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MEDICINE AND MYSTERY
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MEDICINE AND MYSTERY
I am making an attempt to bring the ideas in Iain’s books into the world of medicine. I have started with a self directed course at the local medical school, and one student who wrote daily personal reflections while reading the first 6 chapters of The Master and His Emissary. He found the whole process immensely valuable and sees it impacting significantly on his future role as a physician.
I have recently also written the following article. This is a first draft but I want to work on it more and submit it somewhere.
I am wondering if there are others interested in this application of these ideas to start a discussion group here.
Here is the article.
Medicine as Enchantment, Wonder, and Awe.
The truth of who and what a physician is lies in the enchantment and the wonder of it. The beauty and the joy of it.
Medicine is an art form where the object and the medium and the subject of the art is the human being. It is the wonder of the human body. Its skeleton. Its muscular system creating the most amazing music, and dance and life. It is the internal organ systems that provide the energy for this action. The mind. The emotions.
As medical students we learn anatomy. Physiology. The basic principles of how it all holds together and the systems of homeostasis that create life. But do we see the wonder of it all? The beauty? The awe. we can go down to the cellular level to see it too. And appreciate that all the elements of life are present even there. Meaning. Purpose. Intention. Consciousness.
A physician operating in a world of enchantment will be overcome with the beauty and the mystery of the human body and the human mind, because this is our field of action. This is how and where we practice the arts of medicine. If we ourselves are in awe, then our patients too will be in awe of their own bodies and mind, and through that awe and wonder will find a way to healing because in the end each individual patient is responsible for their own health and well being. In order to be healthy we must be in relationship with the miraculous of own body.
And yet in the way medicine is taught and practiced now the physician sees himself almost as a mechanic. We have UpToDate on all our phones. We have all the guidelines step by step. We have been taught to see the human body and all its functioning as a machine that can be controlled by algorithms. . A machine cannot heal itself. A machine cannot love itself and care for itself. It cannot understand purpose and meaning. It cannot be filled with the awe and wonder of perceiving its own self.
If we treat our patients as machines, and if we see them as machines, then in a very real way they actually become machines. If we treat them and relate to them as miracles, they become that.
In the end every individual is responsible for his/her own health and well being. This is true at every level, even down to the cellular. If they see themeselves as miracles then they will treat themselves that way. So the primary role of the physician has to be to reveal to patients the awe, the wonder, the mystery and the enchantment of who they are. In order to do this we have to discover it ourselves, and it needs to be a core component of the training of a physician as well.
A machine does not experience sunlight. Or joy. Or delight. It is not in relationship with anything. It cannot heal itself because there is nothing in it that is capable of healing.
If I am in awe of my own body then I am going to be highly motivated to take care of myself well. I will avoid toxins. I will engage in healthy pursuits. I will excercise. Because all these things build the sense of awe going higher and higher and higher. They engage the energy. The light.
As physicians we are in a privileged position to learn and know the amazing secrets and miracle of the human body and how it functions. Yes we have a responsibility to apply the knowledge we have about how to deal with things when they go wrong. How the machine functions and how it can be corrected. However this is only one aspect of our responsibility. One side of it. We also have to be able to transmit the awe and wonder of it to out patients. And we are in a unique position to do this.
Our primary responsibility is to transmit this knowing to our patients. Not necessarily to teach them anatomy and physiology although we can still do this in a small way, but to transmit the awe and the wonder of it all so that this knowing can become part of their own lives and start them on the road to their own healing process.
We need to be treating our patients as miracles.
Not as machines.
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12 Replies
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Thank you for initiating this effort, sjahari.
