How do you know?

Posted on October 26, 2025 by marylbrandt

The definition of “knowledge” in English is pretty straightforward – To “know” something means being familiar and/or aware of it in a way that lets us understand. I find it fascinating that English has only one word for “knowledge”, where other languages use multiple words to reflect the depth and nuances of the concept. “Once widespread in Germanic, the verb [to know] is now retained there only in English, where it has widespread application, covering meanings that require two or more verbs in other languages (such as German wissen, kennen, erkennen and in part können; French connaître “perceive, understand, recognize,” savoir “have a knowledge of, know how;” etymonoline

How we understand “knowledge” affects how we teach, how we learn, and how we see the world.

The philosophers of Ancient Greece saw acquiring knowledge as an important part of the human quest for wisdom. Enter episteme, techne, phronesis, gnosis, and doxa. These nuanced ways to think about knowledge and wisdom have a lot to offer us as we navigate the misinformation and philosophical chaos of our time. For those in medicine, these nuanced definitions add beautiful complexity and understanding to our work, with special inspiration for those who teach the healing arts.

Episteme: Intellectual knowledge (Root of “epistemology”, the study of knowledge)

This is the information we learn in our classrooms, from books, and from teachers.

A crowded anatomy classroom scene featuring medical professionals in white lab coats surrounding a patient on a table, engaged in discussion and observation. — The Anatomy Lesson of the Irish College of Surgeons, Robert Jackson, 2010

Techne: Technical knowledge (Root of “technology”)

Techne refers to the technical skills of a profession – the grasp of grammar for a writer, pedagogical skills for a teacher, the ability to perform specific procedures for a surgeon.

Two surgeons in surgical attire engaged in a procedure in an operating room, depicted in a stylized manner. — Photo by Mary L. Brandt, MD

Phronesis: Practical wisdom

I recently read this remarkable essay by Sami Sinada in which he states: “Medical school teaches episteme. Residency builds techne. But phronesis? We assume it appears through osmosis. It doesn’t.”

The entire essay is well worth your time to read, but Dr. Sinada makes an important point – Our medical school and residency curricula have gaps when it comes to teaching practical wisdom (which is the core of doctoring). He goes on to argue that we can close that gap with five important pedagogical choices:

Start with uncertainty, not answers.

Prioritize continuity over episodic care.

Use ethical cases as judgement training.

Make expert reasoning audible.

Require reflective writing.

A 19th-century painting depicting a doctor seated next to a sick child lying on a bed, with concerned family members in a dimly lit room, conveying a sense of care and concern.

Doxa: Common belief, popular opinion. (Root of orthodox)

What strikes me about doxa is that it has no moral weight associated with it. Doxa can refer to the deep orthodoxy of thousands of years of tradition in a culture … everything from how we greet each other to what we believe… as well as culturally accepted, politically motivated lies.

An infographic illustrating different greeting customs around the world, showcasing interactions in various countries with visuals and descriptions. — Source

Gnosis: Insight, deep personal knowing

Gnosis is most often associated with gnosticism, a religious and philosophical movement in the 2nd century. But I wonder if the concept of a deep inner knowing (whether or not you view that as divine) isn’t worth refurbishing for our time as an important way to “know”. Contemplation, meditation, prayer can all open spaces that defy our intellectual understanding, leading to a way of “knowing” that, in some ways, we need now more than ever.

A silhouette of a person sitting on a bench, gazing at a glowing, magical tree surrounded by a starry night sky. — Link to the PBS series Wisdom Keepers

Knowledge without transformation is not wisdom. Paulo Coelho

My “Top 10” from Theology Beer Camp 2025

Posted on October 20, 2025 by marylbrandt

It is mind blowing and soul nourishing to listen to talented orators and scholars about the “whys” and “hows” of current challenges in our individual and communal lives…especially when surrounded by joy and laughter.

