Mitch Krucoff, a cardiologist at Duke University Medical Center, and his nurse practitioner, Suzanne Crater, decided to put prayer to the test with the biggest test of its kind.

Besides prayer, Krucoff wanted to see whether ‘noetic’ therapies, involving some form of remote or mind-body influence, could affect patient outcomes.

He enlisted 150 cardiac patients, recruited from nearby Durham Veterans Affairs Medical Center, and due to have surgery for angioplasty or stents, and divided patient population into five groups.

In addition to standard medical treatment, four of the five were to receive one of the noetic treatments – stress relaxation, healing touch, guided imagery or intercessory prayer. The fifth group would be given no additional intervention besides orthodox medical care. Every patient would undergo continuous monitoring of brain waves, heart rate and blood pressure, to gauge the moment-by-moment effect of these intangible healing influences.

Mitch Krucoff, a cardiologist at Duke University Medical Center, and his nurse practitioner, Suzanne Crater, decided to put prayer to the test with the biggest test of its kind.

Besides prayer, Krucoff wanted to see whether ‘noetic’ therapies, involving some form of remote or mind-body influence, could affect patient outcomes.

He enlisted 150 cardiac patients, recruited from nearby Durham Veterans Affairs Medical Center, and due to have surgery for angioplasty or stents, and divided patient population into five groups.

In addition to standard medical treatment, four of the five were to receive one of the noetic treatments – stress relaxation, healing touch, guided imagery or intercessory prayer. The fifth group would be given no additional intervention besides orthodox medical care. Every patient would undergo continuous monitoring of brain waves, heart rate and blood pressure, to gauge the moment-by-moment effect of these intangible healing influences.

Worldwide recruitment

Krucoff decided to turn up the volume on prayer to full blast. To recruit prayer groups, his nurse-practitioner assistant Suzanne Crater launched a worldwide campaign of solicitation. She wrote to Buddhist monasteries in Nepal and France, and to VirtualJerusalem.com, which arranged for prayers to be placed in the city’s Wailing Wall. She phoned Carmelite nuns in Baltimore to ask for prayers during the evening’s vespers.

By the time she finished her campaign, she had enlisted prayer groups from seven denominations, including Fundamentalists, Moravians, Jews, Buddhists, Catholics, Baptists and members of the Unity Church.

Although Crater and Krucoff left the design of individual prayers to the groups themselves, they stipulated that the patients had to be prayed for by name and that the prayers on behalf of these patients had to concern their healing and recovery. The prayer portion of the study would be blinded, so that neither patients nor staff knew who was going to be prayed for. The other noetic therapies would be administered an hour after the patients had undergone the angioplasty.

The results were impressive. Patients in all the noetic treatment groups enjoyed 30–50 per cent improvements in health during their hospital stay, with fewer complications and a lower incidence of narrowing of the arteries compared with the controls. They also had a 25–30 per cent reduction in adverse outcomes: death, heart attack, or heart failure, a worsening of the state of their arteries or a need for a repeat angioplasty.

Of all the alternative therapies employed, prayer had the most profound effect.

A giant follow-up

Krucoff understood that, for his results to be meaningful, the study needed to be replicated on a far larger scale. He rolled out his study and created MANTRA II by launching into an ambitious recruitment program, eventually enlisting 750 patients from Duke’s Medical Center and nine other hospitals across America, and soliciting 12 prayer groups made up of an even larger, more ecumenical collection of the world’s major religions.

Christians were recruited from Great Britain, Buddhists from Nepal, Muslims from America, Jews from Israel. Duke loudly trumpeted the project as the largest multi-centre study of remote influence, the supreme test of prayer.

With MANTRA II, Krucoff divided the patients into four groups. One group would receive prayer; another, a specially designed program that included music, imagery and touch (or MIT therapy); the third group, MIT plus prayer; and the final control group, standard medical care. Immediately prior to undergoing angioplasty, those assigned to receive MIT would be instructed in a method of relaxed breathing while visualizing a favourite place and listening to calming music of their choice. They would then receive healing touch for 15 minutes from a trained practitioner.

The point of the new study was to examine whether prayer or the noetic interventions would prevent further cardiovascular events in the hospital, such as death, new heart attacks, a need for additional surgery, readmission to the hospital, and signs of a sharp rise in the enzyme creatine phosphokinase, an indication that the heart has suffered damage.

This time, Krucoff also wished to investigate longer-term effects as ‘secondary endpoints’: whether the interventions could alleviate emotional distress, or prevent death or re-hospitalization at any point six months after the patients had been discharged.

9/11 intervenes

Krucoff’s study fell right in the midst of the terrorist attacks of 9/ll and their aftermath. For three months, patient enrolment in the study fell so sharply that he had to amend its design.

He developed a ‘two-tier’ prayer strategy by recruiting 12 ‘second-tier’ prayer groups. As soon as new patients were added to the study, the second-tier groups were to pray for the prayers of the ‘first-tier’ prayer groups, who had been praying for the patients all along.

Through this strategy Krucoff hoped that newly enrolled patients would receive a higher ‘dosage’ of prayer to approximate the amount received by his patients enlisted earlier in the study.

After the enormous advance publicity, Krucoff’s findings were an enormous letdown. When the results were finally in and tallied, there was no denying it: there were no differences in outcomes between any of the various groups during their hospital stay. The only apparent benefit was a slight reduction in distress among the MIT patients prior to the surgery.

Otherwise, the large-scale MANTRA seemed to be an utter failure. Prayer did not seem to make anybody better.

Among the long-term effects, there had been some therapeutic effects in alleviating emotional distress, need for further hospitalization, and even death rates after six months, but these were not considered statistically significant and they hadn’t been the main focus of the study.

Missing the point

But Krucoff’s results as universally interpreted had overlooked one vital finding: the patients with the double-tier prayer groups who had been prayed for had death and re-hospitalization rates over the six months after discharge that were 30 per cent lower than the others. Mortality over six months was also lower among patients given MIT. But the best survival rates of all was those patients who’d been given MIT with prayer.

These results had only been characterized as a ‘suggestive trend’, but they may have been the entire point of the story. Praying worked if the person doing the praying – or his prayers – also had been prayed for.

Prayer works best as a collective venture, a virtuous circle. Then we truly experience that we are not alone.