Nass
Cannon, MD
The aspirational goal of health should be the transformative
integration of body, mind, and soul in a person seeking communion with God and
neighbor. I propose that we broaden our
perspective of health and no longer view it solely as a repair process, the
mere absence of an illness or the prevention of a disease. Some health care
professionals are beginning to view health in the context of relationships—in
the relationship of the person to their own body, mind, and spirit and the
relationship of the person to others. But the type of change that is so
desperately needed in our day, at the individual and institutional levels,
requires spiritual guidance. The teachings of Thomas Merton, which have guided
me in my career as a physician, offer valuable insight into what it means to be
healthy.
The pursuit of bodily fitness is one of our most elemental concepts
of health. It entails proper nutrition, exercise, the prevention of illness,
and the repair of bodily processes. But
fitness may not be so easily achieved. Merton observed, “I cannot make the
universe obey me. I cannot make other people conform to my own whims and
fancies. I cannot make even my own body obey me.” Yet, it is every individual’s responsibility
to strive for the best physical health available through proper care of our
bodies.
Similarly, mental health is more than the absence of a
disease of the brain or a mental illness. Mental health entails a program of mental fitness which may include the
practice of mindfulness or meditation. Scientific
data emphasizing the beneficial effects of these practices presented at the International Symposium on Contemplative Studies
held in Denver in 2012 supports and verifies this claim. This gathering of
researchers, contemplatives, lay practitioners, and investigators presented
their studies and dialogued over research concerning the beneficial effects of mindfulness
practices to one’s mental and physical health. Topics were broad and diverse
with leading researchers from all over the world moderating discussions on the
future of science and spirituality.
They presented scientific evidence to support the theory that mindfulness
practices can calm our minds, open us to the reality of now, and have
measurable mental and physical health benefits.
Mindfulness practices also help us
focus our minds in the pursuit of knowledge and wisdom, which are essential elements
of mental fitness.
But to reach
fruition, mental activity must engage the body. Merton observed:
“A purely mental
life may be destructive if it leads us to substitute thought for life and ideas
for actions. The activity proper to man is not purely mental because man is not
just a disembodied mind. Our destiny is to live out what we think, because
unless we live what we know, we do not even know it. It is only by making our
knowledge part of ourselves, through action, that we enter into the reality that
is signified by our concepts.”
Similarly, Merton notes the interdependence of knowledge and
wisdom:
“It is true that
neither the ancient wisdoms nor the modern sciences are complete in themselves.
They do not stand alone. They call for one another. Wisdom without science is
unable to penetrate the full sapiential meaning of the created and the material
cosmos. Science without wisdom leaves man enslaved to a world of unrelated
objects in which there is no way of discovering (or creating) order and deep significance
in man's own pointless existence. ”
However, a view of health limited to the body and mind and their relationship is
inadequate. This point was addressed in 1948 by the members of the World Health
Organization. They offered a broader view of health, defining it as “a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity.”[i]
At the time this definition was proclaimed, our
capacity to treat medical illness was limited. For example, the treatment of a
heart attack in 1955 was six weeks of bed rest. Today medications and stenting
is routine to prevent and treat heart attacks; for severe heart failure, heart
transplant is a commonplace procedure. The past 50 years has witnessed
tremendous gains in our capacity to diagnose, treat, and prevent illnesses as
well our capacity to expeditiously deliver health care with an infrastructure
of first responders, emergency rooms, and critical care units. Powerful imaging
is available with CT, MRI, and PET scanners while laboratories not only have
more sensitive diagnostic tests but even in some diseases match genes to the
probability of a therapeutic response. Similar progress has been made with
immunization programs minimizing dreaded diseases such as polio while nearly
eradicating smallpox. Drugs to fight infections and cancers abound and become
increasingly more sophisticated while prosthetics for damaged joints and heart
valves are now commonplace.
Certainly we have made progress in our capacity to
diagnose, treat, prevent illnesses, and repair the body. We have made less
progress as a nation and as a world community with the issues of equity of
access and health care justice. We also have made less progress in translating
into action a very broad view of health—transformative integration of
body, mind, spirit in a person seeking communion with the Divine and one’s
neighbor.
But, thankfully, there are some promising
nascent trends. The first of these is the realization that we need health care providers
to make their own journey in this broader vision of health as they seek
integrative transformation of their own body, mind, and spirit while improving
their relationship with others. David Leach, M.D., former executive director of
the Accreditation Council for Graduate Medical Education, gave a fascinating presentation in 2007 in
which he addressed issues surrounding the formation of providers. He believes the formation of health care
providers should be a journey to authenticity through which providers find
their true selves.
He defines the authentic self as “conforming to fact or
reality: trustworthy; not imaginary; not an imitation; genuine; bona fide.” In
the health care setting, he suggests persons in training should undergo an
interior journey to become an authentic person with an authentic professional
life. Leach calls us to use the faculties of our intellect, will, and
imagination to discern the truth, to make good clinical judgments, and to do so
with harmony, creativity, and beauty.