“Have you ever noticed that the happiest people on television are on medication? … but the side effects are hell!” Jean Dominic Crossan (Hmmm… and did you know that there are only two countries in the world that allow direct to consumer marketing of prescription drugs?)

“Heaven and hell are not locations in the future, they are options in the present.” Jean Dominic Crossan

“The battle is not how we worship but what we worship at the altars of our daily lives. That which is central to us is sacred to us.” Stacey Floyd-Thomas

“We were chanting, dancing, and trancing before we could speak… Religion started before belief.” Tripp Fuller

“The United Daughters of the Confederacy sought to create “living monuments” through what children were taught” (This is a history I sort of knew, but not really). We are repeating this today in the current policies of school boards and the Dept of Education to erase our history because it makes white kids “uncomfortable”…“A little discomfort is required to improve. An education that never discomforts never transforms.” …“Control of the narrative is more powerful than bombs.” Kelly Brown Douglas

“What books have torn you wide open?” Kelly Brown Douglas (What an amazing question and truth – the education that sets you free is not just what you learn from teachers in classrooms but also from books… supporting my deep belief that librarians will save our civilization)

West Coast IPA may be my favorite type of beer, and the one that was specially brewed for this event was among the best I’ve ever had.

“Paul intended and wrote to speak to the ages, not just the time he lived in. In thinking about his words, his instructions, his understandings we can and should judge Paul against where we find ourselves today. This means that originalism, or fundamentalism is the wrong approach to the writings of Paul.” Jean Dominic Crossan

Spiritual/faith journeys must be done in community (church) so each of us can do “the work our soul must have” (Church). (the quote is from Katie Geneva Cannon, shared by Stacey Floyd-Thomas)

Photo from Brian Jones

Here’s the website for Theology Beer Camp 2025, so you can see the full list of speakers, topics, and events. Many of the speakers have wonderful podcasts, too!

Life, Faith, and Frogs

Posted on October 15, 2025 by marylbrandt

I have a practice of curating cool things that I share with friends…and (#coincidence?) this post from last week made me think about that practice in a different way. Austin Kleon writes an amazing weekly “newsletter” to send curated stuff he loves to people he knows… but more importantly, to people he wants to know.

I’ve been pondering how to use this website to best serve the people I know (and the people I want to know!) … and I think Austin Kleon just gave me the answer.

So here goes!

My first “letter” to you… a short list of cool stuff that a pediatric surgeon/almost pastor who loves cooking and art (especially writing) thinks approaches “astonishing” (or at least really interesting) and is therefore worth sharing.

Is it Church or church? I’m about to be ordained in the United Church of Christ. I know that surprises you… it kind of surprises me, too, to be honest. But I have come to understand that this is an unexpected extension of my life’s work as a healer… and that church (the place) is really about community (which includes the messiness of being human) while Church is about possibilities. There is something about it that also feels like an act of resistance against a tide of not-love. I’m still figuring it out.

Frogs in Portland. Speaking of resistance… What a statement that Amazon is struggling to keep up with orders for inflatable frog costumes! Although inflatable animal costumes aren’t listed specifically, this kind of protest (mockery and humor) is one of the three ways to undermine autocracy that Nicolas Kristoff describes in this column. (The other two are 1) point out corruption and excess (like massive ballrooms and gold toilets?), and 2) tell individual stories more than making appeals for the principles of democracy.)

Air fryer Okra. If you hate okra this might make you reconsider. No slime, great taste, in a super healthy popcorn-like snack (1lb of okra makes a good snack size bowl for two and has 150 calories, 7.5gm protein, and 14 gm fiber). Add some cumin, garlic powder, or any other spice(s) if you want.

Also Accidental by Ellen C. Bush This poem made me remember and wonder… How many times did I lose count of stitches I placed (or more likely never counted in the first place)? It always seemed to be the first question from my patient (or their parents) once the drapes were off and the dressing placed… “How many stitches did I need, doc?”. What a beautiful reminder that these moments disappear for the sewer, but not those we treat … thanks to a scar (and sometimes a tiny piece of glass left under the skin).

