Archive for November, 2013

For more than 40 years now I have had the privilege and honor of serving a number of professionals — physicians, educators, attorneys, engineers, ministers.  Recently I had the opportunity to once again serve twenty-two physicians who are participants in the Physician Leadership College.  As you might remember, gentle reader, my father was ‘an old-time country doctor’ and so was his father; they did it all — and, I might add, did it quite well.  I would classify them as being ‘attending physicians.’  For them, being attending physicians went far beyond a ‘job description.’  Jacob Needleman in his wonderful book, ‘The Way of the Physician,’ writes that the role of the physician “was the last as well as the first great and honorable passion of man, the fusion of the search for understanding and the impulse to help and serve suffering humanity. . .”

I have known a number of ‘attending physicians’ and all of them remembered being moved by an ideal of who and what a physician is called to be.  I also recall a number of them saying that they did not find any powerful models among their medical school teachers.  When they did stumble upon one — a man (usually a man) of wisdom — the said person was unable to convey how they’d come by it.  Many were competent, many were clever, some demonstrated great kindness and caring — but wisdom?  Not many were seen to be wise.

Many of the other professionals that I have had the privilege of serving related similar experiences; they arrived with similar aspirations and experienced similar disappointment.  They were searching and seeking for ‘something’ and that ‘something’ seemed illusive, if not unattainable.  They all demonstrated a search to be of service in the world AND also sought to remain open to something beyond — many of them captured this ‘something’ in their concepts of ‘attention’ and ‘attending.’  It seems as if the systems that are charged with educating our professionals are failing to develop ‘this something’ in the fledgling professionals that leave their care.  With its emphasis on memorization and reguritative examinations, current professional training (I call it ‘training’ not ‘development’) almost totally neglects the development of the student’s inner life — especially the questions “Who am I?”  “Who am I choosing to become?” “Where am I going?”  “Why am I choosing to go there?” and “What am I called to?”  I am no researcher but it does seem to me that competition for admission to professional schools is now so intense that he who pauses to reflect on such questions risks being left behind, if not left out.

Physicians tell me that rather than enhancing a medical student’s human qualities that their professional training tends to de-humanize them.  Now there is a trap here.  Some believe that ‘humanism’ provides the answer.  David Ehrenfeld, in his challenging book, “The Arrogance of Humanism” writes the following (he is addressing the humanists’ ‘War on Cancer’ [one can remove ‘Cancer’ and replace it with any number of ‘enemies’].  Ehrenfeld writes: “The society clever enough to perform sophisticated research on cancer is the society clever enough to invent sugar substitutes, children’s sleepwear ingredients, food coloring agents, and swimming pool test kits that may cause it.”  This leads me to wonder about the deep assumptions upon which the work of professionals who claim to be humanists rests.

Humanists seem to be fond of attacking ‘religion’ for its untestable assumptions, but humanism contains untestable assumptions of its own.  These are the deep assumptions and are rarely debated.  If the following occurred in others, humanists would call them superstitions – or perhaps elevate them to ‘articles of faith.’  Consider the following humanist assumptions:

All problems are soluble by people.
Many problems are soluble by technology.
Many problems that are not soluble by technology are soluble by politics, economics, etc.
When the crisis appears, we will work together and arrive at a solution before it is too late.
[to be continued. . .]


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The following passages from Epictetus’ ‘Discourses’ stimulated my thinking so I offer them to you, gentle reader.  Perhaps your thinking will also be stimulated, or challenged, or stretched.  Epictetus writes:

If a man objects to truths that are all too evident, it is no easy task finding arguments that will change his mind.  . . .When someone caught in an argument hardens to stone, there is just no more reasoning with them.

Now, a person can suffer two kinds of petrifaction, that of the intellect, and that of the sense of honor, when somebody assumes a defiant stance, resolved neither to assent to self-evident truths nor leave off fighting.  Most of us dread the deadening of the body and will do anything to avoid it.  About the deadening of the soul, however, we don’t care one iota.  Even in the case of the soul, we regard a man as pitiable if he is deficient in thinking or learning.  We pity the mentally retarded, and students with learning difficulties.  But if somebody’s sense of shame and respect are dead, we will actually call this determination.

