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Life And Work On The Brink Of Death: Meet Pediatric Oncologist Ray Barfield

For most of his life, Raymond Barfield was a person of faith. He grew up in the church and maintained his faith right up to his early years as a physician. But his time working as a pediatric oncologist pushed him to the limits of his emotional and spiritual capacity.

He experienced burnout and temporarily abandoned his faith. Those experiences led Barfield to spend years thinking deeply about what it means to believe in God and how to understand love in its truest form. Today Barfield is an oncologist and pediatric palliative care specialist at Duke Health. He is also a writer, and a professor of pediatrics and Christian philosophy at Duke University. He speaks with host Frank Stasio about his philosophical writing and his life’s work as a palliative care physician.


On understanding the language of his patients:
The way that we described them on our rounds — which was mostly with the language of biology — sometimes with the language of finance, sometimes with the language of liability. But none of those languages were the languages families and patients were using. They were talking about what they were afraid of — what they hoped for. They were telling us what was at risk, what they might lose, what they had lost.

On learning to listen with patience and love:
Once I learned how to be more present to them, rather than going straight to the fix, they would tell me things like, “That's the first time that I've ever actually been listened to by a doctor. It's the first time I've felt heard by a doctor."

On his personal crisis while working as a bone marrow transplant physician:
We had a 50 percent mortality rate, and the way we justified it to ourselves is without the transplant it would be 100 percent mortality rate, so at least we're doing better than 100 percent mortality rate. But the density of death and suffering that I experienced during that phase of my career really tested everything about me.

On the challenge of caring for dying patients:
My formation as physician had not given me the skills that I needed to walk into a room where I was no longer able to offer a cure and yet to continue to be meaningfully present as a physician to the patient and to the family. As soon as I lost the language of cure — as soon as I could no longer be the hero that walked into the room and said, “We've got this. I have something that might be able to cure you.” As soon as I lost that, I didn't know what to say.

On reframing his understanding of God:
I came across a Catholic, Thomas Aquinas, who sort of is the central theologian of the Catholic Church. And in his “Summa Theologica,” I came across this one little sentence that changed the way that I framed the search for God. And Thomas Aquinas, the church father of the Catholic church said, “The deepest thing that we can know in this life about God is that we don't know what God is.” And I thought that if Thomas Aquinas can say that then surely it's OK if I don't have a comprehensive explanation for who or what God is.

NOTE: This program originally aired Jan. 8, 2018.

Laura Pellicer is a digital reporter with WUNC’s small but intrepid digital news team.
Longtime NPR correspondent Frank Stasio was named permanent host of The State of Things in June 2006. A native of Buffalo, Frank has been in radio since the age of 19. He began his public radio career at WOI in Ames, Iowa, where he was a magazine show anchor and the station's News Director.