Openings, Offerings, and the Happening of Truth: Medical Education and the Call to Holiness
Mark Kissler, M.D. MS, Resident, Internal Medicine-Pediatrics, University of Colorado School of Medicine
Scot Douglass, PhD, University of Colorado at Boulder
In his conclusion to The Anticipatory Corpse, Jeffrey Bishop claims that rather than clinicians whose sole focus is technical mastery, medicine needs "holy men and women...who offer themselves to the living and the dying”(1). Employing similar language, others claim that the process of educating young health care providers should be one of moral formation(2). Speculation regarding the best model to accomplish this ranges from the long tradition of spiritual formation(3) to ancient and modern philosophical approaches(4). Central in this thinking is the emphasis on physicans’ “offering themselves” in addition to their formidable knowledge and skills in order to break out of the totalizing, stupefying thrall of "scientific" medicine.
If taken seriously, these thinkers put forward various calls to holiness that ask physicians and their educators to occupy spaces that evade the structural closure sought by systems, curricula and core competencies. In doing so, they represent a unique challenge to educators. The goal of this workshop is to create just such a space in which medical educators, students, and philosophers of medicine can work together to discuss some of the practical implications of a call for holiness as it might emerge from within the practice of teaching medicine.
The workshop will begin with a problematization of medical education and its role in cultivating holiness. The facilitators will propose a concept of education/formation that emphasizes the primacy of events of authentic encounter. Such particular events of holiness not only involve the creation of unstable sacred spaces but also engage the productive tensions between becoming and being, the unknown and the known, the particular and the universal, the personal and the professional. To better frame this workshop, the facilitators will work with the attendees to articulate a set of dilemmas that arise when a young physician is asked to engage the singular problems of a particular suffering body.
With these in mind, the facilitators will then explore two distinct philosophical/theological paradigms with the goal of setting them in conversation with one another and with the workshop participants. The first paradigm will look at the idea of a truth event as held by the Apostle Paul, the Russian novelist Fyodor Dostoevsky and the philosopher Martin Heidegger. Particular focus will be on the concept of the “unfinished novel” and the lack of closure of engaging others in the in/between now of an event in progress. Particular attention will be placed upon why alternative models that promise closure, mastery and certitude are far more seductive. The second paradigm, drawing from the work of Alasdair MacIntyre with influences and critiques of Narrative Medicine as articulated by Rita Charon, will explore the concepts of craft and the narrative conception of a life, emphasizing ways that narrative understanding can open outward from situated, particular traditions and in so doing resist totalization. It will interrogate certain types of narrative-making in light of Bishop’s critique of the overlay of fictional, constructed meaning onto biological “reality”—a tempting move that serves only to further alienate the suffering person by denying the ways that meaning is always already embodied. It will conclude with a look toward the philosophy of Emmanuel Levinas and ways that a Levinasian understanding of the other in the midst of MacIntyrian craft may propose modes of engagement with learners.
The facilitators will then invite participation through a number of directed smaller conversations in small groups that address the following central topics, problems and questions:
• Is saint-making a proper goal of education? What forms can this take in a secular/pluralistic medical education? What aspects of selfhood can the physician offer to her patients?
• In what ways can formation in holiness be thought of as a communal task? Can it be thought of as a craft in a MacIntyrian sense?
• What does it take to help learners not be seduced by the false refuge of science? What are ways to interrupt the metaphor of medicine-as-tool (or self-as-tool) and instead to adopt a way of being--and in what ways is this interruption inherently risky?
• How do we integrate the very real demands of practical scientific medical education with the call to holiness?
• What does it mean to be committed to the event of truth in the experience of illness? In what ways/to what degree does the physician have to embrace his/her own mortality in order to accompany a patient through suffering? What is the ultimate cost of this commitment, to learners and to teachers?
The emphasis of this interactive session will be to explore guiding ideas that can be translated to concrete practices, applicable in a secular/pluralistic environment while helping students to break out of the implicit assumptions of such an environment. We will together address the hopes, limitations and challenges implicit to this type of education.
In summary, the workshop will be organized in the following manner:
1. Introduction of the concept of medical education as a call to holiness and its problematic relationship to current models of medical education. (10 minutes)
2. A workshop discussion identifying a set of dilemmas that arise when a young physician is asked to engage the singular problems of a particular suffering body (10 minutes)
3. Presentation of Paradigm 1: Truth as an event in the thinking of Paul, Dostoevsky and Heidegger with particular focus on participating in the
“unfinished novel.” (10 minutes)
4. Presentation of Paradigm 2: The thinking of Alasdair MacIntyre and Emmanuel Levinas in respect to the concepts of medicine as craft and the role of narrative. (10 minutes)
5. Workshop discussion of particular problems, concepts and challenges regarding the goal of educating physicians to answer the call to holiness. (30 minutes)
6. Summary and reflection on future directions. (5 minutes)
This workshop brings together the scholarship, experiences and leadership of two differently trained educators.
• A university professor with degrees in biology, theology and comparative literature who is the founder, director and faculty-in-residence of the Engineering Honors Program and the Andrews Hall Residential College as the University of Colorado, Boulder. He has published books and articles on the Cappadocian Fathers, Patristics and the intersection between contemporary and ancient philosophy. He is currently finishing a monograph on Paul, Dostoevsky and the Event of Truth.
• A practicing resident physician in Internal Medicine-Pediatrics with degrees in Chemical Engineering and Narrative Medicine. He has led workshops in medical humanities and his writing has been published in Academic Medicine, the Journal of Palliative Medicine, and the Journal of the American Medical Association.
