The Healer's Art.
(aired in slightly different form on All Things Considered, May 15, 2003)

 

It was a simple gold-colored metal pin, designed to clip to a stethoscope. It had a red heart, drawn like a valentine; and the words, "The Healer's Art."

I knew I'd never wear it. In fact, I feared it.

I got the pin when I finished a class called "The Healer's Art", designed for medical schools by the doctor and writer Rachel Naomi Remen. The goal of the course is to get medical students to remember the values we cherish, to accept that some things are too big and mysterious to understand by knowing facts, and to accept grief and loss as part of our lives. The course led me to remember the reasons I had come to medicine, reasons that were not only practical but emotional and in some way spiritual. And indeed, Dr. Remen says that she views medicine as her spiritual practice.

But courses like "The Healer's Art" are also part of something larger, a new social contract now in negotiation between doctors and everyone else. Whenever I meet people outside of medicine, I see it. It might be at a party, or even at a bus stop. When people find out that I'm in medical school, they start testing me to find out whether I'm going to become a doctor they'd like, or a jerk. They tell me stories of bad doctors and watch my reaction. Or they tell me about treatments they use, like acupuncture or Chinese herbs, to see if I'll condemn them. Or they just ask me straight out how I'll keep my humanity. If I pass their test, they praise me, often in a way that seems exaggerated: "Oh, you're going to be a wonderful doctor." But this praise clearly has a harsher unspoken ending, something like, "Unlike most of them."

That implicit but constant social criticism influences us, and medical students and doctors are responding. "The Healer's Art" is part of a new movement in medicine to change medicine by changing doctors. Rachel Naomi Remen's ideas have existed in various forms for a long time. But it's only recently that people like Dr. Remen could expect to recruit enthusiastic medical students and faculty across the country for a class like "The Healer's Art".

And yet, focusing on spirituality in medicine carries the risk of creating a church of the doctor. To go to a class and reflect is one thing. To wear a pin and proclaim membership is another. If there is a church of the doctor, do nurses get to come too? What about paramedics, or AIDS activists, or patients? The Healer's Art reinterprets many of the central ideas of the nursing profession for future doctors' edification. So we could just as easily create a church of the nurse, with doctors sitting in back as acolytes.

But that's not how doctors usually arrange things. Those critical conversations at parties may change our demeanor and our approach, but at the end of the conversations there is one thing that hasn't changed: we're still at the center of the story. We might lose our arrogance, but not our power.

And that's why I fear who I might become if I call myself a healer or try to assume any special spiritual role. Arrogance was the demon of past generations of doctors. I don't want our generation to replace it with piety. There are many benefits of this new movement in medicine, but it doesn't change our basic moral challenge. We still have to figure out how to be important without being self-important.

 

copyright 2003 joe wright