The Role of the Friendship House in Medical Formation
Moderator: Mary Elise Nolen is a first year genetic counseling student at the University of South Carolina and former Theology, Medicine, and Culture fellow at Duke Divinity School from 2021-2022 where she focused on disability theology. During her time at Duke, she volunteered with Reality Ministries and was a friend of the north street community and friendship house.
Panelists: Rev. Ben Davison is a lake fellow in parish ministry at Second Presbyterian Church in Indianapolis. Ben lived at the Friendship House with a resident named Alex for three years as he pursued his masters of divinity at Duke. During his time in the friendship house, he was an active volunteer with Reality Ministries; Jackson McNeece is a second year Master of Divinity student and Theology, Medicine, and Culture Fellow at Duke Divinity School. After being “volun-told” to work at Reality for his Spiritual Formation class, he became enthralled with the mission and vision of Reality Ministries. Later that year, he applied to live at Friendship House and moved into the house in August. In the months since, Jackson has become fully accustomed to the rhythms of Friendship House and cherishes the time he spends in the community; Anjola Onadipe is a first year Master of Theological Studies Student and Theology, Medicine, and Culture (TMC) Fellow. He is completing the TMC Fellowship in between his third and fourth year of medical school at the University of Michigan. After completing the TMC Fellowship, he plans to return to medical school and apply for residency in Internal Medicine and Pediatrics. He moved into Friendship House in August and enjoys both the planned and spontaneous time spent with the community; and Alex Furiness is a core resident at Friendship House. He has lived there for 10 years and loves quality hang out time with friends. He also is a good Buckeye fan, but rarely passes up a chance to cheer for his Duke Blue Devils. He is also one of the nicest and most thoughtful people that you will ever meet.
In medical training programs, disability is often conceived of and articulated as a tragic occurrence of physical, emotional, or intellectual abnormalities. The enterprise of modern medicine aims to fix, improve or eliminate disability however possible. As such, physicians’ and aspiring medical students’ didactic work frequently neglects to prepare them to respond to disability with any understanding other than biological deformity. This deficiency in the medical system is made apparent in the way it and its practitioners care for people with disabilities. In the medical model of disability — one of the three models of disability each of us see most often in our respective fields of study — disability is conceived “as an intrinsic, individualized, and inherently negative ‘problem.’ This medical construal of disability, for adherents to the medical model, ought to evoke responses that seek to remediate, minimize, or eliminate disability through therapeutic fixes.”[1]
We believe this is an issue for two reasons. First, the medical model of disability reduces the identity of persons with disabilities to that of their diagnosis. As Christians seeking to promote human flourishing in each person because we believe it is axiomatic to each person’s identity as imago dei (humans being made in the image of God as found in Genesis 1:21), we contend that considering the sum of a person to be their medical diagnosis thwarts this Christian vision. Second, the medical model of disability disorders medicine, asserting technological capacity as the barometer of what is good and permissible and that which ought to be eliminated and discarded. The medical model of disability transforms “can be fixed” to “should be fixed,” imposing a moral culpability upon the patient with disabilities and their primary caregiver to proceed with any medical procedure possible to eliminate the defect. Again, we find this philosophically untenable due to how it transforms the patient from the totality of a person to the mere sum of their disability. Thus, we believe the role of technology within medicine ought to be permitted in so far as it does not interfere with the healthcare provider’s conception and conferral of personhood upon their patient with disabilities. Further, the role of disability is quintessential to medicine because it teaches medicine about the finitude, fragility, and the necessity of community within the human condition.
Despite our disdain for the nature of modern medicine, we cannot harbor malice towards its practitioners and their deficit in this arena. Neither the medical classroom nor the clinic is the best space to learn about disability and acquire the proper skills which are best suited to not only affirm the entirety of the patient but also to accompany the patient and his or her family on their journey. Instead, we propose these lessons are taught outside through communal relationships. In doing so, the responsibility of compassion and support to individuals and their families becomes a robust, cohesive, and thorough endeavor.