About Blessings (which we need more of IMHO). “A blessing is a form of spoken poetry about the divine. It’s an incredibly positive form of speech, but it’s not simply “reframing.” (We don’t need to say, Oh, never mind. Tragedy is great! I love it. This is my new mind-set practice!) We might use blessing as a kind of act that scholar Stephen Chapman calls “emplacement.” Calling something blessed can let us say: This goes here, that goes there. This is beautiful. This is awful. And all of it can be called true.” Kate Bowler in The Book of Alchemy: A Creative Practice for an Inspired Life by Suleika Jaouad

Can You Really “Choose Joy”?

Posted on May 14, 2025 by marylbrandt

Begin every action that is for God’s sake joyfully. – St. Isaac the Syrian

I have a mantra bracelet that says “Choose Joy”… which I wear because, at the time I bought it, it seemed like a really good idea. I still think it’s a good idea, but more and more, I’m not really sure what it means…

Merriam Webster defines joy as an emotion, but I have come to understand that true joy is not just an emotional state. Human experience is nearly always a combination of body, mind, and spirit… or, for healers, a reflection of the state of our physical, emotional, and spiritual health.

Joan Halifax teaches that we are responsible to embrace practices that enable compassion to arise. We can choose to act compassionately, but true compassion is not a choice. I wonder if, like compassion, authentic joy (along with awe and love) isn’t the same. What if joy “arises” within us, welling up from some delightful, deep place that is beyond our mind’s ability to choose? And if that is true, what might the practices be that would nurture joy in our lives?

Notice where you are

Mindfulness, particularly when combined with gratitude, is a powerful way to nurture joy. A few years ago, I wrote this in my journal… “As I sit here now, typing on a work computer with a full day of work ahead of me and a “to do” list that is overwhelming…. I am able to see this computer. I am able to listen to the music someone across the room just put on a speaker for all of us. I am able to type. This place is safe. The people I’m working with are helping others. We are about to have lunch together, to literally break bread as a team. And in consciously making this list of things I might have otherwise taken for granted, I feel the gentle seed of joy beginning to grow.”

Joy is not a binary (there or not), it is more like a spectrum from no sense of joy to overwhelming joy that borders on awe. That’s important because mindfulness (and all other practices) will initially feel like they barely move the needle… and that’s ok. No matter where you start (even if the gauge is on empty), grateful mindfulness will lead to a tiny seed of joy. And over time and with practice, that seed will grow, allowing joy to arise more often and with greater ease.

Nurture the things that bring you joy

Nurturing things you know bring you joy begins with simply noticing when you have joy well up within you. One of the best ways to make this a true practice is to use the “delight practice” described by Ross Gay, an embodied practice that reinforces joy.

That may be enough. But joy also grows through more deliberate practices such as prayer/meditation, reading, journaling, playing music, calling or writing to a friend you haven’t seen in a while, walking in nature, checking in with older relatives if it’s been more than a couple of days, learning something new, cooking for your family and/or friends.

There are many teachers of joy who can also help you on this journey. For example Thich Nat Hanh offers instruction for five practices (mindfulness, letting go, inviting positive seeds, concentration, and insight) to nurture happiness. (If you aren’t familiar with his life and teachings, it is a wonderful place to start as you seek more joy in your life.) The Dalai Lama and Desmond Tutu shared their wisdom in The Book of Joy, which is another wonderful resource to think about and nurture joy.

Bring joy to others

Joy is contagious but even more importantly, making other people happy brings joy to you as well. This doesn’t have to be big gestures or gifts. Take, for example, the “hello ministry” a friend recently described to me. Instead of walking by strangers (and even sometimes acquaintances), this practice is simply to smile and say “hello” to every person who crosses your path. How simple is that? (Or how hard, depending on your day.)

