Monday, May 28, 2018

A Spiritual Review of Systems

If you have ever been to the doctor for a new problem, you undoubtedly have been subjected to a series of questions by the physician as he or she tries to figure out what is causing your problem. Some of these questions are a review of systems (ROS). If you went in for a cough, the doctor probably asked you whether you had any wheezing, troubles breathing, whether you had chills or sweats, runny nose or wheezing. There are review of symptoms questions for the nervous system, the cardiovascular system, the endocrine system, the gastrointestinal system and so forth. 

In our practice of medicine, we have developed a series of questions we call a spiritual review of systems. These questions ask about potential spiritual problems that may be contributing to or even causing your symptoms. The first question asks, “What personal problems are you experiencing in your life?” The questions address issues related to guilt, bitterness, loneliness, fear, addiction, and purpose. We believe these are not simply psychosocial issues, but spiritual ones. When we are out of order spiritually, our mind and bodies will be affected. 

Just as a physical ROS can unearth physical reasons for our symptoms, so the spiritual review of symptoms an unearth spiritual issues that are making us ill. For example, I examined a man who came in with a chief complaint of chest pain. His symptoms sounded like angina, which is caused by clogged arteries of the heart. I sent the patient for a stress test which was surprisingly normal. The patient later disclosed the true source of his chest pain: his wife was about to divorce him because of his ongoing anger problem. His chest pain started soon after the breakdown in their relationship. Once he apologized to his wife for his anger, and expressed a willingness work on this issue, his recurrent chest pain resolved! The cause of the man’s chest pain was principally spiritual in nature. 

Take a look at our spiritual ROS. If you’re a provider, try asking one or some of the questions at a visit with a patient the next time you’re faced with a diagnostic dilemma. Dr. Tournier, who inspired our review of symptoms, made his life’s work unearthing spiritual issues that were causing patient’s physical problems. We think the questions may be fruitful in helping patients get well. 

If you’re not a provider, and you’re experiencing some troubling symptoms, reflect on the questions. Consider if any of the issues they unearth may be contributing to what you’re experiencing. The goal in the process is to foster the spiritual or relational virtues we allude to on the spiritual ROS, and to foster wholeness and peace: with yourself, with others and with God.

To access the spiritual ROS, click HERE.

For the related spiritual virtues, click HERE.

To download a pdf of the above tools, click HERE.

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