Grace building on great practice

Lourdes: 160 years of healing

Greg Daly talks to Ireland’s man on Lourdes’s international medical bureau

Belfast doctor Michael Moran, the first Irishman to serve on the International Medical Committee of Lourdes, has been a regular pilgrim to the shrine for over 20 years.

“I think I was there as a child with Mum and Dad on holiday, but I wasn’t really doing anything,” he says, explaining that he only began volunteering at the shrine when he was 16.

“The way it came about was a place became available at the last minute, and though I wasn’t actually in the planned youth team that was meant to go I ended up basically getting a cancellation, so it sort of almost happened by accident,” he says.

“From that point on I went with the Down and Connor youth team,” he continues, explaining that while he didn’t go every summer during his university years, owing to spending summers in the US and elsewhere, there was “a kind of thread of Lourdes volunteering” over the next eight years.

Director

A year after qualifying as a doctor Down and Connor’s pilgrimage director told him the diocesan medical team was short of people, and asked whether he would be happy to switch to that team instead.

“That was 2005,” he says. “Since then I’ve basically gone every year, initially as a junior doctor and in recent years as the chief medical officer with Down and Connor.”

It was really only as chief medical officer that he became aware of how varied approaches to Lourdes pilgrimages are across Ireland, and how there is a real potential for doctors to work together, as the Italian committee president Alessandro de Franciscis pointed out to him.

“Essentially, we were having a chat about it and he said Ireland’s an ideal country to focus on because it’s small population-wise, and it has a very organised pilgrimage structure, in the sense that the planes land and take off in succession, so you have Clogher diocese landing and then Down and Connor takes off,” Michael says.

“So he said you essentially have a train of pilgrimages throughout the season, but you don’t really talk to each other. The directors will be talking to each other in terms of priests, but not in terms of logistics and that side of things,” he continues, explaining that Ireland could build a network of doctors and nurses who could share experiences, guidelines, and practice.

The upshot of this, he says, was Seirbhís, which held its initial conference of healthcare professionals in Maynooth in March 2014.

It is important for Ireland’s medical professionals to liaise with each other, he says, especially given how different Irish pilgrimages to Lourdes can be.

“You have totally different models of pilgrimage across Ireland but essentially what we’re doing is similar, so you might have for instance Franciscans who will go and have an all-Ireland pilgrimage, similar to the Irish Pilgrimage Trust, and then you have geographically based pilgrimages, like dioceses. Some dioceses you’ll have one doctor with 500 people, others like down and Connor you will have six doctors the 500 people, and then in Dublin diocese you’ll have a different model again,” he says.

“Essentially what I would focus on is that we want to make sure good practice elements were being shared because what we do there is often not what we would do in our day-to-day lives – it’s almost as though we’re doing a different type of medicine for one week of the year in comparison to the medicine that you do day to day,” he continues, pointing out that he is a surgeon and Ear Nose and Throat specialist, but that when volunteering in Lourdes he is effectively volunteering as a general practitioner.

“So we decided to regulate ourselves and have conversations about what we should and shouldn’t be doing  and how we interact with the French healthcare system when we’re there and very practical stuff,” he says, adding that such structures are especially important given the diversity of pilgrims that could be on a plane to Lourdes.

A typical flight, he said, could include people who are old and infirm with a high preponderance of sick people, some long-term and stable, and some who are almost ‘bucket list’ people who had learned some months before the pilgrimage that they had a terminal illness.

Having a proper medical structure is necessary even for insurance purposes, he explains, adding: “I guess the special part of that for us is the role of Lourdes as a sanctuary differentiated say from Fatima, Knock and those sorts of places is that it’s a place where the sick and disabled are really the focus of all attention.”

Medical volunteers are also needed, whether doctors or nurses, he says, adding that the younger ones are valuable not least because they can be especially mindful of medical-legal aspects.

“We need to make sure that the structures that we have are safe and supported so that in 10 years’ time if it’s me with a terminal illness or my dad, then I know that I can have faith in my head than on any given Tuesday in the season a plane will be taking off that will be medically supervised and that I’ll know that there’s still that ethos of care that’s been there since 1858, and we want to continue on for the next number of years,” he says.

An important principle of Church teaching around the miraculous is that grace builds on nature but doesn’t replace it, and it seems clear that at Lourdes excellent medical care is expected.

“We have to be really conscious of the fact that there are sceptics out there and we have to be very firm in our practice in the sense that the care that people receive in Lourdes, be it ongoing respite care or more acute care in the sense of someone who is terminally ill, must be at least as good at what they’re getting at home otherwise we shouldn’t be doing it,” he says.

His nomination to the international committee followed shortly after he set the wheels in motion for the creation of Seirbhís, and was, he says, a complete surprise.

“The appointment came out of the blue by email to say would I accept a nomination if I was proposed and then the formal letter came from the Bishop of Lourdes,” he says, adding that until that point there was no one on the committee from Ireland despite the country’s long tradition of sending pilgrims to Lourdes, adding that “it was almost as if they were overlooking Ireland”.

“It totally blew me away at the time in the sense that I didn’t feel ready,” he says, explaining, “now I feel that I’m giving something back but at the time it was like a bolt out of the blue and I didn’t feel I was the right person straightaway”.

Medical careers, he points out, are highly hierarchical and at the time he had been a relatively junior doctor.

“There were a lot of people who were probably more senior than me medically speaking – and academically – who might have been what you would consider the natural choices,” he says, adding “whatever decision they had made behind the scenes I wasn’t aware of at the time but for whatever reason, design or otherwise, the finger came and pointed at me”.

