CHILD is adding a feature to our web page of essays by pediatricians. They will comment upon healings of children purportedly achieved by Christian Science spiritual treatment.

Christian Science theology holds that one healing proves that Christian Science is a scientific system for healing all diseases. The church's healing claims encourage parents to take foolish risks with their children's lives. Furthermore, the church claims that legislators give Christian Scientists religious exemptions to child neglect laws because of these healings.

Our second contributor in this series is Dr. Seth Asser, a pediatrician in Providence, Rhode Island.

The Christian Science church frequently claims a record of healing more than fifty thousand cases of disease by prayer. Cases with any degree of medical documentation are rare, and with clear medical confirmation are apparently non-existent. Such is illustrated by the case of Holly Zynda.

Holly's story was presented on an episode of the Arts & Entertainment network's Investigative Reports with Bill Kurtis (December 17) entitled "Healing and Prayer: Power or Placebo?" In 1985, 20-month-old Holly was bruising easily. Her mother, Debra, was raised in the Christian Science church and did not want to take Holly to a doctor. However, a neighbor, Kim Brown, identified as a nurse practitioner, recommended that Holly have medical care. The father, Tom Zynda, who was not then a Christian Science member, convinced his wife to take Holly to a pediatrician. The diagnosis of ITP, idiopathic thrombocytopenic purpura, was made based upon a very low platelet count.

ITP is a disorder of young children that leads to easy bruisability and, less commonly, bleeding. This is due to a decrease in the platelets circulating in the blood. Platelets are small cell fragments that are an essential component of clotting. In ITP, an autoimmune reaction often following a typical childhood viral infection, the body's own antibodies attach to platelets and decrease their numbers. The platelets that remain are able to function, but their number is insufficient for normal clotting to occur.

The disease is generally mild. Most children do not need any treatment other than increased vigilance to reduce rough play, contact sports, and accidents. Those with severe bleeding symptoms and extremely low platelet counts may transiently benefit from treatment with steroids or intravenous immunoglobulin. Rarely, a splenectomy may be required if ITP becomes chronic.

Implication: fatal disease

Kurtis and Brown, however, give the impression that ITP is often a fatal disease. Brown tells us solemnly, "Children can die. Children can bleed to death and die."

The disease, Kurtis claims, "has some of the same characteristics as leukemia." He narrates that Holly's doctors considered her condition "critical," monitored her blood count for two months, and put her on prednisone (a steroid). "But," he continues melodramatically, "Holly didn't get better. The medication didn't seem to be helping at all."

Failure of medical care alleged

Feeling he "had nothing to lose," Tom Zynda agreed with his wife to discontinue the medical care and rely exclusively on Christian Science to heal Holly. Echoing typical Christian Science rhetoric, Kurtis says, "Debra was determined to break through her own fear and conquer Holly's disease through her faith."

What is the evidence that Holly's medical treatment was failing? Neighbor Brown says, "She kept getting worse," but no objective evidence is offered to support her impression.

Most children do not respond immediately to steroids. But most important is that the disease is self-limited in well over 95% of cases, remitting on its own within 2 to 6 months.

Nurse claims Christian Science healing

Zynda reports that within 30 days after they discontinued the medication, they noted "a real dramatic change." It's hard for me to understand how something that took 30 days can be called dramatic, but the improvement three months after diagnosis is precisely the expectation that physicians would have for children with ITP.

As evidence to confirm the "miracle," Brown offers her opinion that when patients are taken off anti-inflammatory drugs such as steroids, they get suddenly worse most of the time. But before Brown would have expected improvement, she states to the camera, Holly was running around, and the bruises went away.

Kurtis further inflates the drama of the situation by stating, "Doctors say that ITP can become a chronic, lifelong illness. But 15 years after her battle with the disease, Holly is enjoying the life of a normal, active teenager." He adds, "She's never been to another doctor."

The truth is much less miraculous. By the time Holly was taken off prednisone, it was likely that her platelet count had already begun to improve. And, unlike patients with more severe and chronic autoimmune disorders, a patient with ITP would not likely "get worse" when taken off prednisone. A platelet count would be required to know with certainty when she began to improve.

Disease self-limited in 95% of cases

More important, the overwhelming majority of children with ITP will get better, on their own, with time. Very few go on to the chronic form, when the disruption lasts more than 6 months. For those who do, most do not have serious bleeding as an ongoing problem, and they can remit at any time, most doing so within a few years. Kurtis' implication that severe lifelong problems from ITP are common is incorrect.

His claim that ITP is like leukemia is preposterous. ITP shares the low platelet count and, therefore, easy bruising with leukemia, but the similarity ends there. A simple white-cell count differentiates the two. ITP doesn't have the fevers and malaise that leukemia usually has. ITP is not cancer. ITP usually resolves itself without any medical treatment.

Reasons for fallacious claims

This story illustrates as well as any that an anecdote cannot be offered as proof of therapeutic efficacy. Physicians, who are aware of the natural history of ITP, would not be able to reasonably conclude that it was divine intervention or the power of prayer that helped Holly Zynda. Time and her own physiology were sufficient.