Gratitude journals have been shown to bring joy and, yes, just writing down three things you are grateful for (or three things you did to bring someone else joy) is powerful. But the real power of the gratitude journal is not the nightly list – it’s that it changes how you see your day. Because this nightly task exists, you subconsciously frame your day with gratitude and joy, looking for moments and events to record later.

Fake it until you make it (sort of)

You can’t fake real joy, but you can decide to act joyfully. St. Isaac the Syrian, a 7th Century Eastern Orthodox theologian talks about beginning actions joyfully, which is a choice. In essence you can choose to act joyfully even though you feel no joy. What that specifically means for you may be intentionally smiling, or walking with a posture that says you are happy… but whatever you decide will be unique to you, since each of us expresses joy differently. That being said, there are a few things I believe are common to all who seek to act joyfully – enthusiasm, laughter, and kindness.

(A small caveat…this is an idea to experiment with. Acting in a way that feels inauthentic can also lead to injury (emotional and spiritual)… hence the “sort of”.)

The 10 Commandments of Joy

Susan Sparks (a lawyer, pastor, and stand-up comedian) has come up with 10 Commandments of Joy.

I can’t think of a better way to bless your journey than to share them:

1-Thou Shalt Not Worry

2-Thou Shalt Not Let Anger Steal Your Joy

3-Thou Shalt Believe You Deserve Joy

4-Thou Shalt Laugh with God

5-Thou Shalt Pray It and Say It: I’m Grateful!

6-Thou Shalt Laugh with Your Neighbor—Even if Your Neighbor is a Telemarketer

7-Thou Shalt Laugh and Eat Chocolate and Chili Peppers

8-Thou Shalt Be Like the Little Children

9-Thou Shalt Lean on Laughter in Times of Trouble

10 -Thou Shalt Not Waste ANY Opportunities for Joy

Stumbling Into Grace

Posted on December 30, 2023 by marylbrandt

Most surgeons perform around 500 operations a year for the 30 to 40 years they are in practice. If you add the procedures we do during training, surgeons walk into an operating room with the intention to heal ~15,000-20,000 times during their professional lives. In addition, for every patient a surgeon treats with surgery, there are at least 10 to 20 they will have seen who don’t require surgery but do require care. So the lives impacted during a typical surgical career number well over 100,000 and, when you include their families and friends, probably approaches half a million people.

Nadia Bolz-Weber is a theologian and writer who shares her journey and her remarkable teaching in “The Corners” on Substack

Photo credit – and link to “The Corners”

In her post The Sacred Act of Having No Idea What We Are Doing: On Complimenting Strangers and Sharing our Chicken Dinners, she shared this story…

She shakes my hand and says, “we’ve met – but I do not expect you to remember. I’ve waited 7 years to be able to tell you this: You shared your chicken with me that night and you have no idea what it meant.”

Not what I was expecting her to say.

She went on to tell me how that night, she was at a real low point in the middle of a very painful divorce. We were in the green room and she was supposed to introduce me and she was exhausted and hadn’t eaten all day. Apparently I looked up from my huge chicken dinner and was like, “I’m never gonna eat all of this, please help me out here” and it nearly made her cry.

I have literally no memory of this, but even if I did, I could never have known what it meant to her.

Photo credit

We’ve all had a moment when someone, often a stranger, arrives at a moment of need to share their chicken dinner… or say just the words that heal something we may or may not have known was broken. Whether or not we recognize it, these moments create a subtle but profound shift in the way we view the world and ourselves. And, unbeknownst to us, we deliver the same moments of healing and grace to others. These moments can be deliberate, but more often they are not… and are as simple as picking up a small child covered in bandages to give them a hug, complimenting a stranger’s smile, or bringing a cup of coffee to an exhausted colleague and asking them – really asking them – how they are.

I can’t do it as well as Nadia Bolz-Weber, but here’s my blessing for you….

