Service to Humanity by Thomas Moore
The following excerpt is taken from the book CARE OF THE SOUL IN MEDICINE: Healing Guidance for Patients, Families, and the People Who Care for Them.
I have already referred to Albert Schweitzer’s three-word statement that guided all of his work: reverence for life. I would like to offer another three-word philosophy that could lie at the base of medical practice: service to humanity.
Most doctors and nurses say that they would do the work even if they weren’t paid for it. They are indeed concerned, as they should be, to be paid a good wage for their work. They mean, rather, that their jobs in medicine represent their desire to be of service to humanity. When you ask people in the medical professions what brought them to the work, they will often say, “I wanted to help people.”
The Meaning of Service
Taking “service to humanity” as our mantra, exactly how do we offer service when we’re getting paid? How do we see our work as service when we are applying ideas and techniques that we have learned through study and practice in higher education? Can we really be offering service when we’re doing our jobs rather than volunteering?
Service is related to the words servant and servile, all of which go back to the Latin word, servus, for slave. Service is not slavery, but it does have the connotation of emptying oneself for the benefit of another. Preparing for this book, I talked to a great number of people in the health services; people in every imaginable job related to medicine and in many different institutions and countries. Most of them understood that their calling was to serve, and they found rewards in doing so.
The service aspect might appear in their attitudes toward their work and toward their patients. They felt that they were serving when they went even a short distance past what was required of them: spending more time at work on behalf of a patient, spending more time in the patient’s presence, being more available by talking freely, or sitting rather than standing. That is an interesting notion—service through sitting with a patient, showing her that you are not ready to run off to the next chore or assignment.
The key of service in these examples is going slightly beyond the requirements of the job on behalf of a patient. Dr. Baxter’s stories of his AIDS patients in New York show that service is not only an offering of time, but also personal and emotional effort to do what is necessary for the complete healing of the patient. Dr. Baxter worked for the entire welfare of his patients, attending them not only so that they would have the best medical treatment available but also that they might have a meaningful death. He gave his attention to their families and to the aftermath of the suffering and death of a loved one. He had his limits, of course, but they extended beyond what most would consider his duties as a physician.
Albert Schweitzer not only practiced medicine, he moved to a poor area of Africa and treated needy patients. My plastic surgeon not only did excellent work for his paying patients at home, he traveled to remote areas to offer his skills to children with cleft palates, in places where, without his intervention, they would suffer their scars for their entire lives. My friend Mark McKinney goes out of his way to embrace the people of his city, including gang members, who might otherwise lie outside the sphere of concern of a busy hospital. At the University of Tennessee, George Doebler tends to all types of humans in need, wherever he sees them. Dr. Balfour Mount goes far beyond the expertise of his medical training to create inventive programs for the souls of the citizens of Montreal. The list is endless of medical professionals who indeed feel a calling to service and accomplish it by extending the limits of their creative work. Here we see the soul of medicine: a deep feeling for humanity showing itself in many compassionate and creative modes of service.
One day I sat with a group of nurses in the birthing unit of an East Coast hospital. They loved their work so much that they said if they went a short while without attending a birth, they felt empty and yearned to get back to duty. They e-mailed and phoned from home to see how their patients were doing. Their involvement, they said, was 24/7.
And yet their devotion to their chosen work was overshadowed by an insensitive hospital hierarchy that expected more from them than they could deliver and refused to give them the space and personnel they needed. I could feel both the strength of their dedication and the depth of their disgust with the top-heavy hierarchy that didn’t yet understand the professional status of the ob-gyn nurse.
Studies on doctor arrogance raise some interesting points: Doctors are often unconscious of their arrogance. They may not recognize it until a patient’s lawyer points it out to them. Doctors excuse arrogance, blaming it on a tough training program and the impossible job of treating people in life-and-death situations. Some doctors confuse arrogance with courage and risk-taking which are positive and necessary attitudes in a field full of new adventures and experiments.
One of the best explanations of professional arrogance I have found is one offered by the Swiss Jungian analyst Adolf Guggenbühl-Craig. He talks about a split archetype. In the best of situations, a doctor treats a patient as a fellow human being—both of them are susceptible to mistakes and illness and both have intelligence and good intuitions. But usually this archetype of healing, which has two sides—healer and patient—gets literalized and split up between the two people. The doctor is the healer and the patient the one to be healed. The doctor forgets that he is human, too, and is sometimes a patient. The patient forgets, or may not even realize that she plays a positive role in the healing and can make good judgments and have helpful intuitions as well. This is fertile ground for the dangerous and disrupting condition of doctor arrogance.
Guggenbühl-Craig describes the situation perfectly. “The doctor is no longer able to see his own wounds, his own potential for illness; he sees sickness only in the other. He objectifies illness, distances himself from his own weakness, elevates himself and degrades the patient.”
The solution to this split archetype is to face yourself, acknowledge your arrogance, and make a genuine effort to do something about it. Notice your defensiveness when people give you hints about it. Face your anxieties, your attitude toward your work, and your fears.
When I first began practicing psychotherapy, I realized that I wasn’t fully prepared for the work. I didn’t know some things I should know because I hadn’t faced them in my own life. My first years in this work were effective—I had a good education and good training—but they were difficult because of the personal work on my own soul I knew I had yet to do. I went into therapy myself, I kept a full and intense diary of my inner conflicts and my dreams, and I consulted with many professional and nonprofessional friends. I reached a point where I finally felt more secure in myself as a healer. I saw some good work that I had done, but because of my self-confrontations I didn’t gloat over it.
This experience of mine leads me to think that self-confrontation is an important step in becoming a healer. Like the aspiring Plains healer who didn’t become a shaman because of his fear of rattlesnakes, many physicians fail to evoke the healer in their work because of their fears, and they won’t deal with those fears until they face up to them.
The psychology of service could be one of those human issues that find their way into the soulful education of a health-care worker. It isn’t enough to encourage, inspire, or cajole a person to show some etiquette with patients. Each worker has to deal with emotional issues that any of us might have and may interfere with good community relationships. The soul exists in the rich, sometimes tense space between people, and how you handle that space can make all the difference in creating a healing environment.
Care of the Soul in Medicine: Healing Guidance for Patients, Families, and the People Who Care for Them is published by Hay House and is available at all bookstores or online at: www.hayhouse.com. See Thomas Moore at the I Can Do It! Seminar presented by Hay House: www.ICanDoIt.net. May 14-16th at the San Diego Convention Center. 800.654.5126