To Live Again

A doctor with crippling arthritis helps his patients learn to live with pain.

By Harold Koenig, M.D, Durham, North Carolina

As appeared in

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The patient was in his 40s, but he shuffled into my office like a man twice his age. He gripped the back of a chair and lowered himself into it, wincing. "I don't know what to do," he said. "I'm still hurting. I keep praying about it. But the pain won't go away."

I looked at the man's chart. His name was Robert. He had fallen at work, then undergone a difficult back surgery. He had already been to see me several times.

As I do with all my psychiatric patients, I had taken a detailed psychological and medical history. I had even asked about his faith—he was a deacon at his church.

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Many patients tell me faith is an irreplaceable source of consolation. But that day, Robert confessed to a very different kind of anguish.

"I'm going to tell it to you straight, Doctor," he said. "I've been praying hard about this pain. Every day and night. But it's been years, and it's just as bad as ever. Dr. Koenig, I want to believe that God can heal me. But I think I'm losing my faith. I don't know why God would do this to me. Can you help?"

I put down my chart and looked at Robert, overcome with compassion. Yes, I thought, I can help you. I know exactly how you feel.

Years before, I had been an ambitious young doctor at Duke University. I was in my early 30s and newly married. I had climbed mountains—Mount Kilimanjaro, 14,000-foot peaks in the Rockies. I swam a mile a day and lifted weights. My wife Charmin and I planned to have a baby.

I was strong in my faith too—I felt a powerful calling to bring the love of God to the sick, especially to older patients, who are often shunted aside. I saw lots of patients, applied for research grants and began a wide-ranging study of depression. I felt like an energetic vessel for God's healing work.

Then, one day, I noticed that my right knee and ankle were sore at the end of a hectic day at the hospital. I shrugged off the pain, chalking it up to an old high school wrestling injury. But the pain persisted, then spread to my right wrist.

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After a day writing notes and prescriptions, my hand was unnaturally sore. God, I prayed, you called me to this work. Surely you will keep me healthy enough to do it.

One morning, I went to the garage to change the oil in our car. Lying under the engine, I reached to pull the old filter out. The filter stuck, and my right hand slipped and smacked against a bolt. Pain lanced through my knuckle, then settled into a dull reverberation.

I tried tugging at the filter again, but discovered I could barely move my hand. I slid out and sat up and looked at myself. My knuckle was swollen, and it stung and ached when I touched it.

I'm sure it will go away, I thought. But it didn't. At church, I could barely shake hands with friends. God, please take care of this, I asked. But at the hospital, I had trouble even holding a pen.

Clutching a stack of blank prescription orders, I paced the halls, too embarrassed to ask someone to fill them out for me. Finally, I tried a typewriter. To my relief, I found I could tap the keys with my left hand.

I brought a typewriter from home and lugged it under my arm on my rounds. I looked ridiculous. But what else could I do?

A week later, my finger was still swollen. And my ankle had flared up again. I was limping from room to room. I decided to see a specialist.

When I returned from the doctor, Charmin was playing with our baby boy, Jordan. "Well?" she asked. "Is everything all right?"

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"I'm afraid not," I told her. I had been diagnosed with psoriatic inflammatory arthritis.