‘Do you realize that you are awake?’

‘No, any more than when I dream and have the impression that I am awake.’

‘And is the one impression in no way different from the other?’


Can I go on reasoning with such a person?  What fire or iron can be applied to him, to make him conscious of his condition?  He senses it, but pretends he doesn’t; that makes him even worse off than a corpse.

One person does not notice a contradiction in his reasoning; he is unfortunate.  Another person notices it, all right, but does not budge and does not back down; he is even more unfortunate.  His sense of honor and truthfulness has been excised, and his reason – not excised but brutalized.  Am I to call this strength of character?  I can’t — any more than I can apply the same name to the ‘strength’ of degenerates that enables them to say and do in public whatever they please.

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I have been re-reading Martin Luther King, Jr.’s 1963 ‘Letter from Birmingham Jail.’  Following are some of the questions that have emerged into my consciousness as I re-read and reflected upon this powerful epistle.

Men of ‘genuine good will’ labeled King as an ‘outsider.’

QUESTIONS: When have I been labeled an ‘outsider?’  When have I felt as if I were an ‘outsider?’  When have I labeled another as an ‘outsider?’  What prompted my assigning this label to the other?  When have I treated another as an ‘outsider?’  What forms did this treatment take?  When I was labeled an ‘outsider’ what was the effect upon me?  How did I respond or react?  What was the effect on the other when I labeled him or her as an ‘outsider?’  How did the other respond or react to my labeling them an ‘outsider?’  When have I denied labeling another as an ‘outsider?’  What motivated me to label another as an ‘outsider?’  What is an ‘outsider’ anyway?

King addressed the question, ‘Why am I here?’  He wrote that ‘I. . .am here because I was invited here.  I am here because I have organizational ties here.  But more basically, I am in Birmingham because injustice is here.’

QUESTIONS:  Why am I here?  Why am I choosing to be here?  Was I compelled to be here?  Must I be here?  Do I have a choice to be here or not — how do I know that I have choice or that I have no choice in being here?  Is ‘here’ stationary or am I on my way from ‘here’ to ‘there’?  If so, why am I choosing to go there?  Am I compelled to go ‘there’ from here?

King writes: ‘. . .I am compelled to carry the gospel. . .’

QUESTIONS: What am I compelled to carry?  What are the things that I carry?  What have I chosen to carry?  Why have I chosen to carry those. . .?  What do ‘we’ carry together?  How did we come to carry these together?  Was I coerced into carrying what I carry?  Was I manipulated?  Was I persuaded?  Was I influenced?  Does it matter?  If it does matter, how so?

King writes: ‘I am sure that none of you would want to rest content with the superficial. . .that deals merely with effects and does not grapple with underlying causes.’

QUESTIONS:  When am I willing ‘to rest content with the superficial’?  When am I willing to ‘grapple with underlying causes’?  When and how do I support others who are willing ‘to rest content with the superficial’?  When and how do I help others ‘grapple with underlying causes’?  Why do I choose to resist grappling with ‘underlying causes’?  What motivates me ‘to rest content with the superficial’?  What motivates me to ‘grapple with underlying causes’?

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9-11 & EVIL. . .

Within a month of 9-11 I was invited to spend two days with 240 New York Methodist ministers.  I was invited to help them explore the topic of ‘Evil and Healing.’  As I was preparing for my time with them I realized that 9-11 was indeed an historical turning point that would shift, if not change, our conversations about evil.  Given all of the acts of evil perpetrated since we began to record them, it doesn’t make sense to me to call 9-11 the most horrible evil ever perpetrated.  It was, however, one of the most spectacular.  Al Qaeda’s instinct for creating symbol ensured that a global perception that our ability to protect ourselves was shattered.  One day we seemed invincible, the day after we knew we are vulnerable.  Historically we named places — Lisbon and Auschwitz — that symbolized deep shock, horror and evil (the first being a ‘natural evil’ and the second being a ‘man-made evil’); the new century began by naming a date.