As a physician myself who was deeply engaged in brain injury rehabilitation with sub specialization in Brain Injury Medicine, I fully support your project and am in complete agreement with the need for a re-balancing of medical education and biomedical science between the ‘way of material’ which is, ultimately, the left-hemispheric ‘way of mechanism’, and the right-hemispheric semiotic ‘way of relation’. As Iain’s work and writing makes clear, our culture has emphasized the former over the latter and this has now been played out to the point where it is not only deeply corrupting the practice of medicine but placing our species and all of nature at significant risk of annihilation. Without going into a lot of detail, the push toward rejuvenating a relational foundation for medical practice that recovers the notion of ‘person’ is of crucial importance at a time when the ‘mechanistic formalism’ that de-animates living organisms has assumed the role of unquestioned dominance. The point is that living organisms are categorically different from mechanisms, and the mechanistic formalism with its deterministic ‘ontology of states’, itself, is totally inadequate in dealing with the complex, adaptive, context-dependent functionality of living organisms. This has been shown to be the case by the work of theoretical biologist, Robert Rosen, in his ‘relational biology’ as detailed in his final two books: ‘Life Itself’ and ‘Essays on Life Itself’. The problem with replacing the relational model of the ‘complex’ living organism with the ‘simple’ mechanistic entity run very very deep and also connect to the difference between quantum physics, on the one hand, and Newtonian classical mechanics, on the other. The problem can be related to the Incompleteness Theorems of Kurt Gödel, to the biosemiotics of John Deely, and to the idea that living organisms are independently ‘autopoietic’–self-sustaining, and self-perpetuating, while mechanisms are not! As pointed out by Humberto Maturana and Franscisco Varela. This need to ‘re-balance’ the ‘focally-oriented’ left hemispheric and ‘globally-oriented’ right hemispheric worldviews recognizing that the latter is the ‘Master’, has also been pointed out by the historian of human consciousness, Jean Gebser, in his book, ‘The Ever-Present Origin’. It also relates at a very deep level to the work that Timothy Eastman brings forward in his important book, ‘Untying the Gordian Knot. Process, Reality and Context.’ The mechanistic formalism assumes ‘context-independence’ whereas living organisms and the living, conscious Universe operate adaptively in the realm of ‘context-dependence’. One cannot assume ‘context-independence’ when dealing with the functionality of a living organism. It amounts to transforming a living breathing ‘Thou’ into a dead, inanimate ‘It’. Our patients must be seen as operating in the context of the former category, not exclusively as operating in the latter category. This realization really changes everything.
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Very admirable work sjahari. I have found that Ian’s insights have been essential in my journey to uncover our natural human endowment of wholesome present centered, lively, relaxed, highly energetic awareness/attention capable of shifting easily from states of left hemispheric contraction, to right hemispheric expansion to a third attention that accommodates and moves adaptively to any place in the awareness/attention phenomenological state space. All this requires energy so I have been thinking that we should, as healers, pay attention to mitochondrial health. We could hypothesize that the felt sense of the body in this moment is directly linked to the web of mitochondria throughout the body and the flow of H+ throughout the body in connective tissue microtubules.
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Hi all – psychologist here, involved in complementary/mind-body medicine, using mindfulness for pain management, CBT-I for insomnia, and much more.
All 3 letters are quite beautifully stated.
A friendly challenge; i don’t see anything concrete in what all have summarized from Iain’s work that is fundamentally different from the mechanical/organic duality that has been well articulated in various complementary medicine writings over the past 50 years.
This is not a critique of iain’s work – it’s important, as he writes often in defense of his neurological thesis, to reach people this way who otherwise flatly reject integrative medicine.
But I often wonder – since neuroscience AND biology are at present so permeated with physicalist and dualist assumptions – how much do we lose by elevating materialist science above contemplative writings which – to me at least – have infinitely more dimensions of consciousness developed over thousands of years than any of our current attempts to link neuroscience and consciousness?
not a critique – just something to inspire further contemplation.
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I am looking mainly for specific examples where these ideas are being applied in the work we do as physicians.
I will give one.
As an Internist in a community hospital I was extremely busy with very long days. The time I had available to see patients was very limited.
Nevertheless in my career I never had the complaint from patients that I didnt spend enough time with them. And that is often the complaint when people see their doctors. They come away saying that he barely interacted with them. I would probably have spent less time with them myself and yet the patients had the sense that I was taking all the time in the world.
I believe that was due to the level of sustained attention (RH) I was bring to the interaction. And the time we had together seemed like an eternity (duration).
The biggest complaint that people have in medicine across the board is that there is not enough time. I believe this is because we have lost that sense of enchantment that can expand a few seconds into an eternity.
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Oh, I see.
Maybe it’s different here. In mainstream medicine the doctors objectively have no time. When I’ve been to integrative practitioners who are quite capable of that kind of wondrous sustained attention, if they have limited time, I still feel it.
perhaps it’s a special quality about you.
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It is the same here. I am talking about spending 3 minutes with a patient. When there is that kind of RH attention then time seems to enter another realm of duration.
I dont think there is anything special about me. Definitely not. It’s just that most physicians are so much in their LH and that is where time becomes an issue. When in the LH there is never enough time. In the RH experience time is not an issue in the same way. I think that medical students can find this way of being and that they understand this from other aspects in their lives. Sports for instance where this is well known. The one student I had got it immediately.
