Medical Education, Holism & Metaphysics - the Big Picture

     Bruce Wilson PhD eloquently and persuasively "sought to identify some weaknesses in the way difficult concepts are managed within medical education, by analyzing them through the prism of a metaphysical explanation. This has revealed some systematic reasons for the shortfall in explanatory power, but more importantly, it has allowed an attempt at a systematic solution to that shortfall. It is not recommended that medical education be substantially altered in the direction of explicit metaphysical theorizing, but it is suggested that having a more systematic approach available, with explicit reference to the nature of that approach, can assist in the understanding of the difficult concepts reviewed here: holism, medical uncertainty, personhood and reflective practice. The fact that an analysis of holism provides tools to illuminate the difficult concepts is not only heartening; it is a practical example of holism in action."

       Wilson B. Metaphysics and medical education: taking holism seriously. J Eval Clin Pract 2013; 19(3): 478-84.

Dale Chihuly   http://www.chihulygardenandglass.com/

Intelligently Approaching (vs keep Avoiding) Challenging Aspects of Health Care

     "The adoption of the biopsychosocial model of health has resulted in the use in medical education of concepts such as ‘holism’ and ‘connectedness’, yet medical educators struggle to convey these in a meaningful way to students. There is a growing interest in using techniques such as reflective writing, yet medical educators struggle to explain it and to justify its relevance to students. There is a growing appreciation that students trained exclusively in the scientific aspects of medicine make poor clinicians, yet medical educators cannot easily articulate the nature of the shortcomings. There is increasing pressure on medical experts to minimize their mistakes and on institutions to address the conditions that make mistakes more likely, yet there is no established understanding of what medical error is and how it and the related idea of medical uncertainty may be an inescapable part of the nature of medicine.

     This is not to deny that some form of explanation is forthcoming in each case; only to point out that what these explanations lack is a place in an integrating narrative."

       Wilson B. Metaphysics and medical education: taking holism seriously. J Eval Clin Pract 2013; 19(3): 478-84.
 
     A recent study provided "objective evidence that doctors face interactional challenges when they try to explain that symptoms are medically unexplained and suggest psychological treatment. Practice implications: Doctors may try to avoid provoking patients’ overt resistance because they perceive it as unpleasant. However, the display of overt resistance enables them to deal explicitly with the grounds on which patients reject their explanations and recommendations, and to address patients’ particular concerns."

       Monzoni CM, Duncan R, Grunewald R, Reuber M. Are there interactional reasons why doctors may find it hard to tell patients that their physical symptoms may have emotional causes? A conversation analytic study in neurology outpatients. Patient Education and Counseling 2011; 85(3): e189-e200.

 

Dale Chihuly http://www.chihulygardenandglass.com/

Critical Thinker, Discerning Taste, and Unhappiness

      "Critical thinking is, in short, self-directed, self-disciplined, self-monitored, and self-corrective thinking. It presupposes assent to rigorous standards of excellence and mindful command of their use. It entails effective communication and problem solving abilities and a commitment to overcome our native egocentrism and sociocentrism."  
        (Taken from Richard Paul and Linda Elder, The Miniature Guide to Critical Thinking Concepts and Tools, Foundation for Critical Thinking Press, 2008) http://www.criticalthinking.org/pages/defining-critical-thinking/766

     As the inference to the transcendence of egocentricity and provincialism / tribalism (sociocentrism) suggests, the above is entirely dependent on the thinker's level of overall maturity as a human being. Critical thinking has nothing to do with cynicism nor scientism. Yet both are rampant among folks in health-care - as if it were an essential badge of intelligence - but it is NOT.

     In a broader sense, beyond academia / health-care, our society also respects people with "discerning tastes" such as film, food and wine critics. The more harshly they put down a movie, restaurant or wine, the more titillating the review. Again, being judgmental ie having a negative affect, is given an undeserved place of honor.

     Being cynical and judgmental assures that one is rarely satisfied or happy. With these self-imposed barriers to connecting with life as it is, one is assured of life-long misery. These barriers also take a lot of energy to maintain - AND - people who are consistently negative are a real pain in the ass to be with.

     See also: http://www.johnlovas.com/2013/11/out-of-fearful-pessimism-we-isolate.html
     and: http://healthyhealers.blogspot.ca/2013/11/values-purpose-meaning-quality-of-life.html

EMP Building by Frank O. Gehry, Seattle WA

Enthusiasm, Energy, Zest for Life - What does all that Mean?

     We think of having enthusiasm, vitality, "a real zest for life" as equivalent to being perfectly well-adjusted, healthy and happy. But the sobering fact is that more often than not, we feel less than enthusiastic about things as they are. Why? Is this depression - something wrong with me?
     As we mature, we naturally transition through very different priorities - what made us happy (or sad) when we were 5, may have the opposite effect of us now, and vice versa. So our requirements for meaningful fulfillment continuously change, becoming deeper, more nuanced & expansive - a gradual shift from egocentricity ("me, myself and I") towards allocentricity & ecocentricity (the biggest picture we're able to engage). This is normal, healthy maturation - don't try to medicate it away - celebrate it, investigate it!

