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Archive for September, 2016

I continue to be convinced that one of the greatest gifts we can give to the ‘other’ and to one’s self is the gift of ‘Listening.’  Listening becomes a gift when we strive to listen with quiet, inviting attention; when we listen with all of our being – that is, when we are fully present, ‘in the now’ not ‘in the know.’ When we strive to listen in order to understand, in order to empathize with the other, in order to call forth the voice of the other, in order to affirm the other, and in order to honor the other as a fully human being.  When I listen this way the other grows and so do I; the other is affirmed and so am I.

As you well know, gentle reader, it is easy for me or for you to write these words down – the process sounds doable.  However, you and I know how challenging it truly is for us to listen in this way.

Listening in this way is a creative act, a life-giving and life-affirming force.  Ideas come to life – what lies dormant is nurtured into life; growth occurs.  I grow as the one listening and the other grows as the one listened to.  Listening in this way helps each of us to remember who we truly are – fully human beings deserving to be ‘seen,’ ‘heard,’ ‘accepted, and ‘honored.’

Gentle reader, you and I also know that to listen in this way requires us to commit to listening in this way ‘over time.’  It takes commitment and practice; listening in this way does not happen simply because we are well-intentioned good people.

Have you ever experienced a person who has to talk and talk and talk and talk; the person goes on and on and on and on.  The talk is often ‘superficial’ – we might describe it as ‘blah-blah talk.’  My experience is that this person has rarely, if ever, truly been listened to.  In a true sense the person is ‘testing our patience.’  Are we willing to listen long enough, in the way I described, in order to help the speaker ‘trust’ us?  My experience is that if listened to, over time, in the way I described that this person will indeed find his or her ‘voice’ and begin to trust me with their ‘truth.’  Gradually, over time, the person will trust me with him or herself; the person will choose to risk being transparent and vulnerable.

Listening is this way takes time, skill, patience and a commitment to ‘slowing down.’  Because we are a culture with a ‘hurry sickness’ listening in this way is a challenge for us.  Because of our dis-ease, our ‘hurry sickness,’ we find it difficult (an understatement for many of us) to be patient, to meet the other where he or she is, to suspend our judgments, to listen with undefended receptivity, and to be fully present (for example, how often, as we are listening, do we ruminate about the past or anticipate the future rather than being fully ‘in the now’).

Karl Menniger captures this ‘gift of listening’ quite well: “Listening is a magnetic and strange thing, a creative force. The people who listen to us are the ones we move toward. When we are listened to, it creates us, makes us unfold and expand.”

 

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TRUTH AND UNTRUTH. . .

‘You can’t handle the truth!’ – Colonel Jessep

 ‘Truth’ = a verified or indisputable fact, proposition, principle; the actual state of a matter

One of the things that our current election-year has confirmed is that we are rooted in ‘untruth.’  It seems that we, the electorate for example, daily submit to ‘plausible’ and ‘useful’ lies which then involve us in more and more obvious contradictions.  In order to hide these contradictions from ourselves we need even more plausible lies.  Ironically, the basic falsehood is the lie that as a group, religion, political party, or nation we are totally dedicated to truth.

Moreover, as a group, religion, political party or nation, we can remain dedicated to truth in a manner that is at the same time honest and exclusive: that we have a monopoly of all truth, just as our adversary of the moment has the monopoly of all error (think: political opponent or political party or religion, or pick a certain nation).

We use a great deal of energy to convince ourselves that we cannot preserve our purity of truth if we enter into dialogue (dialogue: a searching conversation) with the ‘other’ (think: ‘enemy’); we know that if we do, the ‘other’ will corrupt us with their/his/her untruth.

More significantly, we believe that ‘truth’ (think: ‘Our Truth!’) cannot be preserved except by the destruction of the ‘other’.  Why?  We have identified the ‘other’ with ‘untruth’ – as ‘living breathing untruth’ – and therefore, to destroy the ‘other’ is to destroy ‘untruth.’

Paradoxically, the ‘other,’ of course, has exactly the same thoughts about us and exactly the same basic policies by which the ‘other’ defends ‘The Truth.’  Like us, the ‘other’ has identified us with dishonesty, insincerity and untruth.  The ‘other’ believes that, if we are destroyed, nothing will be left but ‘Truth.’

Consider if you will, gentle reader, that if we truly sought ‘truth’ then we would begin slowly and laboriously to divest ourselves one by one of all our roots of fiction and delusion: or at least we would strive to do so, for mere willing will not enable us to effect it.

Paradoxically, the one who can best point out our ‘untruth’, and help us to see it, is the ‘other’ whom we wish to destroy.  As I reflect upon this statement I realize that perhaps it is because of this that we actually wish to destroy the ‘other.’  So, too, we can help the ‘other’ see their ‘untruth’ – and that is why the ‘other’ wants to destroy us.