When certain events happen, a mixture of knee-jerk reaction and deep reflection can lead us to question our sense of ourselves, our sense of evil, our vulnerability, and our need for healing versus our need ‘to get even’ or our need ‘to do something about this.’  How do we achieve clarity?  I don’t believe politics can help us here.  Perhaps philosophy can.  Philosophy can offer us a moral orientation that might enable us to sort out our reactions to events like 9-11.

For example, although 9-11 shifted, changed and even transformed a variety of political realities, it shaped no new moral reality.  Perhaps most disturbing was the way 9-11 combined modern technological structures with traditional moral ones.  On the one hand there was massive and well-coordinated destruction, and massive and well-coordinated perception of it –on a scale that earlier ages could not begin to image.  On the other hand there was the sheer and deliberate wish to cause as much death and fear as possible — an image of evil that all ages could relate to and understand (is this the word?).

Personally, I had come to view evil as not having to be rooted in the demonic.  After Auschwitz, for example, I learned that the greatest crimes can be committed by people less likely to arouse terror and awe than contempt and disgust.  Thoughtlessness can be more dangerous than malice.  I am more often threatened by self-serving refusal to see the consequences of conventional actions than by definite desires for destruction.  For whatever reasons, it seems that most of us refrain from acting out our desires for destruction (and for this I am deeply thankful).

What happened on 9-11 was not the product of mindless agents whose self-serving and self-pitying actions led to evils they never quite intended.  On the contrary, the Al Qaeda terrorists knew exactly what they did.  Their clear intentions, and thoughtfulness in realizing them, were evident with each turn they took.  Their goals were clear and calculated and they were perfectly malicious.  They were in a sense perfectly evil.

There is a trap — and we might well have sprung it given our response to 9-11.  The trap is for us to focus on one form of evil so single-mindedly as to suggest that no other kind matters.  And the form that evil took on 9-11 is the easiest to pick out: easier to recognize than less visible forms of violence, easier to confront (we believed) than the slower and more subtle forms of destruction which we are avoiding or denying.  For us, the impossible became true — and, history tell us (perhaps even teaches us if we are open to learning) that what is true often becomes routine.

Kant thought we could understand much about humanity by focusing not on the French Revolution, but on international reaction to it.  If he is correct then what is decisive is our collective reaction to 9-11 rather than the event itself.   This is ‘true’ whether it be a reaction to a death-camp in Poland, a lynching in the South or a terrorist attack in New York.  We need to be clear because as the poet William Stafford remind us, ‘the darkness around us is deep.’  But clarity should not be confused with simplicity, moral clarity least of all.  Too often we seem to settle for moral simplicity — one French philosopher compared Auschwitz to an earthquake and a politician called terrorism a virus and another called for a ‘war on terrorism.’  When I read these statements I do wonder how clear our understanding of evil really is.

One response to evil done is to immerse ourselves in a healing process.  Evil divides, healing helps make whole.  Acts that we deem to be evil will continue — whether ‘natural’ or ‘man-made’ and so healing will also need to continue to be embraced as one response.  Without healing our wounds will fester and these will either continue to cause us to be dis-eased or they will motivate us to ‘get even’ or worse to return evil for evil.

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Gentle reader, I invite you to see my 19 November, 2013 post for the context for this entry and to peruse the first two biological lessons of history.  Today, I continue.

The third biological lesson of history is that life must be generative.  Nature is not fond of organisms, variations or groups that do not regenerate in abundance.  It seems that our mother, Nature, seeks quantity as a prerequisite to selecting quality; she likes large litters; she seems to relish the struggle of the surviving few.  She probably loves watching the upstream struggle that will result in the birth of the few or in the case of we humans, the birth — usually — of the one.

Our mother, Nature, appears to be more interested in the species than in the individual and she makes little difference between civilization and barbarism (it seems that ‘civilization’ has done more to harm her than barbarism ever came close to doing).  Nor does she seem to care that a high birth rate usually occurs within a ‘low’ civilization and that a low birth rate usually occurs within a ‘high’ civilization (here meaning Nature as the process of birth, variation, competition, selection and survival).