Communal relationships care for the soul and to promote human flourishing in the way the modern medical enterprise fails to do. The best solution we envision for the deleterious perspectives of the medical model of disability and modern medicine is a gift each of us on the panel has been given by way of an intentional living community: The Friendship House.
The Friendship House is an intentional community where persons with intellectual disabilities and Duke Divinity Students come together to live. There are two Friendship Houses in Durham, each consisting of two apartments with four people per unit. In each apartment, there are three Duke students and one person with disabilities. The Duke students are not to serve as a caretaker for the person with intellectual disabilities but a friend. They cook together, attend weekly prayer, go on walks, watch sports, and simply enjoy each other’s company. In doing so, the sum of each person is understood in terms of their relationship within the community, not simply what their diagnosis shares about a deficient condition.
It is our hope that through the panel each member of the audience will walk away with a greater understanding not only of Friendship House, but further how communal relationships, and in this instance Christian communal relationships, offer a rejoinder to current medical practice. The medical model of disability interprets disability persons with disabilities as broken machines, but Christian community values each person in their range of abilities as one to be cherished simply for who they are.
[1] Sarah Barton, Becoming the Baptized Body: Disability and the Practice of Christian Community, (Baylor University Press, Waco, 2022) 5.
We believe this is an issue for two reasons. First, the medical model of disability reduces the identity of persons with disabilities to that of their diagnosis. As Christians seeking to promote human flourishing in each person because we believe it is axiomatic to each person’s identity as imago dei (humans being made in the image of God as found in Genesis 1:21), we contend that considering the sum of a person to be their medical diagnosis thwarts this Christian vision. Second, the medical model of disability disorders medicine, asserting technological capacity as the barometer of what is good and permissible and that which ought to be eliminated and discarded. The medical model of disability transforms “can be fixed” to “should be fixed,” imposing a moral culpability upon the patient with disabilities and their primary caregiver to proceed with any medical procedure possible to eliminate the defect. Again, we find this philosophically untenable due to how it transforms the patient from the totality of a person to the mere sum of their disability. Thus, we believe the role of technology within medicine ought to be permitted in so far as it does not interfere with the healthcare provider’s conception and conferral of personhood upon their patient with disabilities. Further, the role of disability is quintessential to medicine because it teaches medicine about the finitude, fragility, and the necessity of community within the human condition.
Despite our disdain for the nature of modern medicine, we cannot harbor malice towards its practitioners and their deficit in this arena. Neither the medical classroom nor the clinic is the best space to learn about disability and acquire the proper skills which are best suited to not only affirm the entirety of the patient but also to accompany the patient and his or her family on their journey. Instead, we propose these lessons are taught outside through communal relationships. In doing so, the responsibility of compassion and support to individuals and their families becomes a robust, cohesive, and thorough endeavor.
Communal relationships care for the soul and to promote human flourishing in the way the modern medical enterprise fails to do. The best solution we envision for the deleterious perspectives of the medical model of disability and modern medicine is a gift each of us on the panel has been given by way of an intentional living community: The Friendship House.
The Friendship House is an intentional community where persons with intellectual disabilities and Duke Divinity Students come together to live. There are two Friendship Houses in Durham, each consisting of two apartments with four people per unit. In each apartment, there are three Duke students and one person with disabilities. The Duke students are not to serve as a caretaker for the person with intellectual disabilities but a friend. They cook together, attend weekly prayer, go on walks, watch sports, and simply enjoy each other’s company. In doing so, the sum of each person is understood in terms of their relationship within the community, not simply what their diagnosis shares about a deficient condition.
It is our hope that through the panel each member of the audience will walk away with a greater understanding not only of Friendship House, but further how communal relationships, and in this instance Christian communal relationships, offer a rejoinder to current medical practice. The medical model of disability interprets disability persons with disabilities as broken machines, but Christian community values each person in their range of abilities as one to be cherished simply for who they are.
[1] Sarah Barton, Becoming the Baptized Body: Disability and the Practice of Christian Community, (Baylor University Press, Waco, 2022) 5.