May you find yourself stumbling into sacred moments (even though you don’t know what you are doing, and probably don’t recognize them). And may you be open enough to recognize, accept, and celebrate the grace of chicken dinners, smiles, and cups of coffee that heal your soul.

Do What’s Right

Posted on December 8, 2023 by marylbrandt

I have the extraordinary of gift of sitting with my father, Floyd Brandt, in hospice this week. His (beautiful) heart is failing, but his mind is still sharp, and his spirit is completely at peace. The following is his last lecture as a professor (to his graduate seminar in Business Ethics)

It gives me great joy to share it with you.

Retiring is a little like having your first child. There is nothing particularly unique about the exercise except it is a first time experience that requires no specific skills or expertise and arrives with an unknown outcome .

The initial inclination while preparing comments for a last class is to draw from all the literature and all of one’s experiences to craft some statement filled with lasting words capable of shaping the hearts and minds of students for their remaining years.

Shortly after entertaining such a prospect, it became immediately apparent that teaching has taught me that that while the words may be forthcoming, the impact is not likely to be so resounding. Given that reality, the best course of action is to make a few short comments and say good-bye.

The closing line from Stephen Sondheim’s song “Send in the Clowns” came to mind. “Isn’t it rich, isn’t it queer, losing my timing so late in my career.”

In these last few minutes of the last organized university class that I will teach, I would like to suggest to each of you:

Define what is important to you. Attempt to determine what you are worshiping, because without that understanding, you are adrift and likely to be pushed ever-which-way.

Come to terms with the finite and the infinite dimensions of your being. Until you come to terms with the end of your existence, you will find living in the present to be difficult.

Cultivate the disciplines necessary to contend with the vagaries of the world around you. Perhaps the most important are the disciplines of the mind and of the spirit. The first step is often that of finding a quiet place to meditate and contemplate.

Learn the significance of uncertainty, choosing, and evaluating and then celebrate them. The definition of who you are is largely a product of the questions you ask and the choices you make. It is difficult to learn that the choices made today are the offspring of choices made yesterday.

Experience the joy of thanksgiving. Recognize that joy and hope are rooted in faith in the belief that what you have and what you are is a gift. As much as possible expunge the demons of comparison and competition and accept that sweeping out the harpies circling round the “enthroned self” never ends.

But then how does one end a last class in ethics except to recall that ethics is obedience to the unenforceable; a product of what you ask of yourself and not what others ask of you.

And finally, do whatever is right.

MD, MDiv

Posted on December 26, 2021 by marylbrandt

I published my first article addressing physician wellness in 2009. Physician wellbeing wasn’t ever part of my academic plan, but over time it became part of my mission. As a Program Director, Dean of Student Affairs, and mentor I watched, and wasn’t always able to help, trainees and colleagues as they struggled. This struggle, which we have (I believe inappropriately) called “burnout” led to weariness, sadness, and distress for almost everyone in my sphere of influence, no matter where they were in their professional journey.

For some it was career limiting.

For some it was life limiting

For some it was fatal.

As physician suicide and burnout in medicine became a reality that couldn’t be ignored, I became part of the movement of healers who began to work with policy makers and hospital administrators to try to make a difference. We worked on ways to convince those in power that this was not just about doing the right thing, but that it helped institutions with their metrics of success since it was clear that physicians in distress affected the bottom line. Despite these efforts, there was rarely any substantial change. In fact, most of us agreed that both objectively and subjectively things were getting worse. I began to realize we weren’t speaking the same language. They were measuring attendance at mandatory wellness training sessions and celebrating “success” because >90% of docs attended. But they weren’t measuring the right thing. They weren’t paying attention to metrics of healer distress, how many of their physicians were quitting their career in medicine, the number of divorces, the rate of substance abuse, or, most tragically, the increasing number of healers who were dying by suicide.

