Simone Weil's "Attention" in Clinical Practice
Mark Kissler, MD, Director of Narrative Medicine, Division of Hospital Medicine, University of Colorado School of Medicine
There are few human activities that require attention more than the practice of medicine. Attention is required for the technical, instrumental delivery of care (interpreting clinical information, forming judgements, and acting with expert precision), and research is ongoing into ways that human-centered design principles might improve environments that are, at their baseline, highly interruptive. Even more importantly, attention is essential to the interpersonal dimension of care, which includes acts of witnessing, presence, discernment, and compassion. In a sense, attention can speak the language both of RVUs (a billing measure) and of the Good Samaritan. It is an indispensable concept for those who hope not only to change healthcare institutions but also to revitalize the spiritual and ethical dimension of care.
The French thinker Simone Weil (1909-43) proposed one of the most important, and original, concepts of attention in the last century. For Weil, attention is not an attitude of strained focus but of spiritual waiting; it requires purification of the will, gentle directedness toward the origin of actions, and the diminishment of the self. Contemporary medicine often urges the contrary: perpetual hurry, effortful will, focus on material and objective ends rather than the underlying motivations of actions, and a self-aggrandizing heroic bio-technical narrative. The result of the contemporary situation is not only that clinicians encounter barriers to doing their best work, but that the work itself has started to lose its orienting connection to the good.
The proposed paper describes Weil’s concept of attention, particularly as developed in Gravity and Grace, Waiting for God, and her letters. It demonstrates important differences between this concept and current calls for mindfulness in clinical practice (for Weil, attention entails moving toward practical engagement of suffering and ever more fully into the real world of affliction and contingency). It then discusses how Weil’s form of attention might influence the care of others in their bodies and their souls. It addresses whether attention of this kind might find a home within the contemporary clinic, or whether the clinic itself is antithetical to the promotion of deep, fundamentally religious attention. As Weil wrote in Gravity and Grace, “Absolutely unmixed attention is prayer.”
This investigation is part of an ongoing program of research into the ways that the concept of attention in clinical medicine might be informed by contributions from theology, philosophy, anthropology, and cognitive science, with the goal of informing healthcare innovations in environmental design, system improvement, and philosophies of care.
The French thinker Simone Weil (1909-43) proposed one of the most important, and original, concepts of attention in the last century. For Weil, attention is not an attitude of strained focus but of spiritual waiting; it requires purification of the will, gentle directedness toward the origin of actions, and the diminishment of the self. Contemporary medicine often urges the contrary: perpetual hurry, effortful will, focus on material and objective ends rather than the underlying motivations of actions, and a self-aggrandizing heroic bio-technical narrative. The result of the contemporary situation is not only that clinicians encounter barriers to doing their best work, but that the work itself has started to lose its orienting connection to the good.
The proposed paper describes Weil’s concept of attention, particularly as developed in Gravity and Grace, Waiting for God, and her letters. It demonstrates important differences between this concept and current calls for mindfulness in clinical practice (for Weil, attention entails moving toward practical engagement of suffering and ever more fully into the real world of affliction and contingency). It then discusses how Weil’s form of attention might influence the care of others in their bodies and their souls. It addresses whether attention of this kind might find a home within the contemporary clinic, or whether the clinic itself is antithetical to the promotion of deep, fundamentally religious attention. As Weil wrote in Gravity and Grace, “Absolutely unmixed attention is prayer.”
This investigation is part of an ongoing program of research into the ways that the concept of attention in clinical medicine might be informed by contributions from theology, philosophy, anthropology, and cognitive science, with the goal of informing healthcare innovations in environmental design, system improvement, and philosophies of care.