Care From the Margins: Restoring Embodiment in Pre-Medical Formation through the Certified Nursing Assistant (CNA) Role
Lily Weir, Duke Divinity School, Durham, NC
Many medical students have spent countless hours researching in laboratories and studying for science exams. Fewer, however, have provided hands-on care for another human being experiencing illness. This lack of clinical praxis is reflected also in medical humanities training, including training that focuses on theology and medicine. In such instruction, students may write papers on death, suffering, and caretaking without experiencing proximity to the sick and suffering.
By contrast, the origins of healthcare in Christian tradition, particularly in the work of St. Basil of Caesarea, prioritized hands-on care for the sick and the poor. In this essay, I reflect on the contrast between the formation brought about by such hands-on practices of care for the sick and contemporary disembodied forms of intellectual formation, to argue that current educational models are inapt for forming future clinicians who can provide person-centered care. I propose in response that theologically-grounded pre-medical and medical formation should include patient care through the clinical role of the Certified Nursing Assistant (CNA).
As an undergraduate I studied medical humanities and theology while completing premedical requirements. Yet, I learned most about personhood and medical practice through working as a CNA in a memory care facility. I gained practical benefits from this experience, including improved bedside manner and confidence interacting with patients, but I arguably also learned a Christian theological approach to healthcare, insofar as the work CNAs characteristically do is the kind of work that was central to the hospitality provided in institutions like Basil’s early hospital. I propose, then, that through work as a CNA prospective clinicians can learn habits consistent with the early church’s healing traditions, thereby developing a theology of suffering through accompaniment and an embodied understanding of medical care.
By centering hands-on CNA-level care for patients in their pre-clinical education, future medical practitioners can develop theologies of suffering that avoid merely intellectual approaches to theodicy. Such clinical praxis teaches the trainee, at the outset of her medical journey, that patients’ wellbeing and identity are integrally related to their bodies. This work would likely constitute a prospective physician's first encounters with patients, providing an anticipatory antidote to the mechanistic view of the body as what Bishop calls the “anticipatory corpse” (particularly notable when a student’s first interaction with a body is with a cadaver). In bathing, dressing, and feeding patients, students can develop an understanding of embodiment and care that transcends physiology and diagnosis to prioritize personhood and accompaniment. Additionally, due to the shortage of CNAs in many medical settings, students would be practically meeting the needs of sick in their own communities, apprenticing themselves to the habits of hospitality central both to Christian witness and to the profession of medicine.
By contrast, the origins of healthcare in Christian tradition, particularly in the work of St. Basil of Caesarea, prioritized hands-on care for the sick and the poor. In this essay, I reflect on the contrast between the formation brought about by such hands-on practices of care for the sick and contemporary disembodied forms of intellectual formation, to argue that current educational models are inapt for forming future clinicians who can provide person-centered care. I propose in response that theologically-grounded pre-medical and medical formation should include patient care through the clinical role of the Certified Nursing Assistant (CNA).
As an undergraduate I studied medical humanities and theology while completing premedical requirements. Yet, I learned most about personhood and medical practice through working as a CNA in a memory care facility. I gained practical benefits from this experience, including improved bedside manner and confidence interacting with patients, but I arguably also learned a Christian theological approach to healthcare, insofar as the work CNAs characteristically do is the kind of work that was central to the hospitality provided in institutions like Basil’s early hospital. I propose, then, that through work as a CNA prospective clinicians can learn habits consistent with the early church’s healing traditions, thereby developing a theology of suffering through accompaniment and an embodied understanding of medical care.
By centering hands-on CNA-level care for patients in their pre-clinical education, future medical practitioners can develop theologies of suffering that avoid merely intellectual approaches to theodicy. Such clinical praxis teaches the trainee, at the outset of her medical journey, that patients’ wellbeing and identity are integrally related to their bodies. This work would likely constitute a prospective physician's first encounters with patients, providing an anticipatory antidote to the mechanistic view of the body as what Bishop calls the “anticipatory corpse” (particularly notable when a student’s first interaction with a body is with a cadaver). In bathing, dressing, and feeding patients, students can develop an understanding of embodiment and care that transcends physiology and diagnosis to prioritize personhood and accompaniment. Additionally, due to the shortage of CNAs in many medical settings, students would be practically meeting the needs of sick in their own communities, apprenticing themselves to the habits of hospitality central both to Christian witness and to the profession of medicine.