Roy L., a patient at Duke Heart Center, was facing his third heart procedure. His physician, Duke cardiologist Mitchell Krucoff, MD, had him scheduled for an angioplasty and stent placement. Roy was, understandably, a little nervous. But he trusted his Duke team -- and put himself in their hands.

Roy may have come through the procedure as well as he did thanks to some other hands, too -- those of people he didn’t even know, clasped in prayer for his well-being. Earlier, he had decided to participate in a clinical trial designed to study the effects of remote prayer on patient outcomes. It was only after the study was completed that he learned he had been on the receiving end of prayers sent from nuns, monks, priests, and rabbis all over the world, with his name attached to them.

Roy was part of a pilot study coordinated by Krucoff and nurse practitioner Susanne Crater, PhD, looking at the effects of "distant prayer" on the outcome of patients undergoing high-risk procedures. Called MANTRA (Monitoring and Actualization of Noetic Teachings), the study has yielded some provocative findings.

Did those distant well-wishers help Roy during his angioplasty? Or did his own faith -- he says that, while he’s “not a church-going man, I believe in the Lord” -- help him pull through? Can the prayers that soothe spirits also heal bodies?

Krucoff, long interested in the role of prayer and spirituality in healing, has been studying the topic since 1996. Back then, such studies tended to be sketchy, few, and far between. These days, however, he has company. "We're seeing an increasing number of systematic investigations of prayer or spiritual interventions, including several with federal funding,” Krucoff says.

MRI brain scans have documented the deep state of rest, calm, and relaxation that envelopes the brain of a person who is meditating. Since prayer can resemble meditation, the effects of the two processes may be similar.

But prayer is more than just repetition and physiological responses, says Harold G. Koenig, MD. A medical doctor and psychiatrist, Koenig is director of Duke’s Center for the Study of Spirituality, Theology and Health and the author of some 35 books. He has compiled a wealth of data showing that people with religious faith lead healthier lives.

For example, says Koenig, persons who depend on religious beliefs to cope enjoy better survival rates following heart surgery than those who do not; in one study conducted in Israel, religious people had a 20 percent lower death rate from cardiovascular disease than their less spiritual peers.

Religion provides what Koenig calls "a world view," a perspective on problems that helps people better cope with life's ups and downs. "Having that world view helps people integrate difficult life changes and relieves the stress that goes along with them," Koenig says. "A world view also gives people a sense of meaning and purpose in their lives.”

Also, says Koenig, "people who are more religious tend to become depressed less often. And when they do become depressed, they recover more quickly. Because depression has been linked to negative outcomes in heart disease and other conditions, that has consequences for their physical health and the quality of their lives."

The role of religious faith in healing is so important, Koenig says, that he believes physicians should obtain spiritual histories as part of their medical and social histories. Such a history could be used to find out how patients cope with illness, the sort of support systems available to them, and any strongly held beliefs that might influence medical care.

Krucoff’s studies -- which seek to find out whether even those unaware of prayers on their behalf can realize its benefits -- go several steps further. "We're not looking at prayer as an alternative to established medical procedures such as angioplasty," he emphasizes. "We're looking at whether adding a level of spiritual energy could make the high-tech interventions on which modern medicine relies work better. Does that spiritual force make people better, heal faster, suffer less?"

Roy L. and 150 other patients took part in MANTRA's pilot study. All suffer from acute heart disease, and all needed emergency angioplasty -- a stressful and potentially hazardous procedure.

In the pilot study, the patients were assigned to a control group or to touch therapy, stress relaxation, imagery, or distant prayer. A therapist came to the bedsides of patients in the touch, stress-relaxation, and imagery groups, but not to the bedsides in the control or distant-prayer groups. Like Roy, people in those two groups didn't know whether prayers were being sent their way or not.

Those early results "were very suggestive that there may be a benefit to these therapies," Krucoff says. He and Crater have since completed MANTRA II, which followed 750 patients undergoing angioplasty at nine clinical centers around the country. The results have been consistent with those of the earlier study, and compare favorably with outcomes from angioplasty using standard care.

"Prayer is a person’s primary link to the creator,” Koenig says. “Whether there is a creator or not, people believe there is. And if you believe in God, sometimes God responds by doing miracles -- by breaking into the natural order of the universe in a way scientists and doctors cannot understand.

"It doesn’t happen all the time,” he adds. “But it does happen often enough to give many of us the desire to learn more about how to harness this mysterious force to enhance the healing process.

“And it gives patients and the people who love them hope.”