In my time in paediatrics last year I discovered what would have to be my favourite illness – croup. It can be diagnosed on inspection, and rapidly resolves with adrenaline and an oral corticosteroid. Worried parents bring in their child with acute respiratory distress, occasionally on the verge of arrest, and you get the chance to make an instant diagnosis and deliver an almost immediate cure. This is medical practice at its most rewarding!

I'm not a surgeon, but I imagine surgery is similar – you often get the chance to cure life-threatening problems completely. This is what we love about our job! These moments are always a boost for our insatiable egos.

Unfortunately our love of the cure leaves us with a distaste for the incurable. There is nothing satisfying about stringing someone along in end-stage cardiac failure just so they can spend another day in respiratory distress, gasping to cling on to what remains of their life. Or is there?

Healing or curing?

I am in debt to a friend of mine, Dr Doug Bridge, with respect to this question. Doug is a Christian palliative care physician – gentle and softly spoken, yet bone-jarringly honest about his struggles and hurts. I have learnt so much from sitting at the feet of this man.

Doug always catches attention when he tells people that he considers himself a healer. A healer? In palliative care? But all of his patients die!

He confesses that his patients don't get cured, but insists that they do often get healed. In the broader sense, the word 'healing' is probably best understood to have little to do with 'curing'.

It is possible that conventional medicine, even Christian conventional medicine, is lagging behind in our grasp of this concept. It is something that the New Age movement and alternative medicine disciplines seem to have taken hold of some time ago, perhaps in reaction to the cold, biological problem-solving that has often (at least in the past) characterised conventional health care. It seems people don't want to be treated as a walking culture-medium of disease, but as a whole person!

Thankfully this not-so-revolutionary thinking is creeping into our education, where we are now taught not only the biopsychosocial model, but also that spirituality is important to our patients. All over the world spirituality is being gradually added to healthcare curricula as even secularists come to appreciate that our ignorance of this facet of health care has been almost criminal.

To be healers we have to come to see that whilst inflammatory bowel disease may be the diagnosis, it is the depression and the existential confusion of our patient that is most in need of remedy! And once again we find ourselves in a place of tremendous privilege. We have the opportunity to come alongside our patients and their families in their most vulnerable moments when their physical, psychological, emotional, relational and spiritual crises are all brought to the surface. And as Christians we are the best equipped to be able to offer support in all these respects. At least we ought to be.

When someone becomes unwell their priorities change. You will have heard that no one says on their deathbed that they wish they'd made more money, or that they regret not having spent more time in the office. People who are sick suddenly realise what is important to them – family, friends and God. Even people who don't believe in God often begin reflecting on their mortality, and what may or may not lie beyond.

In these moments of reflection, people often become aware of old wounds that they need healed: rifts in the family that need to be dealt with, things that have been left unsaid to loved ones and friends, guilt over past transgressions that need resolution either with people or with God, or both.

This is the time for the healer. These patients don't just need chemotherapy, they need to be healed. And remember, healing may not involve them being cured.

The reality is of course that we don't have the time or the emotional resources to be able to sit down with every patient and explore their tattered relationship with their estranged father, or to solve their existential crisis. Similarly, we aren't called by God to heal everyone – we are called to be faithful in obedience, and to heal where and when he says so. It isn't up to us to save the world. But what we can do is be aware that there is more to healing that just addressing a physical disease process.

Difficult problems and hurting people

I like to use as my example those patients with unexplained chronic pain: they are suffering in a way that we find difficult to understand. These people aren't just suffering a physical affliction – they often have a complex of sicknesses that has entangled their minds, their emotions, their relationships and their understanding of God. So many of our colleagues, having failed to find an obvious physical explanation for their ongoing pain, then go about explaining in a circuitous fashion that really the pain is 'all in their head'. This is not healing. We must realise that how we explain this awkward diagnosis will have a tremendous long-term impact on how this person is going to understand their pain for years to come. You may have a healing effect, or a damaging effect – think carefully how you will respond.