     See also: http://healthyhealers.blogspot.ca/search?q=chasing

 

Massimo Ripani   http://travel.nationalgeographic.com

Errors in Judgment, Blind Spots, Rationalizing, Denial, no Guilt, only Shame

     We all do the best we can all the time. AND we all behave badly at times.
     Inappropriate, unethical, immoral behavior relies on our selective blindness to, and / or rationalizing away of, everything that tells us "DO NOT do this!" So we can go against our own values ("do wrong") YET STILL feel good about ourselves ie keep thinking that we're good, decent, honest etc. We can do wrong AND feel we've done nothing wrong.
     People "caught red-handed" typically vociferously cry innocent. It usually sounds like outright lying, but I'm starting to suspect that "perps" actually believe what they're saying - believe their own lies.
     The (appropriate) sense of guilt * seems to be missing, and may take a long time (if ever) to appear. But there's a lot of shame * (humiliation, loosing face) to being caught, and anger at those who do the catching. 
     If we allow ourselves to mature as human beings, we see reality increasingly more clearly (with less & less self-serving bias), and we're less & less able to stomach our own excuses for improper behavior. Our priorities gradually shift from self-centeredness to a wiser, bigger picture of life.

* http://healthyhealers.blogspot.ca/search?q=guilt

Randy Craig   http://travel.nationalgeographic.com

Life is Infinitely More than what can be known through Science

"Are the mystics and sages insane? Because they all tell variations on the same story, don't they? The story of awakening one morning and discovering you are one with the All, in a timeless and eternal and infinite fashion. Yes, maybe they are crazy, these divine fools. Maybe they are mumbling idiots in the face of the Abyss. Maybe they need a nice, understanding therapist. Yes, I'm sure that would help. But then, I wonder. Maybe the evolutionary sequence really is from matter to body to mind to soul to spirit, each transcending and including, each with a greater depth and greater consciousness and wider embrace. And in the highest reaches of evolution, maybe, just maybe, an individual's consciousness does indeed touch infinity—a total embrace of the entire Kosmos—a Kosmic consciousness that is Spirit awakened to its own true nature. It's at least plausible. And tell me: is that story, sung by mystics and sages the world over, any crazier than the scientific materialism story, which is that the entire sequence is a tale told by an idiot, full of sound and fury, signifying absolutely nothing? Listen very carefully: just which of those two stories actually sounds totally insane?" — Ken Wilber, A Brief History of Everything, 42–3   http://en.wikipedia.org/wiki/Ken_Wilber

Dale Chihuly http://www.chihulygardenandglass.com/

First International Congress on Whole Person Care - Oct 17-20, 2013 – McGill University, Montréal, Canada

The First International Congress on Whole Person Care
October 17-20, 2013 – McGill University, Montréal, Canada

Dear Colleague,

This is a gentle reminder that the deadline for submitting abstracts for poster presentation at The First International Congress on Whole Person Care is May 31, 2013.  Submissions are welcome from all disciplines within the health care professions on the topic of whole person care, which is healthcare that relates to the recipient of care as a whole person (as opposed to a relationship limited to a disease, an organ system or even a whole body).

*A full list of subject categories as well as submission instructions and descriptions of each type of presentation can be found on the Congress website (www.wpc2013.ca).

Presented by McGill Programs in Whole Person Care, McGill University, the first university center specifically focused on whole person care, this Congress will bring together acknowledged experts from around the world, and will put you at the cutting edge of what it means to practice whole person care.

Designed for physicians, nurses and other healthcare professionals, the programme will include plenaries and interactive workshops by leaders in the field, as well as opportunities to share the latest research findings through oral and poster presentations – all this, in an environment that is nurturing and conducive to deep interaction and reflection.

PROGRAMME UPDATE
The updated Agenda including the oral presentations from accepted abstracts is now available on our website: http://www.wpc2013.ca/en/agenda.htm

For more information, please visit www.wpc2013.ca or call +1 450-292-3456 ext. 227.

We look forward to welcoming you this Fall.

Sincerely,

April O’Donoughue
Congress Coordinator

The First International Congress on Whole Person Care
2013 Congress Secretariat
c/o O’Donoughue & Associates Event Management
75 chemin Mountain
Mansonville, Québec, Canada J0E 1X0

Tel: +1 450-292-3456, ext. 228
Fax: +1 450-292-3453
E-mail: info@wpc2013.ca
Web: www.wpc2013.ca

Montreal at night    www.tripadvisor.ca

Nothing is carved in stone?

     At Seattle's Pike Place Market, one vendor sells stones with carved quotations - some funny, others quite powerful:

     When walking through hell,
     KEEP WALKING


     See also: http://healthyhealers.blogspot.ca/2013/05/life-is-infinitely-more-than-what-can.html 

Seattle, WA