"Vive Jésus!": Toward a Neo-Salesian Spirituality for Students of Medicine
Andrew Michel, MD, Frist College of Medicine at Belmont University, Nashville, TN
Some might hold that "great coherence" in medical practice is best achieved by translating spiritual and religious practices into universal language for generic application by a general audience. Nevertheless, translations risk dilution of the sacred power and meaning of particularistic practices embedded in spiritual traditions that enliven the souls of those membered to these traditions. This paper boldly explores a radical proposition by imagining how a neo-Salesian spirituality for physician trainees might paradoxically answer pressing needs in the contemporary landscape of medicine by adhering faithfully to particularistic assumptions for persons who choose to follow a dedicated rule of life.
To keep pace with the rapidly expanding medical knowledge base and the shifting landscape of the contemporary healthcare ecosystem, educators within formative medical training environments now seek to train “master adaptive learners” who are intuitively responsive to the moment’s need and who function in interdisciplinary teams to provide timely “right at hand” care delivery, including the judicious use of technologies—pharmaceutical, surgical, and otherwise (Cutrer, et. al., “Fostering the Development of Master Adaptive Learners: A Conceptual Model to Guide Skill Acquisition in Medical Education.”Academic Medicine, 2017). In this context, contemporary medical educators increasingly utilize active case-based learning modalities to explicitly simulate clinical care and cultivate tacit, practical wisdom in physician trainees. Medical educators are also increasingly attending to physician identity, self-care, and well-being, as well as the social determinants of health and the ways health disparities are connected to socio-economic status and diversity.
These movements are inducing an era of experimentation in medical education unseen since 1910’s Flexner Report. Medicine’s reliance upon an ultra-rational “encyclopedic” knowing—characteristic of the Age of Reason following the Enlightenment—was helpful in an age when a solo practitioner might hold a broad fund of knowledge in self-sufficiency but is now increasingly inadequate to the flux of current demands and dynamics of contemporary healthcare practice. To find a medical education which maintains the rigor of a physician’s life while privileging the power of improvisational, intuitive knowing over against the hyper-rational, discursive epistemology that has characterized medical education since Flexner, we need to draw on a parallel era.
A well-rounded, flexible, harmonizing, epistemology for medical practitioners can be reclaimed from a historical period likewise fraught with perils and possibilities— the “Great Century of the Soul” in France, a period notable for remarkable developments in art, literature, and spirituality simultaneously fraught with the French Wars of Religion during the reigns of Louis XIII and Louis XIV. The resulting practices could provide not only a needed pedagogy for medical education but also an anchored spirituality for medical practitioners needed now more than ever to re-enchant medicine and support the formation and resilience of physicians of the future.
Toward this end, this paper outlines a neo-Salesian rule of life for medicine, modeled on the spiritual exercises of Saint Francis de Sales, Doctor of Divine Love (1567-1622) who charitably extended a ministry of spiritual guidance to lay persons in everyday life in sixteenth century France. This rule would encompass four core dimensions of Salesian spirituality: 1. heart-centered entrustment to God in daily rhythms of “method-less” prayer and discernment, 2. cultivation of the “little virtues” of humility, meekness, and gentleness, 3. deepening in intuitive knowing as it relates to practical wisdom, and 4. sustenance in the solidarity of spiritual friendship in the life-long missional practice of healing. The stability and centeredness occasioned as the enjoyed fruit of this neo-Salesian spirituality readies the artisan of medicine with intuitive sensibilities for mission in apostolic service to those impoverished in illness of body, mind, and spirit. Insofar as these fruits may transcend the individual practitioner, the paper concludes by gesturing to radical possibilities of transformation of the sociopolitical and neo-liberal economic landscape of the contemporary health care ecosystem, as neo-Salesian physician-apostles are sent out like yeast “worked all through the dough” (Matthew 13:33).
To keep pace with the rapidly expanding medical knowledge base and the shifting landscape of the contemporary healthcare ecosystem, educators within formative medical training environments now seek to train “master adaptive learners” who are intuitively responsive to the moment’s need and who function in interdisciplinary teams to provide timely “right at hand” care delivery, including the judicious use of technologies—pharmaceutical, surgical, and otherwise (Cutrer, et. al., “Fostering the Development of Master Adaptive Learners: A Conceptual Model to Guide Skill Acquisition in Medical Education.”Academic Medicine, 2017). In this context, contemporary medical educators increasingly utilize active case-based learning modalities to explicitly simulate clinical care and cultivate tacit, practical wisdom in physician trainees. Medical educators are also increasingly attending to physician identity, self-care, and well-being, as well as the social determinants of health and the ways health disparities are connected to socio-economic status and diversity.
These movements are inducing an era of experimentation in medical education unseen since 1910’s Flexner Report. Medicine’s reliance upon an ultra-rational “encyclopedic” knowing—characteristic of the Age of Reason following the Enlightenment—was helpful in an age when a solo practitioner might hold a broad fund of knowledge in self-sufficiency but is now increasingly inadequate to the flux of current demands and dynamics of contemporary healthcare practice. To find a medical education which maintains the rigor of a physician’s life while privileging the power of improvisational, intuitive knowing over against the hyper-rational, discursive epistemology that has characterized medical education since Flexner, we need to draw on a parallel era.
A well-rounded, flexible, harmonizing, epistemology for medical practitioners can be reclaimed from a historical period likewise fraught with perils and possibilities— the “Great Century of the Soul” in France, a period notable for remarkable developments in art, literature, and spirituality simultaneously fraught with the French Wars of Religion during the reigns of Louis XIII and Louis XIV. The resulting practices could provide not only a needed pedagogy for medical education but also an anchored spirituality for medical practitioners needed now more than ever to re-enchant medicine and support the formation and resilience of physicians of the future.
Toward this end, this paper outlines a neo-Salesian rule of life for medicine, modeled on the spiritual exercises of Saint Francis de Sales, Doctor of Divine Love (1567-1622) who charitably extended a ministry of spiritual guidance to lay persons in everyday life in sixteenth century France. This rule would encompass four core dimensions of Salesian spirituality: 1. heart-centered entrustment to God in daily rhythms of “method-less” prayer and discernment, 2. cultivation of the “little virtues” of humility, meekness, and gentleness, 3. deepening in intuitive knowing as it relates to practical wisdom, and 4. sustenance in the solidarity of spiritual friendship in the life-long missional practice of healing. The stability and centeredness occasioned as the enjoyed fruit of this neo-Salesian spirituality readies the artisan of medicine with intuitive sensibilities for mission in apostolic service to those impoverished in illness of body, mind, and spirit. Insofar as these fruits may transcend the individual practitioner, the paper concludes by gesturing to radical possibilities of transformation of the sociopolitical and neo-liberal economic landscape of the contemporary health care ecosystem, as neo-Salesian physician-apostles are sent out like yeast “worked all through the dough” (Matthew 13:33).