Lourdes: A Uniquely Catholic Approach to Medicine

Lourdes: the impossible clinic

As Dr. de Franciscis likes to say, “Lourdes as a clinic is an utter failure.” While thousands of cures have been studied over its 150-year history, tens of millions of sick people have come from all over the world who were not cured. So why do people come to Lourdes?

Medically, it does not make sense for sick people to travel to Lourdes. It does not make sense to take wheelchair- or bed-bound pilgrims, pack up all of their medications and support devices, and ship them across land and sea to a little town in southern France. But that is what the patients want. Some pilgrimage groups have the mission to take to Lourdes anyone who wants to come, regardless of medical support needed, even fulfilling the wish of some to die at Lourdes.

The current trend of literature on religion and medicine has been to link spirituality or meditation as a tool for better physiological health outcomes (Shuman 2003, xvi). However, pilgrims coming to Lourdes find much more than this. For those whom I met in terminal stages of illness, biomedicine can only provide a pain-free and comfortable death. It cannot help them accept their situation and prepare themselves to meet God.

With the excellent standards of care they provide, the volunteer physicians give their pilgrim patients the ability to receive the spiritual care that they desperately desire. Because of this unique role of health care in Lourdes, many doctors have told me that they find themselves needing to be both spiritual guides and medical practitioners.

In Lourdes, I have prayed with patients and their doctors in critical medical situations as they received the anointing of the sick. I have attended mass with them. I have accompanied the sick on their faith journey. Lourdes is a unique place which seems to institutionalize the amalgamation of health care and the practice of religion. I found that it is not just the spirituality of patients, but the spirituality of the doctors that has an impact on care.

I have encountered again and again what seems to be—what I can only describe as—a peace that finds the sick and their families. I saw it in the crying faces of people leaving the Baths, the pools where pilgrims can be submersed in the water from the spring. I saw it in the faces of parents pushing their sick children in wheelchairs during the evening candle processions. I saw it in an elderly lady speaking in a language I could not understand, who sat in the grotto one night and burst into tears as she showed me pictures of her family as I put my arm around her.

Are these just complex emotional reactions that we will eventually be able to describe with biomedical means? Is the real reason why people cry when they hear beautiful music just an appoggiatura-induced neuronal pattern stimulating a complex release of dopamine and other neurotransmitters (Doucleff 2012)? No. I believe these are reflections of the inexplicable, unquantifiable qualities of a soul that cannot be manipulated by biomedical sciences.

The doctors and healthcare providers I witnessed at Lourdes find the inherent dignity of the human person through the recognition of the souls of their patients. This recognition that informs their practice of medicine even as they return home after caring for pilgrim groups is what I think distinguishes the Catholic physician.

Le Bureau

The Office of Medical Finding sits on the top floor of Accueil Jean Paul II where doctors, medical students, and other health professional of any faith who are traveling to Lourdes can come and register. If a claimed miracle seems legitimate and the person is in Lourdes, the Bureau is convoked and these physicians are free to ask questions and examine the medical records of the proposed cured person. If the case is declared legitimate by vote, it will be further examined in depth and confirmed by the International Medical Committee of Lourdes, a collection of forty eminent physicians ¹ which meets in the fall to examine the cases of the year.

The Bureau follows the Lambertini criteria to declare if a cure or spontaneous remission associated with Lourdes is “medically unexplainable according to current medical knowledge.” It is up to the bishop of the diocese of the person who is healed to declare whether it is a case of a miracle or not. It is the same criteria used at the Vatican to declare miracles in the process of the canonization for sainthood. According to the Lambertini criteria, the disease must be serious and impossible to cure by current human means as well as not be in a stage liable to remission. The cure must be instantaneous, complete, permanent, and must not be preceded by treatment to which the cure could be attributed. In order to comply with these criteria, the cases can sometimes take decades of follow up and observation before they are “cleared” by the Medical Bureau.

Because of this process, Lourdes seems to be one of the few places in the world where there is a legitimate conversation between medicine and the Church. The work of the Medical Bureau facilitates this conversation. All doctors and health professionals of any or no faith are welcome to come and register with the Notre Dame de Lourdes International Medical Association and participate in the proceedings. This spirit of welcome pervades all of the Bureau's work and was fundamental to my stay at Lourdes.

I was welcomed to look through and study in depth a few dossiers (the complete documentation of every case including lab reports, tests, and imaging) which had been deemed to clear the Lambertini criteria. Each of these dossiers are hundreds of pages long. For me, this examination vividly made real this term “miracle” that seems to be thrown around in everyday language. I won't go into individual cases here—there are many comprehensive reviews published by the International Medical Committee ² —but as I read each of them, I felt an uncomfortableness; an unsettling feeling that I could not reconcile the verified facts.

The facts are simple, yet infinitely perplexing. A person had a disease, came to Lourdes, and then the person did not have the disease. The system of the verification of these facts is so comprehensive and unbiased that each case is not a matter of believing or not believing, it is a matter of accepting verified incongruous facts that in the end point toward an inexplicable cure.

Ethan Allen, an American revolutionary and philosopher, exemplifies a popular sentiment about miracles in his book, Reason, the Only Oracle of Man:

Nothing is more obvious than the fact that in those parts of the world where learning and science have prevailed, miracles have ceased, but in the barbarous and ignorant parts of the world, miracles are still in vogue. (Allen 1784, 39)

But the Bureau's work defies this sentiment. Founded amidst societal suspicion of religion following the French Revolutionary period in 1883, the Medical Bureau is a place where learning and science prevail. The Bureau accomplishes the task of removing superstition and speculation from the episcopal declarations that these cures are miracles or signs of divine intervention. In doing so, the work of the Bureau gives us the precise faculty to comprehend the wonders of the work of God.

This desire to search for Truth, beyond what is measurable and quantifiable, again, is a point of distinction among Catholic physicians. It is a desire that needs cultivating and renewal. I have rediscovered this desire in Lourdes, and it will continue to inform the rest of my career.

Conclusions

Every person I have met in Lourdes came here searching for something. Something that they could not necessarily put into words. Or, in the case of people who come back annually, the chance to renew what they did once discover here.

What I found in Lourdes was the capacity to seek the face of Christ in those for whom I am entrusted to care. I have learned how to journey with patients in their disease rather than running diagnostic algorithms in my head. I have been reminded that being a physician is not just a series of examinations and certifications, but truly a vocation where we are privileged to understand in a greater capacity that which is made in the image and likeness of God. My experiences breathed life into the call by the curia for physicians to be “ministers of life” (Pontifical Council for Pastoral Assistance to Health Care Workers 1995).

As far as practical learning, Lourdes tends to attract pilgrims with random and obscure diseases that most physicians might see once in their lifetime of practice. My encounters with these patients have given me faces and moving stories of their personal struggles with their disease to go along with what I have only read about in textbooks.

The experiences I have had in Lourdes as a medical student have been indispensable to my formation as a physician. My opportunity should not be unique. There is a real need for physicians to come and regularly volunteer at Lourdes. The higher the level of medical care that can be provided, the greater the opportunity sick pilgrims will have to be able to come to search for the Truth in the wonder of God's work. To use physical care as a tool to provide critical spiritual care is something that will transform my approach to medicine. I feel as if my drive to study medicine has taken a different tone in that I am not studying only to make my patients physically better, but also to help in caring for their souls. Regardless of whatever phase of medicine someone is in, I believe that there are experiences unique to Lourdes that can inform their practice of medicine.