Summer song

Grass under halogen

draped by noonish shadows.

I stroll like a lazy football player

without a ball.

This all happens at summer

when boats cut open oceans.

Hating sweat

I'm waiting for winter.

The Nightfloater's Prayer

Mincha with tallis and tefillin.

A systematic review of the effectiveness of prayer for the sick

[click the post title for the full abstract]
Intercessory prayer for the alleviation of ill health.
Roberts L, Ahmed I, Hall S.
Hertford College, Cattle Street, Oxford, UK, OX1 3BW. leannerobert_uk at yahoo dot co dot uk
Cochrane Systematic Reviews 2007.

BACKGROUND: Prayer is an ancient and widely used intervention for alleviating illness and promoting good health. Whilst the outcomes of trials of prayer cannot be interpreted as 'proof/disproof' of God's response to those praying, there may be an effect of prayer not dependent on divine intervention. This may be quantifiable; which makes this investigation of a widely used health care intervention both possible and important.

OBJECTIVES: To review the effectiveness of intercessory prayer as an additional intervention for those with health problems already receiving standard medical care.

SEARCH STRATEGY: We systematically searched ten databases (June 2005).

SELECTION CRITERIA: We included any randomised trial of personal, focused, committed and organised intercessory prayer with those interceding holding some belief that they are praying to a God. This prayer should be offered on behalf of anyone with health problems.

DATA COLLECTION AND ANALYSIS: We extracted data independently and analysed on an intention to treat basis calculating, for binary data, the fixed effect relative risk (RR), their 95% confidence intervals (CI), and the number needed to treat or harm (NNT or NNH).

MAIN RESULTS: Ten studies are now included (n=7646). We found a slight difference between groups, favouring prayer for death (6 RCTs, N=6782, RR 0.88 CI 0.80 to 0.97, NNT 42 CI 25 to 167, I(2 )83%) but no differences between groups for clinical state, complications or leaving the study early. Individual studies did find some effects. One trial separated death data into 'high' and 'low' risk and found prayer had a positive effect on those at 'high' risk of death (1 RCT, N=445, RR 0.3 CI 0.2 to 0.46, NNT 8 CI 7 to 11). A second study found a positive effect of prayer on women undergoing IVF treatment with significantly more successful implantations in the prayer group compared with standard care (1 RCT, n=169, RR 0.68 CI 0.53 to 0.86, NNT 5 CI 3 to 10). A larger study assessed the effect of awareness of prayer and found those aware of receiving prayer had significantly more post operative complications than those not receiving prayer (1 RCT, n=1198, RR 1.15 CI 1.04 to 1.28, NNH 14 CI 8 to 50) and those uncertain if they were receiving prayer (1 RCT, n=1205, RR 1.12 CI 1.01 to 1.24, NNH 17 CI 9 to 201)

AUTHORS' CONCLUSIONS: It is not sensible to interpret any of the interesting results with great confidence. However, for women hoping for successful IVF treatment there are some data suggesting a favourable outcome of prayer but these data are derived from only one of the smaller trials. On the other hand, one of the larger studies suggests that those undergoing operations may not wish to know of the prayer that is being offered on their behalf. Most data are equivocal. The evidence presented so far is interesting enough to justify further study into the human aspects of the effects of prayer. However it is impossible to prove or disprove in trials any supposed benefit that derives from God's response to prayer.

The piano (a poem by Yonia Fain)

My neighbor, the famous pianist,
has gotten ever sicker the past two years,
his body has slowly shrunk
as if he were hiding himself from the world
and somewhere, with trembling hands,
holding onto a concealed
center of life.

And then one day
he entrusted me
with his apartment keys.
He had to go into the hospital
for an operation
and he asked me
to take care of his two vases
in the window.

"I can bring them to my place,"
I offered.

"No, no," he stammered.
"The piano has to live with somebody."
He hung his head
and added as if embarrassed,
"If you have time, it would be good
if once a week, in the evening,
you could just sit for a moment
by the piano."

(from Der Finfter Zman, CYCO Farlag, 2008. Original Yiddish here. Translation mine.)

Kay Ryan, poet laureate

In honor of the poet laureate being someone whose books I actually own, a selection. A short selection - the shortest possible. One poem.

Great Thoughts

Great thoughts
do not nourish
small thoughts
as parents do children.

Like the eucalyptus,
they make the soil
beneath them barren.

Standing in a
grove of them
is hideous.

(from Say Uncle, Grove Press, 2000)

More health care is not better

What explains the large variation in health care costs across the country? You would expect that the regions with the highest health care expenditures have the sickest patients, or have the highest prevalence of chronic health conditions.

But you would be wrong. Health care expenditures are highest where health care supply is the highest. As the number of hospital beds, doctors, and medical technologies (”supply-limited health care”) increases, the use of these goods increases as well.

More in Clinical Correlations, the blog of NYU Internal Medicine.