Ignoring the natural course of a self-limited disorder is a typical error made by believers of unsubstantiated claims. Inflating severity and over-dramatizing are other typical mistakes. Physicians would not likely describe her case as "critical." She needed immediate medical attention, but she was not in critical condition. She also had a very low likelihood of progressing to chronic ITP.

In addition to the story of Holly Zynda, the show presented other believers in faith healing as well as members of the medical community who are currently promoting prayer as an adjunctive therapeutic modality.

There was some attempt to balance these views with stories of the failure of faith healing and Christian Science, such as that of CHILD's founder Rita Swan, and with more skeptical medical opinions.

Next frontier?

Television, however, tempts producers to give weight to opinions or theories that haven't earned it. Controversy is considered newsworthy. Failure to meet scientific standards of proof is relatively boring on the small screen. Thus, Kurtis describes Harold Koenig, a psychiatrist who promotes the integration of spirituality into medical care, as "a pioneer in the exploration of medicine's next frontier."

While few would dispute that religious beliefs and practices are important to patients as they confront illness, there is little evidence, despite the hundreds of studies noted by Kurtis, that prayer or ritual has any substantial independent efficacy.

This is hardly medicine's "next frontier." Rather, faith healing, particularly as exemplified by the narrow-minded philosophy of the Christian Scientists, is a remnant of the nineteenth century. It recalls a time in which science had much less to offer than it does today. A time when years of life expectancy in America were in the 40's, as opposed to the high 70's that we enjoy today.

Russian roulette

Holly Zynda was fortunate, not that her mother had faith in Christian Science, but that she had a relatively benign and self-limited disease. As documented many times in CHILD newsletters and in medical journals, other children whose parents eschewed medical treatment and relied exclusively upon faith healing have not been as fortunate.

When parents play Russian roulette with their children's lives, sometimes they live. That doesn't prove that the game is safe. It is the unnecessary deaths which demonstrate that it is not.

May 1, 2002

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Our first contributor, Dr. Joseph Chiaro, reviewed testimonies of healing in two Christian Science periodicals. He provided pediatric critical care at the Orlando Regional Medical Center for many years, worked for eight years as medical director for the Boggy Creek Gang camp for children with chronic illnesses, and is now Florida Deputy Secretary of Health.  He is expressing his personal views in this essay. 

I have been asked to comment on the concept of a medical cure that would occur "miraculously." First, it is important to define the terms. Webster defines "miracle" as "an event or action that apparently contradicts known scientific laws and is hence thought to be due to supernatural causes, esp. to an act of God." A "cure" is a "restoration to health or sound condition."

I have practiced medicine for nearly thirty years and hold board certifications in both pediatrics and pediatric critical care. During my career, I have provided care for thousands of the very sickest of children. I am convinced that most of these children would have died or been severely impaired had they not been treated. Fortunately, most were restored to health. On one occasion, however, a patient under my care receiving the best of treatment from multiple consultants and me, continued to deteriorate and was approaching death. Having nothing more to offer this child, I turned to prayer. In what can only be described as an act that contradicted known scientific laws, the patient started to improve and was ultimately restored to complete health.

Why had I not prayed earlier? Because I feel God has given me the opportunity to study and learn medicine and to apply my knowledge to effect a cure. In the New Testament of the Holy Bible, the writer James (James 5:14) asks and then answers an important question. He writes: "Is any among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord." The noted Bible expositor, Charles R. Swindoll offers an interpretation of this passage in his Bible Study Guide of James. Swindoll says, "The construction of this sentence in the Greek text indicates that one action actually goes before the other, in other words, the anointing is to precede the praying. Therefore, we may translate this passage ‘Let them pray over him, having anointed him with oil." He writes further that "The specific Greek term used in James 5:14 for anointing does not convey the thought we usually ascribe to it, that is, a religious ceremony in which oil is applied to the head. Here it means ‘to apply or rub something into the skin.’…In Biblical times, oil was used on one who was sick for its medicinal effects. We find this occurring in Luke 10:34…Translating into today’s terms, oil represents antibiotics, various other medications, surgery, therapy, and so on." James teaches us to use the very best medicine at our disposal, and having done so, to pray God’s blessing on our efforts. God is available to hear our pleas and by His grace heal us when He so chooses.

My medical experience (and that of countless other physicians with whom I have worked) is that while miraculous cures do occur, they are rare events. By definition, miracles must be rare in that they "contradict known scientific laws." If these types of cures were common, they would establish a scientific law, not contradict one. And not only must they be rare, but more importantly, they must be verifiable. That is to say, it must first be established that the patient possesses the illness or condition of which he or she is to be cured. I have had multiple patients tell me of miraculous cures of various illnesses, only to read the patients’ charts and discover that the illnesses had not existed in the first place. In more than instance, I have carefully explained the child’s condition and treatment options only to realize later that the parents of the child totally misunderstood what was said. Were these patients then "cured" of a condition that never existed? Hardly.

