“Whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is gracious, if there is any excellence and if there is anything worthy of praise, think about these things.”
It’s so good to be here with you—what an exciting day. I was asked to share some thoughts that might be relevant to you all as you get started on this incredible ride. I’ll get back to the Paul in a moment—just to say here that, from a purely literary sense, there’s something to admire in his lists, their cadence and directionality. Most of the rest of what I’ll have to say is from Greek pagans but they just can’t compete with this poetry, so I put it first.
I remember sitting where you are now on my first day. The woman who is now my wife was halfway across the country; I was in a new city, sweating profusely, with a slowly dawning perception that I didn’t actually know what I was getting myself into. Over time I found a place, some solid friends, some good study habits. We all helped one another through. I’m sure you will do the same.
What I wanted to share with you today, though, is something that I think is pretty important you know up front. Here it is: You are all about to devote a tremendous amount of time and energy over the next four to…fourteen years…on something that is not enough. I’ll say it again: a tremendous amount of time and energy will go to something that isn’t enough. Medicine—the science, the practice—won’t get you through. It can’t sustain you on its own, through all through the hard days, the specter of burnout, nor can it sustain the lives we will cultivate with others while we are here in school. There’s a temptation sometimes to think it will, or at least to slip into the illusion that the whole world is just a somewhat distracting corner of medicine, instead of remembering that medicine is really just a small part of the world. But we can’t forget that—and our patients, if we listen to them, won’t let us.
For us, medicine is (or will soon be) a way of life. We’ll eat and sleep in the hospitals—and sometimes, we won’t eat or sleep, but we’ll still be in the hospitals. But for the patients we serve, their days are anything but normal. They—often regardless of how sick they are—are in extremis. This day that you just walked into represents to them disorientation, rupture, interruption of their story and sense of self, reckoning with an unseen, threatening force. We would do well not to forget that.
Narrative theorist Arthur Frank writes of what he terms ‘spaceship ethics,’ named after a physician’s anecdote of leaving his home and imagining his car a spaceship, carrying him to a distant world where “terrible things happen,” all the while refusing to acknowledge that his planet and the planet of the hospital are one in the same. The problem here is that the physician is isolated—from his patients, his role, and even from himself. What Frank proposes instead is to invest deeply in stories–essentially, being willing to be open to the ways that stories are the first inroads to a more personal and specific way of being-toward-the-other. Others have picked up his argument to strongly argue that we as clinicians need also to look outside of medicine, and toward things like living traditions, authentic relationships, good art, the natural world–not just to relate to our patients better or to help ourselves recharge but also to help us do the work that, ideally, we’re trying to do. Medicine—the science—pushes us to efficiency, effectiveness, near-perfection. There is a lot of power in that. But healing—I hesitate to call it an art because it is more than that, more than artifice and closer perhaps to a way of being—healing sometimes requires inefficiency. Hesitation. Our wounded nature encountering another wounded nature, and stopping long enough to witness their suffering and, even if we cannot take it away, being willing to be changed by it. How?
I promised you pagans. Aristotle said, “the virtue of a man…will be the state of character which makes a man good and which makes him do his own work well.” There is a sense, in his writing, that virtues—from virtus, excellence, worth, developed through habit—are the raw materials for a well-favored life in which work is integrated into a greater and more important pursuit of being a good human being. Philosopher Craig Irvine at Columbia wrote, “I must care for my hands, if I am to lift the fallen; my heart, if I am to love the stranger; my mind, if I am to cure the ill; my eyes, if I am to find the lost, and my soul, if I am to guide them home.” I would challenge you to find a few ways to sustain yourselves that are not simply disconnected from medicine, and to avoid the slow gravity toward “spaceship ethics”—but instead to look to each other to begin to cultivate those strengths—humility, courage, charity, patience—that can sustain us as we remain human in the face of the suffering we will inevitably see.
Baylor has given me a tremendous education. Now in my fourth year I can almost feel the first little shoots of competence poking up over the vast freshly-fertilized fields of my inexperience. Thomas Merton said, “The world is made up of people who are fully alive in it: that is, of the people who can be themselves in it and can enter into a living and fruitful relationship with each other in it.” Education, then, should be one of the ways that we learn who we are, what we have to offer, and how to make that offering valid to the contemporary world. Baylor has provided that type of space for me while laying a solid foundation, and I have confidence that the faculty here will do the same for you.
As I look ahead, there’s one particular virtue that I would personally like to cultivate, that seems especially fitting especially after this last month at Texas Children’s Hospital with patients and families who are uprooted from home. Here’s a long quote from Henri Nouwen from his book called “The Wounded Healer,” and then I’ll wrap up.
“Hospitality is the virtue that allows us to break through the narrowness of our own fears and to open our houses to the stranger, with the intuition that salvation comes to us in the form of a tired traveler…Paradoxically, by withdrawing into ourselves, not out of self-pity but out of humility, we create the space for others to be themselves and to come to us on their own terms…But human withdrawal is a very painful and lonely process, because it forces us to directly face our own condition in all its misery as well as all its beauty…[W]hen we have finally found the anchor place for our lives within our own center we can be free to let others enter into the space created for them, and allow them to dance their own dance, sing their own song, and speak their own language without fear. Then our presence is no longer threatening and demanding, but inviting and liberating.”
Enjoy this time—it is fun. Study hard, and try to do it for someone else. Be good to one another, to your patients, to yourselves. I wish you all the best.
The address given by the Mark Kissler, MS4, the 2014 Debakey Scholar of Baylor College of Medicine on July 30, 2014 at convocation for the class of 2018.
This speech was so touching to this aspiring doctor. Thank you for your hard work – I know that kind of depth and wisdom does not come easily. You are a very real inspiration.