Oncologist Confidential: I Pray With My Patients

Ellie Kincaid

February 03, 2020

The first person who told Alyssa Rieber, MD, that she probably had cancer prayed with her. She doesn't remember the particulars of the prayer, but it was "so impactful," she said. She was in medical school at the time and spent her first year going between class and chemotherapy and radiation treatment for Hodgkin lymphoma. Her classmates at the University of Alabama in Birmingham helped her study. Now an oncologist, she too prays with her patients after asking permission. She also advises them of the standard of care. "It has been, universally, very uplifting for the patient, their family, and me," she said. "It's such a special thing to be able to do."

Alyssa Rieber, MD. MD Anderson

She'd planned to become a family practitioner in a small town, but her experience as a cancer patient drew her to specialize in oncology instead. "Going through treatment was hard," she said, "but I was really inspired by my physician, my treating team, the nurses who took care of me in infusion, and also the other patients."

Rieber is now the chair of the Department of General Oncology in the Division of Cancer Medicine at the University of Texas MD Anderson Cancer Center in Houston. She also leads MD Anderson's oncology program at Lyndon B. Johnson Hospital, a county hospital where many patients lack adequate insurance coverage and meet criteria for free or discounted care.

The following conversation between Rieber and Medscape Medical News associate managing editor Ellie Kincaid has been condensed and edited for clarity.

What did your experience with cancer teach you about what patients need from oncologists?

I know from first-hand experience the emotions that people go through when they're first diagnosed. I'm able to talk about that and really speak to their and their family members' anxiety as somebody who's lived through it. It allows me to have a deeper understanding of their current situation based on what I went through. I'm able to use that to encourage people.

I can speak with authority and also know what topics need to be stressed immediately and what topics can be addressed as time goes by. Nutrition is always a touchy subject with patients and their families. Family members are going to try to get patients to eat, and patients are going to use that as a mechanism of control, and it creates a lot of stress or anxiety for patients and their families. Getting that out in the open and talking about it really helps everyone.

I definitely hug patients. I cry with them if it's at that point, and really just get to walk alongside them during their struggles and bolster them. I pray with them. When I was first diagnosed, the person who told me that I probably had cancer prayed with me, and that was so impactful. And so I do pray with patients and their families.

How do you approach that?

A lot of times patients bring up their faith. If they say, "It's in God's hands," then I approach them, or if they're very anxious and tearful, I ask them, "Do you pray?" They say "yes" or "no." If they say "yes," I say, "Can I pray for you?" It has been, universally, very uplifting for the patient, their family, and me. It's such a special thing to be able to do.

What do you pray for?

For everyone I pray for complete healing. Whether they have widely metastatic disease or not, whether I think that they're going to die soon or not, I pray for complete healing for them, first. And then I pray that God will give them comfort and peace during their treatment, during all of the journey that they have to go through, and if He chooses not to heal them, that He will give them the ability to face that and be strong. I pray for the treatment team, I pray for me, I pray for everyone they come across during the course of their treatment, that everyone will be uplifting and encouraging for them, and I pray for their family, that their family is able to handle what they're going through, and that they'll be able to bless others through that time.

I touch on the same points whenever I pray for people. I just want to ask for healing in case nobody else has. I believe that first we have to ask. It's something that I developed, and I've felt that it's been incredibly helpful for patients.

In her oncology practice, Alyssa Rieber, MD, draws from her own experience as a cancer patient.

How do you handle the emotionally difficult parts of your job?

I am very free and quick to cry. Then I'm able to express it and move on. I don't forget those emotions, but I can't live in them. Otherwise I'd never be able to pick myself up off the floor.

I cope with a few things. One is my faith. I have a strong belief that everything happens for a reason and for a purpose. I may not understand it, but I believe that God is in control, and that's my base coping [mechanism]. The second is I have phenomenal family and friends. My home life turns on very quickly when I get home. I have two kids and a wonderful husband and a very vibrant and busy life outside of work that demands and requires my attention. It's easy to flip into that role of mom and wife because it needs to be done. That helps me have joy outside of work. Then it's the usual suspects: spending time with friends and alcohol. Those things are incredibly helpful.

Whenever you have a day where it's full of sadness with patients who are progressing or at the end of life, that's hard to shake off. You just kind of acknowledge it, and then you need to be able to be present for the next person, because they deserve your time and attention too.

What would you be doing if you weren't a doctor?

When I was applying to medical school, I also thought about applying to massage therapy school. Another love of mine is ranching, because I come from a long line of ranchers, so a goat farm where I make goat cheese would be second on my list. The third would be owning a coffee shop and bakery. A distant fourth would be a missionary. I do have dreams of opening a place where you can have coffee and baked goods and then have goat yoga in the back. Just combine it all, right?

What would your colleagues say is the most difficult thing about working with you?

Maybe that I'm easily distracted and not quick to return emails.

Is there a hot topic in oncology that you have an opinion about?

I think that the cost [of cancer care] is way too high and the access is too limited. Even insured folks have difficulty with copays, accessing in-network providers that can provide clinical trials, and getting treatment where they are. It's getting out of control. Whenever a month's worth of pill therapy costs $10,000 to 15,000 and you have a copay for that, it's crazy. Patients have to choose between lifesaving cancer care or buying food. This is absolutely unacceptable.

What's the most unusual item in your office?

It's a rainbow loom pumpkin spice latte in a frappuccino cup handmade by my daughter.

Rieber considers this gift from her daughter the most unusual item in her office.

Ellie Kincaid is Medscape's associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine.

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