Journal of Sacred Work

  The medical-industrial complex is so bent on fixing us & billing us that it threatens to crush our hearts in the process. –  Erie Chapman

  Rachel Remen, M.D., first told the story in 1992. She described an old German women with cancer who came to one of her healing retreats. At the retreat, there was lots of hugging and kind words. The woman liked the kindness, but her upbringing caused her some discomfort with what she called, "all ‘dis hugging business." 
   One day, Dr. Remen saw the woman emerge from some alone-time wearing a big smile. "What is it?"" she asked the cancer patient.
   "I been asking God about whether it is okay for me to hug strangers," the woman said. "God says to me, ‘What is ‘dis with the strangers. I don’t make strangers. You do.’"…

   For decades now, Dr. Remen has been treating patients, writing books, and designing a marvelous course for doctors called "Meaning in Medicine."  The course is now taught in dozens of American medical schools and dozens more plan to offer it. At the heart of this program is a challenge to doctors to stay in touch with soul, to recognize that all the work being done to train their memories and enhance their analytical skills are of no value unless they retain their humanity and their humility.
   Remen’s course comes just in time. Advances in technology threaten the art of medicine just as rising business incentives challenge charities to keep track of mission. The medical-industrial complex threatens to crush the human heart.

  The medical relationship is "a human relationship, not a relationship between an expert and a problem," Remen writes. "I was certainly not trained [in medical school] to be a fellow human being."
   Remen’s course seeks to draw human from the fringes of medical practice back to the center. She has an uphill climb. Few, if any, medical schools will yet block a student from receiving their degree because of poor bedside manner. For aspiring doctors, the key to successful academic achievement, and the awarding of the still-coveted M.D. degree, are the skills of memory and analysis.
   Once in practice, business pressures on private practicing physicians become enormous.
   What chance does Remen’s mission have against these giant forces?
   Ultimately, the answer lies with each individual doctor and every other caregiver. The more medicine is driven by science and business, the more the practice becomes a transactional process and the greater the "burnout" factor. It’s ennobling to be a caregiver. It’s exhausting to be only a button-pusher and a biller.
   One of the most humanizing forces on doctors comes when they end up as patients themselves. As the movie "The Doctor" made powerfully clear, transactional medical treatment seems to lots of doctors until one of them is on the receiving end. Suddenly, the heart of medicine becomes incredibly important.
   As one veteran physician told me when he emerged from his first experience as a patient after twenty-five years in practice: "My favorite caregiver was the housekeeper. I looked forward to her visit every day. I really think she is the one who helped me get better."

-Erie Chapman