If by chance we humans become too numerous for the food supply, our mother, Nature, has three agents to help her restore a balance: famine, pestilence and war [two are directly related to Nature and one is directly related to we humans].  Thomas Malthus wrote an essay in 1798, ‘Essay on Population.’  He explained that without these periodic checks the birth rate of humans would so far exceed the death rate that the number of mouths to be fed would nullify any increase in our ability to produce food [he might have been wrong about this one; the one thing he did not address and perhaps the one thing that might lead to our demise was ‘fresh drinking water’ — the lack of it, actually].  Malthus was a clergyman and was said to be a person of good will AND he pointed out that providing relief funds or supplies to the poor encouraged them to marry early and have large families thus making the problem more severe.  His conclusion was that famine, pestilence and war would continue to be Nature’s winnowing tools.

Although it appears as if Malthus was wrong — we are producing more food and we could produce enough food to feed everyone on our planet — he might also have been correct for there is a limit to the fertility of the soil.  As medicine, sanitation and charity continue to thrive more and more of us will live into adulthood and more and more of us will reproduce and the risks of over-population will continue to be globally present.  Two things seem to mitigate population growth, however: birth-control, education (the more highly educated the fewer children, seems to continue to be a norm) and ‘wealth’ (the wealthier tend to have fewer children).

Nature is committed to regeneration; life will continue to be generative.  For us humans the challenge entails ‘to what extent will we choose health for all’ and thus to what extent will we choose to be good stewards of our planet?  Any choice for ill-health (dis-ease) might well result in the demise of all — perhaps not today, perhaps not in our life-time, but given the systemic nature of Nature our continual choices for ill-health will result in our demise.

Nature’s three agents, famine, pestilence and war will not save us from ourselves.  Perhaps this is the fourth lesson of Biology and History, a lesson we have yet to fully embrace: We humans, not Nature, will be the cause of our demise and Nature will become the agent we employ in our own demise.  Considering this, I now pause. . .

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Consider that history is a fragment of biology — the laws of biology are some of the fundamental lessons of history.  For example, we humans are subject to the processes and trials of evolution.  We are dependent upon a variety of groups if we are going to survive the trials and the strife that come with being human AND the groups themselves are always in peril — if they don’t survive neither will I, neither will you, neither will we.

Given this, gentle reader, consider that one of the first biological lessons of history is that life is competition-based.  Now, for example, competition is likely to be rooted in cooperation when food is bountiful but when food becomes scarce violence might well replace cooperation.  We humans will within the next two or three generations face a shortage of fresh water and my anxiety rises when I image what will then happen to us humans.  Because our nature is relational we do respond to a natural disaster by reaching out to those affected; the loss of fresh water however will not occur as a result of a ‘natural disaster’ but because we humans are not good stewards of what we have been entrusted with.

We humans are living paradoxes.  We are caring and supportive AND we are acquisitive, greedy, and war-like because deep within our psyche we remember that we had to chase and kill in order to survive (our forefathers and foremothers would stuff themselves when there was food to be had for they did not know when they would have food again).  Consider, gentle reader, that war is a nation’s way of eating.  Ironically, war promotes co-operation because it is the ultimate form of competition (we fight together to obtain more land, more food, more slaves, more status, more power, more ‘wealth’ and to bring the conquered into the ‘fold’ — they will embrace our political system for example [or will they]; we also defend ourselves against those who want to ‘conquer us’).

A second biological lesson of history is that life is selection.  In the competition for food or mates or power some organisms succeed and some fail.  In the struggle for existence some are better equipped than others to meet the challenges of survival.  It is helpful for me to remember that Nature [here meaning the total reality and its processes] has not read the American Declaration of Independence or the French Revolution’s ‘Declaration of the Rights of Man’ and therefore, we are all born ‘unfree’ and ‘unequal.’  We are subject to our physical and psychological heredity and to the customs and traditions of our group.  We are diversely endowed in health and strength and in mental capacity and qualities of character (gifts, talents, abilities that are ‘natural’ to each of us and that might serve us well or that might actually hinder our progress within our specific culture).  Nature loves difference.  ‘Difference’ is the necessary material for evolution (even identical twins differ in hundreds of ways).

