“Doctor you discharge her for us for a week we’ll come back.”

“This condition is not meant for the white man’s medicine.”

“Let me call my pastor, we have faith.”

“She has stepped on something.”

“It’s our enemy’s handiwork, her rivals (work, business, social or romantic) are at work.”

These are statements you get used to hearing daily and trying to navigate this tortuous thorny area makes a difference in how you are able to treat your client effectively as a medic.

We had gone through three seizure  episodes, uncontrollable blood pressure and kidney failure all present before her admission a month earlier and just when you thought you were winning, they insist it’s time to leave. You negotiate, even ask them to bring the pastor over to the hospital to pray but to no avail (yes, you can guess who is behind the sudden urge to leave immediately). She is an adult, so  you spend days trying to make them understand the implications of their action, you make them write a discharge against medical advice letter , get a commissioner of oaths to swear to that effect, just to let them have time to reflect on what they are doing. They insist that’s their path of healing.

With a heavy heart, you can’t hold them prisoner any longer, they fulfilled all conditions so you let them leave. “We will be back in week” they assure you.  One week you call them, “Oh we are in the village, she is doing well we will come next week”. You sigh and go on. You have a lot of work to do. Second week they call “We are fine, we are taking your medicines”. Third week, no call. Finally you call them again and the father exclaims “Oh Doc! Asabea is dead oo, she had another one of those episodes and this time your team was not there to save her!”

“Let me call my pastor” are the first words uttered by the mother of the 12-year-old child with severe lupus affecting her heart and kidneys. She can’t breathe, she looks so ill. She hasn’t even called the husband who is said to be travelling. She places the call to the pastor and insists that they are not going on admission no matter what you say. She will be fine when she brings her back in a few weeks’ time, how can you the doctor be so negative in saying that she will die if she is left unattended? She forgets she brought her daughter because of a crisis and not under duress. You pull the educated doctor card this time and threaten her with legal action if the child dies. Children belong to the state, you say, and if she dies they will come after her and the pastor.

The mother now calls the father. He and the uncle show up at the clinic after haggling with the mother for 3 hours (all this is going on while you are seeing to other patients in the oversubscribed outpatients’ clinic.) You explain to the father how ill the child is and what the consequences can be. They reluctantly agree to be admitted but they are already planning when they would be discharged. “It’s going to be another battle to save this one” you mutter to yourself.

It’s hard not to become disenchanted with all forms of religion as a medical professional from some of the things you see. We are not the demons some pastors pray against. We didn’t manufacture or impose the diagnosis on our patients. We have faith too, we these faithless doctors hoping and praying that they do come back looking better. When it’s beyond our capacity we also look to the Higher Power to save this precious one.

God still works to heal people in ways that defy medical knowledge. It is never wrong to pray for healing. The Bible tells us to pray for whatever we need and that includes healing from diseases. But sometimes healing does not occur, even to the most loving, God-centered people. In one of Paul’s letters he talks about a “thorn in the flesh,” some kind of physical ailment. Paul was certainly a man of faith, yet he was not healed of it (2 Corinthians 12:8-10)

The other reality is we all will die. Every person who has ever been healed has died. Even Lazarus, the dear friend Jesus raised from the dead, died again.

I strongly support freedom of religion and at least as strongly the right of a mentally competent adult to choose their treatment and even to refuse medical treatment if that is their wish, as long as they fully understand the possible consequences up to and including death. Doctors can’t force treatments on competent adults who understand the consequences. That would be a violation of their right to self-determination or autonomy to do so. Children however are a different matter altogether.  (The view is that adults are permitted to refuse treatment even if they die as a result, but they do not have the right to kill their children through such choices.) And usually when the severe complication or death happens the pastor is far away from this trouble, he doesn’t even come to visit.

Let us remember in Matthew 22:21 Jesus said “Render to Caesar the things that are Caesar’s; and to God the things that are God’s.” Romans 13:1 says “Let every person be in subjection to the governing authorities. For there is no authority except from God and those which exist are established by God.”

Once you brought yourself willingly to the hospital why do you make it so hard for us to also do our part? Medicine must be taken according to directions to be effective. To take it once in a while when the directions say three times a day will mean limited results, if any. No matter how good the medicine is, it must be taken according to the directions or it won’t work.  Remember that it takes time for medicine to work. Most people give spiritualist or herbalists a lot of time, patience, and money to work. They are diligent about their instructions. They don’t just take one dose and expect a miracle. These same people ignore the counsel of medical doctors.

Ignoring reality is almost consistently disastrous. Death by misfortune is heartbreaking; death however by stupidity is simply stupid.

Let’s us learn when and how to give Caesar his due and God His own.