The primary values with which to arm oneself are integrity, altruism,
and prudence. Overall, Leach says it’s not enough for institutions to certify
that their trainees have competence in science and procedural skills, but that they
need to create an institutional culture that nurtures the formation of the
person. This environment should allow and not prevent the journey to
authenticity and the recovery of one’s true self, as Merton taught.
In pointing out how
our institutional healthcare culture fails the trainee by providing a workplace
full of frenzy, Leach quotes Thomas Merton:
"There is a pervasive form of
modern violence to which the idealist...most easily succumbs: activism and
overwork. The rush and pressure of modern life are a form, perhaps the most
common form of its innate violence. To
allow oneself to be carried away by a multitude of conflicting concerns, to
surrender to too many demands, to commit
oneself to too many projects, to want to help everyone in everything is to
succumb to violence. The frenzy of the
activist neutralizes his (or her) work…It destroys the fruitfulness of his (or
her) work, because it kills the root of inner wisdom which makes the work
fruitful."
Leach calls for the transformation of institutions to allow providers
in training to move from frenzy to wisdom as individuals and as professionals.
With regard to patients, Leach also expects institutions to have as their
goal the treatment of the whole person. Some academic institutions have responded
with variable intensity to this call by establishing integrative medicine
programs. Among many others, a few illustrative examples include University of North Carolina Integrative Medicine Program, University of Texas MD Anderson Cancer Center,
and The Osher Center for Integrative Medicine,
a collaboration between Brigham and Women’s Hospital and Harvard Medical School.
We are seeing some hopeful movements towards a broader view
of health, but, I propose that these are only early milestones to a larger
vision of health. Merton points us in this direction in his call for us to find
our true selves. The principle barrier to finding our true self is our
attachment to our false-self, which for Merton, is the god we make of
ourselves. He notes:
"The inner, basic, metaphysical
defilement of fallen man is his profound and illusory conviction that he is a
god and that the universe is centered upon him…Yet in our desire to be as
gods…we seek what one might call a relative omnipotence: the power to have
everything we want, to enjoy everything we desire, to demand that all our
wishes be satisfied and our will should never be frustrated or opposed. It is a
radical falsity which rots our moral life in its very roots because it makes
everything we do more or less a lie."
As a result, we hide. Like Adam we hide from God, we hide
from our true self, and we hide from others. We fear that we will be
discovered, unmasked, unclothed, and be naked before the truth of God which is
God’s truth in us. This refusal is not merely a refusal to live authentically
in one’s vocation; it is a much more profound refusal to be the image and likeness
of God.
Merton calls us to recover our true self, which he describes
vividly:
"At the center of our being is a
point of nothingness which is untouched by sin and by illusion, a point of pure
truth, a point or spark which belongs entirely to God… This little point of
nothingness and of absolute poverty is the pure glory of God in us… It is like
a pure diamond, blazing with the invisible light of heaven. It is in everybody,
and if we could see it we would see these billions of points of light coming
together in the face and blaze of a sun that would make all the darkness and
cruelty of life vanish completely…I have no program for this seeing. It is only
given. But the gate of heaven is everywhere."
The journey to recover one’s true self is a journey towards integrative
transformation requiring progressive reconciliation of body, mind, and
soul. One’s physical pursuit of bodily
fitness and mental pursuit of truth remain necessary goals, not ends in
themselves but rather integrated into our deep search for God’s truth within
us. Our recovery of this “pure truth” is the recovery of our true self which is
the image and likeness of God.
If the goal of health is integrative transformation, what
are the means? Such means may include mindfulness
practices such as meditation, prayer, grace, and contemplation. From the
perspective of health as the transformative integration of body, mind, spirit
in a person seeking communion with the Divine and one’s neighbor, I would like
to suggest the following definition:
Health
is a striving of the body by the pursuit of fitness, of the mind by the pursuit
of knowledge and wisdom, of the soul by the pursuit of love for self and others
in a person desiring integration, harmony and wholeness and relatedness of
body, mind, spirit, seeking communion with the Spirit of God and peace with
one’s neighbor.
Someone seeking health from this perspective would manifest
certain attributes. Their communion with
God would infuse their souls with a spirit of mercy, God’s own Spirit, which
would enflame their minds to works of compassion and service to others. Their
healthiness would manifest itself by attitudes of mercy and compassion and
deeds of service, an expression of their seeking communion with God and neighbor. In recovering their true self, they would
experience Thomas Merton’s realization, “My dear brothers, we are already one.
But we imagine that we are not. What we have to recover is our original unity.
We have to be what we are.”
[i] Preamble to the Constitution of the World Health
Organization as adopted by the International Health Conference, New York, 19-22
June, 1946; signed on 22 July 1946 by the representatives of 61 States
(Official Records of the World Health Organization, no. 2, p. 100) and entered
into force on 7 April 1948.
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