While describing himself as “obviously very honoured and happy to have taken on the role” he says that around the time of his appointment he said he felt he wasn’t the right choice but was “fully committed to making sure that (he) would develop into the role”.

“It felt like a very big responsibility, and I said I’d take it on fully and would give it everything I’ve got,” he says.

Online

Much of his work around Lourdes concerns encouraging young Irish doctors to come to the shrine, he says, but in terms of the committee most work is conducted online.

“It really just involves some email traffic back and forward, occasionally meeting up with people face to face, like with somebody who claimed to be cured just last year, so we do a kind of deep dive into individual cases,” he says.

“And then at the meeting itself which is usually in autumn/winter we meet and discuss cases in detail and have a multidisciplinary discussion with a panel of surgeons, oncologists, psychiatrists, general practitioners every kind of speciality you can imagine. It takes place in a multilingual setting that’s being simultaneously translated so it gives everyone a chance to discuss things,” he says.

Tasked as it is with establishing whether cures cannot be explained medically – it’s for the Church to decide whether such cures should then be considered miraculous – the committee acts in a slow and methodical fashion.

“One thing I’d say about it is that it’s very bureaucratic, so if there’s anything that’s in doubt or that needs to be clarified, the committee is quite happy to push it on to next year for action again,” he says.

“There’s no rush in terms of making decisions, anything that comes out of the committee is always very well analysed and it has to almost have unanimous support because of the nature of what we’re saying,” he continues.

“It is a very dry medical discussion that we have in terms of the occurrences, trying to leave the belief side of it apart although many of us do of course come at it from a Faith perspective, when we are dealing with it as a committee, it’s very much a dry, medical – almost sceptical ‘Devil’s advocate’ – thing.”

The committee is certainly kept busy with a steady flows of claims to consider, he says.

“I did a study for the sanctuary last year, and you get about 30 a year. The season runs from about Easter until around about October, and essentially that’s about one claim a week, which is quite a high volume,” he says, although many of these cases aren’t really capable of being tested.

“A lot of people who think that something happened to them in the context of a short trip to Lourdes go straight home and it’s not until the following year that they actually report anything, which means that going through the process about the miracle for affirmation or otherwise is difficult because you don’t have evidence at the time,” he says.

“It’s really important that people – if something happens – that they flag it to the sanctuary immediately,” be begins to add, but pauses. “Well, it’s important if you think that’s important to you. If a person has been healed in any way, be it psychological or spiritual, they don’t need to report it if they don’t want to. It’s an absolutely personal and private thing, but if they do want to go through the whole process of authentication and verification, then the detail that we need is quite intense and the timing of investigations and examinations is absolutely crucial.”

One topic of debate in the committee is the black-and-white nature of committee verdicts, he says, pointing out that in reality there are three types of claims put forward.

The first, he says, are “inexplicable cures where we say we cannot explain medically any reason for the cure and that’s when we pass them back to the realm of the Church and the person’s bishop”.

Then, he says, “there are the ones where there’s no evidence to substantiate it, which doesn’t necessarily mean that it’s a claim without any foundation, but often there’s not enough evidence to support it and therefore we can’t really comment on it – it might be a really convincing story, but we just don’t have enough evidence”.

Finally, he says, there is a middle ground “where there’s quite a lot of very remarkable cures where for example we might have some really barn door evidence in support of spontaneous remission of an illness in the context of Lourdes, but maybe the person didn’t have a biopsy or a CT scan soon enough before their trip to Lourdes for us to say well we can’t really prove that it happened that week”.

There are, he says, “loads” of such stories, and that they can be known in Lourdes and across Ireland and throughout the world, but they simply cannot be registered by the committee.

“The current tone is that remarkable shouldn’t be discussed at all because it’s not good enough, so there are only two categories – either they’re inexplicable or we can’t comment. I do believe in the grey area in the middle, but from a medical point of view the committee’s current position is that it’s black or white,” he says.

The number that are deemed inexplicable is, he said, “perishingly small”, currently standing at just 69, though he adds that another case was voted on last year and is currently in the hands of the pilgrim’s local bishop.

“It’s very difficult to get any healing to fit the categories, and there’s an argument that we need to revamp the criteria – it’s a source of controversy among the committee itself,” he says, pointing out the criteria that are used for adjudicating date back to the 18th Century, when, he says, “the standard probably would have been lump and then no lump”.

With the numbers formally deemed inexplicable at odds with the popular perception – bolstered by numerous remarkable cures that have not been formally approved of – he says some can wonder why doctors try to bring science into play to adjudicate in these matters, and he admits that there’s something to that.

Explanation

“It goes back to the Lourdes quote, which I think St Bernadette said, about how for those who believe no explanation is required, for those who do not believe no explanation is possible,” he says, adding “if you’re a faithful person from Ireland it probably wouldn’t matter to you what we say, because …you’ll have had more of an experience”.

One thing that always strikes him about those believing they have been healed, he says, is a distinct sense of unworthiness.

“People who have been cured by miracles – the one thing they have in common is a very, very obvious sense of ‘why me?’ They always feel like it should have been the person beside them that day, and why they didn’t really go asking for healing and yet this happened so the question becomes ‘what should I do now?’”

It is, he says, “a very overwhelming thing for them to take on board”.

Medical professionals interested in volunteering at Lourdes can contact Michael through seirbhis.wordpress.com