Inequality is ‘natural’ and ‘inborn’ AND it grows with the complexity of civilization.  Here are a few to consider: Hereditary inequalities breed social inequalities; an invention or discovery tends to make the strong stronger and the weak relatively weaker; economic development specializes functions, differentiates abilities, and makes individuals unequally valuable to their group.

Nature laughs when humans speak of the union between freedom and equality.  Why?  Consider that freedom and equality are sworn enemies and when one prevails the other perishes.  What!?  Leave humans free and their natural inequalities will multiply — probably geometrically — as in England and the United States in the 1800s under laissez-faire.  To check the growth of inequality, liberty will be sacrificed (see Russia, 1917).  Alas, even when repressed, inequality grows (see Russia after 1917).  As one philosopher noted thousands of years ago, only the man who is below average in economic ability desires equality while those who are conscious of superior ability desire freedom (freedom from…freedom to…).  It seems that in the end superior ability will have its way.  It does appear as if equality of legal justice and educational opportunity helps mitigate some of this inequality and those who have the ‘power’ seem to know this (which is why in our country there continues to be a movement to weaken our public educational systems — how about this for a conspiracy theory).

On the positive side, a society in which all potential abilities are nurtured and developed and then function will have a survival advantage when it comes to the competition between and among groups.  As we are learning (are we truly learning what I will now note?), competition becomes more severe and perhaps more violent, as distance between societies and cultures diminishes (via technology, education, and economics).  Resources are, indeed, becoming more scarce (fresh water, clean air, food, forests, etc.) and history teaches us that when this happens co-operation among all decreases and competition increases.  Sadly, we humans, are causing most of this to occur; Nature is powerless to stop us . . . well, Nature could literally stop us and she might well do so as a result of our being poor stewards of our earth. [to be continued]

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Gentle reader, you might explore some of my previous postings where I quote from Epictetus’ “Discourses.’  Today I will share with you a ‘smell’ of what he wrote when it came to ‘Progress.’  Epictetus writes:

Whoever is making progress, after learning from philosophers that desire is directed toward good things and avoidance directed toward bad, and having also learned that impassivity and a good flow of life are not attained except through unerring desire and unfailing avoidance — that person will do away with desire altogether, or else defer it to another time, and exercise avoidance only on things within the moral sphere.

. . .What is the goal of virtue, after all, except in a life that flows smoothly?  So who is making progress — the person who has read many of Chrysippus’ books?  Is virtue no more than this — to become literate in Chrysippus? 

. . .Don’t you want to show him the purpose of virtue, so that he will know what real progress consists in?  Look for it in your volition, friend — that is, in your desire and avoidance.  Make it your goal never to fail in your desires or experience things you would rather avoid; try never to err in impulse and repulsion; aim to be perfect also in the practice of attention and withholding judgment. 

. . .If you aim to be perfect when you are still anxious and apprehensive, how have you made progress?  So let’s see some evidence of it.  But no, it’s as if I were to say to an athlete, ‘Show me your shoulders,’ and he responded with, ‘Have a look at my weights.’  ‘Get out of here with you and your gigantic weights!’ I’d say, ‘What I want to see isn’t the weights but how you’ve profited from using them.’ 

‘Take the treatise “On Impulse” and see how well I’ve read it.’  Idiot.  It’s not “that” I’m after, I want to know how you put impulse and repulsion into practice, and desire and avoidance as well  I want to know how you apply and prepare yourself, and how you practice “attention,” so that I can decide whether with you these functions operate in harmony with nature.  If you “are,” in fact, acting in accord with nature, then show me, and I will be the first to say that you are making progress.  But otherwise, be off, and rather than just comment on books, you might as well as write one yourself. 

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