Recently I reviewed three alleged "healings" reported in the Christian Science Sentinel. Each writer expressed the belief that a miraculous cure had occurred in his or her life. The implication was made in each case that the only requirement for a miracle to occur is for the patient to desire it. These medical events illustrate well the misunderstanding that can so easily arise in medicine. In the first report (Sentinel Sept. 22, 1986), an individual described having a collapsed lung as a result of pneumonia. After an Xray and an examination, the treating physician recommended surgery to remove the lung, the patient claims. However, over the subsequent two days the patient (a child at the time of his illness) asked God for help and was cured. As a result, the surgery was not necessary. We know that appropriate management of this child would be to administer antibiotics, supplemental oxygen, and perhaps updraft treatments while awaiting complete laboratory testing to determine the cause of the pneumonia. But surely the parents and child misunderstood the physician, as surgery to remove an acutely infected lung is unheard of. What is common, however, is for part of the infected lung to collapse ("atelectasis" is the medical term) only to re-expand in one to three days as a result of proper medical treatment. This is not a contradiction of scientific law; it is a manifestation of it.

A second miracle is alleged by an individual who was diagnosed in childhood "over seven decades ago" as having "diabetes in the last stages" (Sentinel July 26, 1999). The diagnosis was made by a local doctor and confirmed by a "specialist in this field." The affected individual elected with her parents’ consent, to choose prayer over the prescribed medicine. At issue here is simply the diagnosis. Diabetes in the last stages in a child leaves the patient dehydrated, severely malnourished, and with affected mentation, if not in a coma. No blood sugar count or other objective data are offered to support the diagnosis, but the clinical picture presented is inconsistent with the last stages of childhood diabetes. Even if the writer’s blood sugar was elevated, there are multiple reasons and causes for a child to have an elevated blood sugar and many of these conditions resolve spontaneously.

Finally, a case is presented of a woman who suspected that she had diabetes and obtained a physician confirmation of her condition (Sentinel July 26, 1999). The physician prescribed insulin but the patient chose instead "to rely on God, and only God, for healing." (Patient’s emphasis) The woman goes on, however, to inform the reader that she became more careful about what she ate and that she increased her amount of exercise. We know that weight loss and increased exercise frequently can manage adult onset (so called Type II) diabetes. Although the woman ultimately "paid no more attention to diet and exercise," it is not unreasonable to assume that an improved lifestyle, not a miraculous healing, led to the patient’s improved condition.

Since Christian Science uses the Holy Bible to explain and support its theories of healing, it is appropriate to review recorded instances of healing contained therein. I will limit my discussion to the miraculous healings performed by Jesus and mentioned in the gospel of Luke for two reasons: 1) Luke was a physician and able to verify both the presence of illness and the resultant healing, and 2) Luke carefully investigated the reports of miraculous healing so that we might know the truth (Luke 1: 3,4). Jesus is recorded as healing: Simon’s mother-in-law of a high fever (4:38.39); a man with advanced leprosy (5:12,13); a paralyzed man (5:18-25); a man with a deformed hand (6:6-10); a Roman officer’s servant boy who was near death (7:2-10); a woman with a twelve year bleeding disorder (8:43); a woman bent double (13:10-13); a man suffering from dropsy (14:1-4); ten lepers (17:13-19); and a blind man (18:35-43). Even a cursory review of the healings demonstrates that each of these persons desired to be healed, and in most cases had suffered a life of misery as a result of his or her illness. But in spite of each individual’s deep desire for healing, none was healed until he or she came under the power of God. Interestingly, on two occasions, Jesus healed demon possessed men even after they expressed the desire to be left alone. (8:27-36 and 9:38-42). And in two other instances, Luke records that Jesus brought dead individuals back to life (7:11-16 and 8:41-55). Serving as the Great Physician, Jesus told his detractors that "it is the sick who need a doctor." (Luke 5:31) Jesus healed by the power of His Father, God, not by asking the sick to reorder their thinking.

Can we assume then that God healed all of those who came believing, or that He only required faith to be healed? The apostle Paul certainly found that not to be the case. Paul records that he asked God at least three times to be healed but was denied each time. (2 Cor. 12:7-9) According to the apostle, God may allow infirmity in order to teach us what He would have us know. Clearly, it is God’s power and prerogative to heal. Jesus prayed, even as He faced death, "not my will but thine (God’s) be done."

What then should be our approach to illness prevention and cure today? The Holy Bible asks: "Do you not know that your body is the temple of the Holy Spirit?" (1 Cor. 6:19) In other words, living a lifestyle consistent with good health is a Biblical mandate. For example, gluttony and drunkenness are specifically discouraged. But most of us disregard the advice. Obesity and alcoholism, with their primary and secondary deleterious effects on health, remain major causes of morbidity and mortality in our country. But what if I do maintain a healthy lifestyle and still contract pneumonia or cancer? Where does the Bible tell me to turn if my child breaks his arm or develops diabetes or meningitis? With dependence on God, I am to turn to those physicians who have the wisdom and skill to help me, while praying that God in His grace will heal me.

Nov. 12, 2000

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