In the end, no one can show another the ‘untruth’ that is within unless the other is convinced that his critic first sees the other as a fully human being and seeks to love the good that resides within the other.  So while we are willing to inform the ‘other’ that ‘You are wrong!’ we will never be able to do so effectively until we can ourselves identify and appreciate where the ‘other’ is right.  Nor can we be open to hearing the criticism of ‘the other’ until we accept that we are not ‘all truth and light’ – at our best we are, like all human beings, living paradoxes of light and darkness, good and evil, virtue and vice.

‘Love’ rooted in ‘Empathy’ is the key to opening the locked door to recognizing and embracing the ‘other’ and the ‘truth’ the other holds.  As long as we do not act out of love rooted in empathy, we will not have access to the ‘other’ as living paradox and to the ‘other’s’ truth.  For thousands of years all faith and humanistic traditions have emerged a form of the same ‘Golden Rule.’  So here is the question: Are we willing to ‘love the other’ as we want to be loved? 

 

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Give me Liberty, or give me Death — Many years ago, Patrick Henry uttered these famous words, words which resound today in the hearts of many folks around the world.  ‘Liberty’ entails both ‘Freedom From’ and ‘Freedom To.’

For us, our American history is rooted in our effort to gain ‘freedom from’ the political, economic, and spiritual manacles that have bound us.  The battles for freedom were fought by the oppressed – by those who sought new liberties.  The battles were fought against those who had privileges to defend.

While a particular class was fighting for its own liberation from domination, it truly believed itself to be fighting for human freedom itself and thus they were able to appeal to an ideal; an ideal captured so powerfully by Patrick Henry.

Lest we forget, the classes that were fighting against oppression too often ended up siding with the enemies of freedom when victory was won and the victorious now had their own privileges to defend.  This scene is once again being played out in our country by the privileged who are fear-full of the immigrant, the ‘stranger,’ the ‘Muslim,’ the vote-seeker, and the ‘refugee.’  It is being played out by those ‘good Americans’ and ‘good Christians’ who are railing against those who are peace-fully demonstrating by ‘taking a knee’ for the ‘freedoms’ they believe have been adulterated.  It is being played out in the States that continue to not only refuse to extend ‘civil rights’ to all but go a step further in their defense of their ‘freedom’ by passing laws that prohibit some from enjoying the freedom that Patrick Henry was willing to die for.

Many have died in the battles for freedom – to die in the struggle against oppression was better than to live without freedom.  Such a death was the ultimate assertion of their freedom; they lived what Patrick Henry believed.

With our ‘Freedom’ in America, history seemed to prove that it was indeed possible for we humans to govern ourselves, to make decisions for ourselves, to think and freely choose as we saw fit.  In America our principles of economic liberalism, of political democracy, of religious liberty, and of ‘the individual before community,’ gave expression to the longing for freedom.

With the advent of this type of ‘Freedom’ in the world, we humans overthrew the domination of nature (or so we still tend to think until Mother Nature reminds us of who is really in charge); we humans overthrew the domination of the Church (although some in America desire that democracy be replaced with a theocracy – as an aside, I find it ironic that the folks in America who want us to become a theocracy are threatened by other countries who are, for the most part, theocracies).  We humans have also overthrown the domination of the absolutist state (although, again, there are those in America who are seeking to install an absolutist state).

These ‘abolitions’ of external domination seemed to not only be necessary but they were a sufficient condition required in order to attain the ultimate goal: Freedom.

Sadly, today in America, ‘Democracy’ – and hence ‘Freedom’ – is being threatened.  Many years ago John Dewey put this threat into words when he wrote: The serious threat to our democracy is not the existence of foreign totalitarian states.  It is the existence within our own personal attitudes and within our own institutions of conditions which have given a victory to external authority, discipline, uniformity and dependence upon ‘The Leader.’  The battlefield is here – within ourselves. 

Liberty…Freedom…Equality…for ALL or, eventually, for none.  Germany taught us a hard lesson.  Have we learned our lesson?

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A consequence to medical advances has required doctors to become specialists if they wish to remain informed in any particular ‘field of medicine.’  This specialization has resulted in a change in the image of the practitioner.  Involved as the doctor must be in the minutiae of his or her practice, the doctor is prone to dim down the sick to uniformity, to become oblivious to the personal aspect of human being.

One blunder in much of primitive medicine was in the tendency to personalize disease; the error in much of contemporary medicine is the tendency to depersonalize the patient, to treat the disease and ignore the person.  So, I hold a question: Is it true that specialization and compassion are mutually exclusive?  The failure of ‘both-and’ is due, it seems to me, to a loss of awareness as to what it means to be a person, of what it means to be human and to the distortion of the concept and image of being a doctor.

