prayer and meditation and other such practices.
Whereas you might have other persons, who would say of themselves,
oh I'm culturally Jewish, or
I practice some of the major holy days, but I don't go regularly to Temple.
And those persons would likely have a lower degree of religiosity.
So physicians tend to rank lower in terms of this measure.
Also, it's been found among house officers,
physicians who work in the hospital setting.
That those who have a poorer sense of religious coping as measured by
survey instruments, and those who have a worse sense of
spiritual well-being as described in questionnaires and
surveys, tend to have stronger depressive symptoms than physicians who report
a higher degree of religious coping and a stronger sense of spiritual well being.
So for some physicians for whom religion is important, there seems to
be a correlative effect on their mental health, particularly as they are engaging
the high intensity, high stress situations that hospitals often offer.
So, with that, it's important to realize that even though physicians may not have
a strong connection to a religious faith, that most of the people we're serving
want spirituality included in their medical care in some form or fashion.
For example, well over two-thirds of patients have said that they want their
physicians to consider their spiritual needs as they're undergoing treatment.
Nearly all of them say that their spiritual beliefs are a source of
comfort and help for them in their times of need.
Yet less than one in five physicians currently discuss such issues with
their patients.
So the question is, why would that be?
Please pause the video for a moment and think about what your reasons might be for
not wanting to engage spiritual issues with patients.
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All right, welcome back.
So, some of the reasons that clinicians have described as reasons of
reluctance for addressing spirituality with their patients include the following,
it's a private patient matter.
And this make sense because physicians are already busy, and it may feel
like an invasion of people's privacy to discuss this kind of issue with them.
Many patients don't want it.
Well, that's actually not quite as valid a reason, because it does seem to be
the case that patients really want their spiritual needs discussed and addressed.
It's not our job.
Well, there's some truth to that, in that hopefully you'll
have a chaplain nearby who can address the needs more explicitly.
But you can't count on the spiritual issues only
coming up when the Chaplain is near by.
It's very likely that when you're describing a diagnosis, or
talking about a prognosis with a patient, particularly if
that is a very serious illness, that spiritual matters are going to come up,
and so it will be important for you to engage it.
Even if you don't feel like you have, you can do a thorough job of it, and
frankly you don't need to do a thorough job.
It's quite simple, and I'll describe it in more detail later.
Many clinicians are uncomfortable with it.
Well, this is natural.
Again, this is not something that is a normal part of most people's medical
training, but fortunately at UCSF it is something that we emphasize and
hopefully this video and
other opportunities you will have will help you to feel more comfortable with it.
I can't guarantee that you're gonna feel enormously comfortable with it,
but at least a little bit more comfortable.
And physicians in particular often feel like they don't do it well or
they aren't prepared for it.
And some of the reasons why they don't feel like they're prepared include.
A lack of time which is the bane of our existence in health care these days.
Feeling untrained for it, this video series is meant to help alleviate that.
And cannot identify interested patients.
Well, here again, the chaplain might be a good research person to help you with your
assessment and with figuring out who really would like to
speak about these issues and who doesn't really wanna talk about them right now.
So even though you might feel uncomfortable talking about
spirituality, or
you might feel like it's a little invasive to broach the subject with your patients.
It's still a right that patients have to experience spiritual care.
And this comes directly from the joint commissions regulatory standards for
acute care hospitals.
Patients have a fundamental right to considerate care that safeguards their
personal dignity and respects their cultural, psychosocial, and
spiritual values, and it doesn't say that only the chaplain provides this.
It's actually assuming that all of us in healthcare, nurses, social workers,
therapists, chaplains, all of us, have to pay attention to this, and
provide care that is respectful and sensitive and compassionate.
So in summary, spirituality is a vital part of human experience.
Now some people may express their spirituality through religious ideas,
practices, rituals but
it can arise in a number of other ways that are just as meaningful.
You may have a patient who says I feel most connected to the sacred when I
am out in nature.
And that is just as valid an expression of spirituality as the patient who
says when I go to temple that's when I feel close to God.
Many people in the US have a specific religious affiliation that brings them
a sense of identity and comfort and they want us, us health care givers,
to take those values and beliefs into account, as we provide treatment to them.