The truth is that our hospitals and surgeries often feature some seemingly unlovable people. Almost every field of medicine has its so-called 'heartsink' patients:

• the 25 year old hypochondriac woman who can't seem to accept that her chest pain is musculoskeletal in origin
• the 41 year old Type I diabetic who is readmitted with diabetic ketoacidosis every other week because of alcoholism and non-compliance
• the 31 year old woman with chronic pelvic pain who can still tell you her list of twelve concurrent diagnoses ('endometriosis, irritable bowel syndrome, peritoneal adhesions…') despite twelve essentially normal laparoscopies
• the 54 year old man who has been on a disability pension for 17 years for back pain since being discharged from the army, yet still manages to put a new roof on his house
• the 19 year old man who says his severe abdominal pain only responds to IV morphine
• the 39 year old woman who bursts into tears with another emotional crisis each time she is about to be discharged

Suffering people often gravitate toward the health system. Many of them have been deserted by friends and family, and the only place where anyone even listens to what they have to say is the hospital! We are faced with them every day. As a junior member of medical staff, I often hear my senior colleagues speaking of such patients – usually to mock or belittle them. It is very difficult to avoid falling into the same mindset, as we often find ourselves inadvertently imitating our 'superiors'. The cynicism is contagious.

Why is it we have so little tolerance for such people? They comprise a very large part of what we do, and yet we seemingly can't stand them! I think part of it is still that we like to cure people. We like the ego boost of having rescued some poor soul from the jaws of illness – it makes us feel big. 'Thank you doctor!' they say, as we smile humbly, 'Just doing my job, Ma'am'.

The problem is that people with chronic pain often don't get cured. They don't say, 'Thank you doctor!', they just come back the next day and complain that you made it worse than it was before. One's ego doesn't cope with this very well. And when we don't know what's going on we sometimes blame the patient for not getting better. Eventually we decide to avoid them, or to be so rude to them that they go and see someone else.

These patients have often been jettisoned by strings of doctors, and are almost accustomed to being treated like refuse. As Christians we ought to be prepared to take some of these patients on, but if we continue to think of the cure as our goal, then we will likely be disappointed.

As Christian healers we want to be providing support for patients who are trying to come to grips with their suffering. We want to help them heal their broken relationships. We want to facilitate them in being healed in their relationship with God. We have this opportunity before us, and need to consider prayerfully in each situation what we should be doing with it.

Healing in others

Dealing with terminal illness is probably the most obvious opportunity we have to address healing directly. Whether we admit to it or not, we do have some say in how long we can keep people alive. Sometimes we keep people alive too long, just because we have the technology. Often this is more a reflection of our own difficulty in coming to terms with death than what is best for the patient and their family. Many doctors find it difficult to accept the death of their patients, and keeping them alive as long as possible perhaps alleviates some of their anxiety about being unable to face their own primary questions of life and death.

However, there are times when keeping someone alive just long enough is of great value with respect to healing. I witnessed a typical example during my intensive care placement several years ago: I cared for a 68 year old man who had suffered a huge intracerebral haemorrhage. He never regained consciousness after the initial bleed, and required ventilation throughout his time in ICU. This had obviously come as a complete shock to his family, many of whom lived on the other side of Australia. We kept this man on a ventilator for several days knowing he had effectively no chance of ever recovering consciousness. I watched my consultant observing the family very closely as the days passed, as they flew one by one into Perth to see their ailing father. We discovered that they hadn't been together like this in 15 years, and that there were a lot of unresolved issues within the family. We watched them as they embraced, cried together, and said things to one another that they'd clearly never said before. We saw them hold their comatose father's hand, whisper into his ear of their love, or just lie their head on his chest and cry.

When the time was right we knew it – they had said their goodbyes. We had been explaining as the days had passed that inevitably we would need to wean him off the ventilator to see whether he could breathe for himself. They understood that he would almost certainly die. They were all present through the day as we reduced his assisted ventilation and extubated him. He did breathe on for several hours afterwards, and then eventually passed on from this life, with his family all around him, reconciled to one another and to their grieving mother, having been brought together in the face of a great tragedy. That man was not cured, but truly we were the witnesses of tremendous healing in his family.