What many of us fear is an increased alienation between the healer and the sick.  Some describe this alienation as the doctor-being-executive and the patient-being-consumer/customer.  In treating the patient the doctor is morally involved.  What transpires between doctor and patient is more than a commercial transaction.

Medicine is not simply merchandise, and the relationship between doctor and patient is blasphemously distorted when conceived primarily in terms of economics: the doctor a merchant and the patient a customer.  The bottom line is billable hours rather than or more than healing and health.

Lest we forget, what comes to pass in the doctor’s office is a profoundly human association, involving concern, trust, response-ability and responsibility.  The doctor enters into a covenant with the patient.  The doctor penetrates the patient’s life.  The patient is literally a sufferer; the doctor is the incarnation of hope.  The patient is a human being entrusted to the care of a doctor.

The doctor is a trustee and holds the patient and the patient’s health in trust.  In other relationships trust may be replaceable by shrewdness, in the doctor-patient relationship trust is the essence.  Yet, the doctor is not alone in holding this ‘trust.’  The patient must also hold ‘trust’ – trust in one’s self and trust in the doctor.  The patient is a partner, not a bystander.

To heal, to save a human life, is to do the work of God.  To heal is to do the holy.  There is nothing greater.  The essence of God is reflected in the majesty of medicine.  A patient is a person in crisis and anxiety, and few experiences have such a decisive impact upon our ability to understand the meaning of being human as the way in which the doctor relates him or herself to us at such times.

The doctor is not only a healer of dis-ease and disease; the doctor is also a source of emanation of the spirit of concern and compassion.  As I bring to a close our brief exploration of The Doctor as Person, I leave us with a quotation from William Osler, one of the co-founders of John Hopkins Hospital:  The good physician treats the disease; the great physician treats the patient who has the disease.  I am proud to say that my father and grandfather were great physicians.

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What manner of person is the doctor?  Thanks to my father and grandfather, I knew many different physicians as I was growing up.  Since 1973, when I began to formally serve physicians, I have had the privilege of meeting many more.  Many of these physicians are persons who have consciously chosen to go to the areas of dis-ease, disease and distress; they chose to show up, be present and pay attention to sickness and affliction, to injury and anguish, to fear and anxiety.  Most importantly, they chose to engage people, not symptoms or ailments alone.

For these physicians, medicine was/is more than a profession.  For them, medicine has a soul.  For them, medicine is not a career but a calling.  As a calling, medicine does involve the application of knowledge and the exercise of skill AND it also involves engaging the ‘patient as person.’  Historically, medicine is not an occupation for those to whom career is more precious than humanity.  Traditionally, physicians do not value comfort and serenity and economics above service to other persons.  The physician’s mission is, indeed, prophetic – the physician strives to call forth the best in those he or she serves.  As a prophet the physician reminds – sometimes strongly reminds – those served what they, ‘the patient,’ have been entrusted with: Their very being.  In serving, the physician and the one served become partners; they need each other; they depend upon one another for they are truly ‘partners.’

The weight of a physician’s burden is heavy and often grave.  In other professions mistakes, inattention and blunders may be forgivable even remediable; for the physician, however, one mistake and the person served might be severely harmed.  Ironically, with the advent of more and more sophisticated medical technology the ‘errors’ do not seem to be minimized and yet technology continues to put the physician-patient relationship is at risk.

Even as medical science is progressing, the physician-patient relationship continues to be transformed and, as a result, this relationship is deteriorating.  Five years ago I enjoyed a personal relationship with my physician – I had access to him via a simple phone call.  If I felt I needed to see him he would ‘find a way of working me in.’ Today, I have another doctor and I might get to see her every 3 or 4 months; if I have a need for a doctor today I am to go to ‘immediate care’ and a doctor that does not know me will be called upon to serve me.

My new doctor and the folks at immediate care do strive to ‘see me’ and to relate to me as a person AND I am well aware of the time constraints they have – these time constraints permeate the waiting room and the examination room.  I also know that if I take too much of the doctor’s time then the people coming after me will have to wait longer.  The pressure for all of us to ‘get on with it’ is felt by all of us.

Now I understand that the doctor-patient relationship has deteriorated because ‘medicine’ has changed.  The doctors of ‘old’ saw fewer patients and so were able to develop a ‘personal and professional’ relationship with each person-patient.  For example, one of the doctors that I have been helping develop his leadership capacities (he has ‘released time’ for his leadership development) will often see 25-30 patients a day [as an aside: one of the main reasons my doctor of five years ago retired was because he was asked to see more and more patients every day; sadly, medicine lost an excellent doctor – he is not the only doctor-person to ‘retire’ in response to a demand to see more patients].

In order to help the doctor be both a physician and a person it is imperative that the patient is seen as person and that a relationship between physician-person and patient-person be developed, nurtured and sustained over time.  Sadly, there are fewer and fewer doctors who are able to practice ‘medicine-as-relationship.’  Why? – You might ask.

 

 

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