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When in the practice of brain injury rehabilitation, one very quickly realizes the inadequacy of a mechanistic brain function model in assisting each individual in their unique process of recovery, and how important the relational aspect of human functionality is in guiding the process of recovery. Very similar injuries can have vastly different functional outcomes depending on the relational context and its richness and the element of external support and encouragement, as well as the avoidance of over-burdening the recovering individual and the risk of precipitating a ‘catastrophic reaction’ ( see: https://www.researchgate.net/publication/266872143_Surviving_Catastrophic_Reaction_after_Brain_Injury_The_Use_of_Self-_Regulation_and_Self-Other_Regulation ) as described by pioneering brain injury treatment specialist, Kurt Goldstein, in his magnum opus and seminal book, ‘The Organism. A Holistic Approach to Biology Derived from Pathological Data in Man’ ( See: https://en.wikipedia.org/wiki/The_Organism#:~:text=The%20Organism%3A%20A%20Holistic%20Approach,am%20kranken%20Menschen%2C%20in%201934. and also see, for access to this text:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1043886/ ).
So these ideas run very deep and have very significant implications and application in particular fields of medical practice, where there is a fundamental requirement to address the subtleties and distinguishing factors of the ‘person’ who is the patient one is serving…
See: https://dialnet.unirioja.es/descarga/articulo/4102375.pdf (which discusses the ‘recovery of person’ through the process of philosophical transition from an ‘Age of Ideas’ to an ‘Age of Signs’ which is discussed in much more detail by John Deely in his magnum opus,
‘The Four Ages of Human Understanding‘ which I consider to be a must-read for anyone interested in the current fundamental transition in human understanding that is occurring, and also see:
https://pubmed.ncbi.nlm.nih.gov/30411181/ which is an article by Alan B Astrow discussing the address given to the American Medical Association by Abraham Joshua Heschel titled ‘The Patient as a Person’… and the ‘Disenchantment of Medicine‘.
What we are really talking about and what is needed is a process directed toward the ‘Reenchantment of Medicine‘…
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thanks for these references. I have been investigating Disenchantment as well as Max Weber from the Jungian Point of view. Everything connects.
And this makes me want to return to Osler’s writing as well. There seems to be little left of it in teaching clinical skills.
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Funny that you should mention Max Weber and the issue of ‘Disenchantment’ which goes along with the dominance of the mechanistic formalism, Sjahari. I am currently reading a great book about this whole issue by Roderick Main which you can find at this link…
The author proposes a recurrent sequence of ‘Enchantment-Disenchantment-Reenchantment’ emphasizing the current need for a process of moving from the Disenchantment of mechanistic scientism to the Reenchantment of a new relational biomedical science that involves integrating and transcending the mechanistic formalism for modeling living beings.
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I have that book and read it last year. The relationship between this and Jung’s work with Synchronicity is quite interesting. This book was part of a web course on synchronicity given by the Centre for Applied Jungian Analysis. I encouraged them to invite Iain.
There is a lot of overlap.
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I very much agree!
There is potential deep richness available in linking up Iain McGilchrist’s approach to the division of ‘how-to’ strategies between the two hemispheres, and the ‘Depth Psychology’ of CG Jung, which, as Jung noted in a comment made at his 80th birthday party, had been entirely anticipated in the writing of the ‘Maggid of Mezerich‘, Rabbi Dov Baer, the leading student of the founder of Hasidism, the Baal Shem Tov ( the ‘Master of the Good Name’ ). This connection is also of great interest in linking up Iain’s ideas with the ideas of Jung’s leading student, Erich Neumann, regarding the origins and history of ‘consciousness’ (or what I would prefer to call human species-specific reflective egoic ‘meta-consciousness‘ following the suggestion of Bernardo Kastrup and consistent with the ideas of Donald Hoffman–ie. in distinguishing between the ‘meta-consciousness‘ of the distinctly human ‘egoic‘ inner speech that is specific to the evolved human interface with reality conferred by biological evolution as an optimized, but NON-VERIDICAL means of sustaining embodied survival, and the primary, elemental, experiential consciousness of the hidden relational matrix that constitutes the reality of possibility, which is also consistent with what quantum physicist, Ruth E Kastner calls the ‘Q<b class=””>uantum Substratum‘ out of which the quantized spacetime aspect of the species-specific human interface emerges ( see: https://arxiv.org/abs/2103.11245 ).
arxiv.org
The Relativistic Transactional Interpretation and Spacetime Emergence
We consider the manner in which the spacetime manifold emerges from a quantum substratum through the transactional process, in which spacetime events and their connections are established. In this account, there is no background spacetime as is generally assumed in … Continue reading
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I notice that Iain is giving a talk on this same topic ;at Duke University in April
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