Room for the miraculous?

Sometimes God surprises us, and does provide not only healing, but a miraculous cure. Jesus led by example in his earthly ministry of healing, and said that his disciples would be known for performing such miracles themselves. I am still exploring in my own life what this means for us as Christian practitioners today.

The year before last I was part of a hepatology team that diagnosed a 25 year old Christian girl with inoperable hepatocellular carcinoma just weeks before her wedding. She, her fiancé, and her whole family were strong believers, and had a wonderful faith that she would be healed. Knowing that I was a Christian, they confided in me. They were contemplating refusing the recommended therapy (palliative chemo-embolisation of the largest tumours) because they believed God would heal her. They wanted to know whether I believed she would be healed.

I found this a difficult position. I don't recall exactly what I said at the time, but if I have my chance again it might be something more like this:

I would explain to them what I think it is to place your trust in the divine healer rather than the healing. Let's imagine I grew up on a farm. As a young boy, I was always asking my father when I'd be allowed to drive a car. He would never name a particular day or time, he would only reassure me that when the time was right, I would be allowed, and that he would teach me. It would be only natural for me to ask again from time to time, even to beg to be allowed to give it a try. But, knowing that my father is good and wise, at the end of the day I sleep easy, trusting that when the time is right, I will be allowed to drive that car. Knowing the timing is not as important as knowing that my dad will honour his promise.

I see healing in a similar way. God has told us that in him we will be healed, restored to completeness, when the time is right. I believe him absolutely, and at the end of the day I sleep easy knowing that when it is his time, he will live up to his promise. It is not for me to know the time, though it would be only natural for me to ask him now and again to hurry along!

My trust is in the healer, not in the timing of the healing. He is faithful – I know I will be healed. I don't know when. It might be as I pass from this life into the next, it might be sooner. It is not for me to worry, and I should feel free to pursue or refuse the various treatments as I see fit, in accordance with my measure of faith.

I don't know whether this would have been helpful for her or not, but this makes great sense to me. We have peace knowing that our Father will heal us completely, and we should place our trust in that. We shouldn't expect, unless God gives us specific reason to, that he will physically heal us of our illness in this life – he may not. But if we place our trust in the healer rather than in the event of the physical healing, we know we are safe with him, and can let him determine the timing of our restoration… in this life, or the next.

A personal journey

I used a similar perspective with the illness of my own father, who died of metastatic malignant melanoma a little over a year ago. In the time between his diagnosis and eventual death he had received a very tangible touch from God, a reassurance that he was healed. My dad believed that, and I did too, even though I never held out much hope that he would beat his metastatic disease. The transformation in his final months assured me that God had wrought salvation in his life, and left me in no doubt about his eternal destiny.

And the thing is, he was healed. I was with him as he died. He was unconscious for some hours before his death. I thought he was going to last long into the night, and perhaps into the next day. Even so, I read a benediction from Numbers 6:24-26 over him with my eldest brother also by his side. The rest of my large family had taken a moment's respite in the kitchen:

The Lord bless you and keep you;
the Lord make his face shine upon you and be gracious to you;
the Lord turn his face toward you
and give you peace.

Then to our great surprise, just as I finished those words, he stopped breathing. I am grateful that God allowed him five or six more gasps over the next few minutes, as it allowed us to get everyone else quickly back into the room for his last moments, as we farewelled my beloved dad – restored to perfection, healed as promised.

It is wonderfully rewarding treating croup. But it is even more fulfilling seeing God at work around us, bringing healing to those who are suffering. We have an opportunity to be a part of this ministry, even in the most mundane things that happen in our day. We might feel we do the same things every day, just to different patients. But we ought to remember that for each patient it may be the first time that this has happened to them! They are feeling vulnerable and uncertain, and are wondering about the things that matter most – their families and friends, and the state of their soul. God is at work – let us be obedient to his prompting as he uses us to heal and restore.