Let me pause here for a minute to state something obvious. I know that policy makers and hospital administrators don’t go to work to make life difficult for the healers in their systems. In fact, I suspect that they are experiencing much of the same distress that we are experiencing because, at its core, the issue here is what we value and how we talk about those values.

I began to wonder if we needed an entirely new approach. So I went back to graduate school. Most of my friends thought it was crazy that at this stage of a classic academic career, I would go back to school, but I did. I enrolled in the Master of Divinity program at Iliff School of Theology to learn new ways to think about values… and different ways to heal.

I will continue to talk about how to eat well at work because our physical well-being is important. I will also keep writing here (and elsewhere) about staying connected with and for others, because our mental health is also important. But in the weeks and months to come I hope to write more about values and how we might work together, healers and administrators, to heal our patients – and each other.

Shapiro DE, Duquette C, Abbott LM, Babineau T, Pearl A, Haidet P. Beyond Burnout: A Physician Wellness Hierarchy Designed to Prioritize Interventions at the Systems Level. Am J Med. 2019 May;132(5):556-563. PMID: 30553832.

A Blessing for Healers Working at Christmas

Posted on December 24, 2020 by marylbrandt

Lessons from the Pandemic: Richard Rohr, Walking, and Lawn Chairs

Posted on August 16, 2020 by marylbrandt

It’s almost impossible during times of stress to be motivated to do hard things. For all but the most hardcore exercisers, ice cream just seems more soothing than running when you are emotionally exhausted (Right?). I’m no different. But, as much as I would like to think “later” will be ok to regain what I have lost in these months of being more sedentary than usual, I have begun to realize that I needed to get moving again.

Enter Richard Rohr

I’ve been a fan of Richard Rohr for years. He’s a gifted writer with the laugh and smiling eyes of someone who has tapped into something I want to know more about. I subscribe to his weekly email, which this week introduced Jonathan Stall’s practice of moving “as a way to invite brave creativity.”

There is a lot to unpack in that idea.

What exactly would “brave creativity” look like? I’m not sure, but it sounded like something I, and I suspect all of us, need more of right now.

“We invite you, as able, to take some time this weekend to move mindfully through your local area.”

I set off on a different kind of walk.

I grabbed my mask and headed out for a walk in my neighborhood, trying to think about this not just as exercise, but as something more. I read Jonathan Stall’s advice again:

Bring something to jot ideas down while you are out, but more importantly, invite your “goals/pains/dreams” to join you on this walk.
Walk for at least 30-40 minutes
Wear a mask if you get within 6-10 feet of anyone (respect for your neighbor)
Start the walk with a sense of being open. “As you begin to move, seek the realms of wonder, of space, and of reaching high into what’s possible…”

Where did all these lawn chairs come from?

I’ve walked many times before in my neighborhood, and I’m an observant person. But today, as I walked, I began to notice all the chairs on people’s lawns and all the swings, and “tires” hanging from trees.

Were they always here and I didn’t notice them?

Are more people sitting outside now than before – even though it’s outrageously hot here in August?

Is this because of how much we all need (safe) connection to each other during the time of pandemic?

Are there actually more chairs, swings and tires because of how much we all need to hear birds, see trees and listen to the cicadas in the summer evening right now?

Next steps?

Yes, there will be next steps. This experiment led me to more questions than answers, but I had a real a sense of being taught, too.

Try it?

Let me know what you see.

#CareForTheHealers – “Guard Your Spirit”

Posted on March 25, 2020 by marylbrandt

Taking care of patients in this time is beyond stressful. I’m keeping my eye out for anything that might help support healers of all kinds. This was sent to me today and I found it profoundly helpful. Take 5 minutes to listen to this amazing professor, pastor and friend.

This video was made for the students of Illiff School of Theology by Dr. Cathie Kelsey. Although the specific examples she uses are from the Christian faith, the practice she teaches in this video can use text from any religious tradition, or no religion at all – perhaps a poem, a quote, or an inspiring song?