Physicians, as a group, tend to be less religious than the general population, but
we need to consider a patient's spiritual needs,
as part of a holistic and multidisciplinary plan of care.
It should be something that's discussed just as much as what the patient's
dietary preferences are, and what kind of pharmacological regimen you're going to
pursue in terms of their treatment.
It's an element of their existence as a human being, and
we need to pay attention to it.
And patients have the right to be treated in
a way that respects their spiritualities.
So I hope that this video has helped you to
see the importance of paying attention to spirituality in patient care.
But you may be asking yourself, well, how do I do that?
Well, please stay tuned because in part two, we'll deal with that in more detail.
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How Old is Future Trunks? | Dragon Ball Code - Duration: 3:43.
Future Trunks is one of the most loved characters in Dragon Ball.
Sadly, his whole life is filled with sadness, sorrow and anger.
He Lost everyone and had to grow up fast in order to survive.
He didn't even have a childhood.
But putting that aside.
What we want to know is how old is he.
Hey how's it going my name is Raf and welcome to Dragon Ball code.
Today we are going to find out how old Future Trunks is.
And if you still remember that moment when he first appeared and we barely knew anything
about him, hit that like button.
Future trunks was born in age 766.
This is the same year where Goku passes away due to the heart virus.
From there everything just starts going down the hill.
The next year android 17 and 18 appear.
And they kill every single one of the Z fighters except for Gohan.
During the next 13 years Gohan trains him and tries to teach him how to become a Super
Saiyan.
In the manga he was able to do it during this time, not in the anime.
Now in age 780 he is 14.
This is where the tournament of power takes place in the past.
Here Trunks and Gohan end up fighting the androids but they are terribly defeated.
Gohan even looses an arm.
Then in age 781 tragedy strikes again and the androids kill Gohan.
In the anime, this is when he turned into a super saiyan which in my opinion made it
a lot more epic.
He channeled all that ager and pain to help him transform.
Kinda like when Goku turned super Saiyan for the first time.
Now, he hides and trains for 3 years to face the androids, but when he does, he is defeated
again.
With this whole tragedy that is going on Bulma and him decide to travel in time.
And in age 784 he goes 20 years in the past to try and prevent what happened in the future
from happening.
Here he is 17.
He kills Frieza, warns everyone about the androids, gives Goku the medicine for the
heart virus and returns to his time.
In age 785 he goes back to the past to help everyone with the androids and Cell.
Soon after they defeat Cell he goes back to his time and destroys the androids from the
future.
Then this is where it gets complicated because as he was traveling back and forward he kept
creating multiple timelines.
So in age 788, when he is 22, he prepares to go back to the past to tell everyone that
he had destroyed the androids, but as he is getting ready to go, he is killed by cell.
And Cell takes the time machine to go to the past.
And that's the same Cell they fight in the past.
The thing is that Trunks is still alive in other timelines… yeah it's complicated
so, we will stick with the timelines where he is still alive and pretend that he never
died.
Then a few years later he finds Dabura and Babidi and he destroys both of them preventing
Majin Buu from being revived.
Then in age 796 Zamasu and Goku Black appear bringing havoc to his timeline.
Then with the help of Bulma (again) he makes a one way trip to 16 years in the past, to
age 780.
Here he tells the gang about what is going on and they decide to help.
They make multiple trips back and forward until they finally beat Goku Black and Zamasu.
Trunks and Mai are the only ones that survive from this timeline.
The whole timeline gets erased.
Then, Trunks and Mai decide to go back and live in a timeline were themselves already
exist.
They leave and this is the last time we see Future Trunks.
So the last time we se Future Trunks he is 30.
But you have to remember the he went into the time Chamber 2 times while they were fighting
Cell.
He spent a total of 2 days in there which means that he spent 2 years inside.
So this makes Future Trunks 30, but physically 32.
And there you have it.
If you enjoyed this please share it with your friends and of course if you like Dragon Ball
content make sure to subscribe and hit that bell icon with a burning attack so you can
get notifications whenever I post a new video.
Thanks for watching and I'll see you later.
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