Scot Douglass, PhD, University of Colorado at Boulder
In his conclusion to The Anticipatory Corpse, Jeffrey Bishop claims that rather than clinicians whose sole focus is technical mastery, medicine needs "holy men and women...who offer themselves to the living and the dying”(1). Employing similar language, others claim that the process of educating young health care providers should be one of moral formation(2). Speculation regarding the best model to accomplish this ranges from the long tradition of spiritual formation(3) to ancient and modern philosophical approaches(4). Central in this thinking is the emphasis on physicans’ “offering themselves” in addition to their formidable knowledge and skills in order to break out of the totalizing, stupefying thrall of "scientific" medicine.
If taken seriously, these thinkers put forward various calls to holiness that ask physicians and their educators to occupy spaces that evade the structural closure sought by systems, curricula and core competencies. In doing so, they represent a unique challenge to educators. The goal of this workshop is to create just such a space in which medical educators, students, and philosophers of medicine can work together to discuss some of the practical implications of a call for holiness as it might emerge from within the practice of teaching medicine.
The workshop will begin with a problematization of medical education and its role in cultivating holiness. The facilitators will propose a concept of education/formation that emphasizes the primacy of events of authentic encounter. Such particular events of holiness not only involve the creation of unstable sacred spaces but also engage the productive tensions between becoming and being, the unknown and the known, the particular and the universal, the personal and the professional. To better frame this workshop, the facilitators will work with the attendees to articulate a set of dilemmas that arise when a young physician is asked to engage the singular problems of a particular suffering body.
With these in mind, the facilitators will then explore two distinct philosophical/theological paradigms with the goal of setting them in conversation with one another and with the workshop participants. The first paradigm will look at the idea of a truth event as held by the Apostle Paul, the Russian novelist Fyodor Dostoevsky and the philosopher Martin Heidegger. Particular focus will be on the concept of the “unfinished novel” and the lack of closure of engaging others in the in/between now of an event in progress. Particular attention will be placed upon why alternative models that promise closure, mastery and certitude are far more seductive. The second paradigm, drawing from the work of Alasdair MacIntyre with influences and critiques of Narrative Medicine as articulated by Rita Charon, will explore the concepts of craft and the narrative conception of a life, emphasizing ways that narrative understanding can open outward from situated, particular traditions and in so doing resist totalization. It will interrogate certain types of narrative-making in light of Bishop’s critique of the overlay of fictional, constructed meaning onto biological “reality”—a tempting move that serves only to further alienate the suffering person by denying the ways that meaning is always already embodied. It will conclude with a look toward the philosophy of Emmanuel Levinas and ways that a Levinasian understanding of the other in the midst of MacIntyrian craft may propose modes of engagement with learners.
The facilitators will then invite participation through a number of directed smaller conversations in small groups that address the following central topics, problems and questions:
• Is saint-making a proper goal of education? What forms can this take in a secular/pluralistic medical education? What aspects of selfhood can the physician offer to her patients?
• In what ways can formation in holiness be thought of as a communal task? Can it be thought of as a craft in a MacIntyrian sense?
• What does it take to help learners not be seduced by the false refuge of science? What are ways to interrupt the metaphor of medicine-as-tool (or self-as-tool) and instead to adopt a way of being--and in what ways is this interruption inherently risky?
• How do we integrate the very real demands of practical scientific medical education with the call to holiness?
• What does it mean to be committed to the event of truth in the experience of illness? In what ways/to what degree does the physician have to embrace his/her own mortality in order to accompany a patient through suffering? What is the ultimate cost of this commitment, to learners and to teachers?
The emphasis of this interactive session will be to explore guiding ideas that can be translated to concrete practices, applicable in a secular/pluralistic environment while helping students to break out of the implicit assumptions of such an environment. We will together address the hopes, limitations and challenges implicit to this type of education.
In summary, the workshop will be organized in the following manner:
1. Introduction of the concept of medical education as a call to holiness and its problematic relationship to current models of medical education. (10 minutes)
2. A workshop discussion identifying a set of dilemmas that arise when a young physician is asked to engage the singular problems of a particular suffering body (10 minutes)
3. Presentation of Paradigm 1: Truth as an event in the thinking of Paul, Dostoevsky and Heidegger with particular focus on participating in the
“unfinished novel.” (10 minutes)
4. Presentation of Paradigm 2: The thinking of Alasdair MacIntyre and Emmanuel Levinas in respect to the concepts of medicine as craft and the role of narrative. (10 minutes)
5. Workshop discussion of particular problems, concepts and challenges regarding the goal of educating physicians to answer the call to holiness. (30 minutes)
6. Summary and reflection on future directions. (5 minutes)
This workshop brings together the scholarship, experiences and leadership of two differently trained educators.
• A university professor with degrees in biology, theology and comparative literature who is the founder, director and faculty-in-residence of the Engineering Honors Program and the Andrews Hall Residential College as the University of Colorado, Boulder. He has published books and articles on the Cappadocian Fathers, Patristics and the intersection between contemporary and ancient philosophy. He is currently finishing a monograph on Paul, Dostoevsky and the Event of Truth.
• A practicing resident physician in Internal Medicine-Pediatrics with degrees in Chemical Engineering and Narrative Medicine. He has led workshops in medical humanities and his writing has been published in Academic Medicine, the Journal of Palliative Medicine, and the Journal of the American Medical Association.