What Is the Soul of Medicine?

July 2, 2018 by

cover of The Soul of Medicine Plough Quarterly magazine

My first job after high school was as a nursing home janitor. It wasn’t exactly my dream job, and I’m not sure I would recommend the experience to anyone. But working a year as a janitor in Fair Valley Nursing Home brought to my attention the loneliness and pain shared by thousands of senior citizens as, instead of facing their last years surrounded and cared for by loved ones, they often live their final months isolated and afraid among near-strangers.

Of course, this is not always the case – every family’s circumstances are unique, and for many families, placing their parents in a nursing home is the only option. Some residents were visited weekly or even daily. But still, there was Ada, who silently wept day and night; Billie, who I found fumbling with the windows: “Gotta get out of here somehow”; and Ella, who listened to ancient family bluegrass recordings whenever she felt low.

There were some great moments, too: hearing about the years Ella worked in a glass factory; dancing with Berenice, who was convinced I was her granddaughter (from Greece); singing Disney themes with Ruby. But during my time at Fair Valley, I struggled to come to terms with the highly programmed atmosphere, where residents who didn’t especially like chirpy Bingo games or craft projects holed up in their rooms to watch TV or sat staring vacantly in the hallways and lobbies.

I wondered how this system of warehousing people who were no longer useful to society ever came to be acceptable, even normal. I questioned a business model that fired nurses who couldn’t work double shifts because they had children at home (then rehired them days later, desperate for staffing), that held other employees for more than fifty years at little more than minimum wage, that filled each wing with more residents than the CNAs could care for: in short, one that prioritized efficiency over care. I knew it wasn’t the staff: they’re some of the hardest-working, most dedicated people I’ve met. As an eighteen-year-old fresh out of high school, I was overwhelmed by the systemic injustices in just this one facility, and by my inability to fix any of it. When I left Fair Valley to begin college, I still hadn’t solved anyone’s problems, and the questions continued to rankle me.

Now, several years later, my work could hardly be more different, and has little to do with the healthcare field. But in the last month or two, my Fair Valley impasse came to mind again while I proofread articles for the Plough Quarterly. The current issue, titled “The Soul of Medicine,” tackles healthcare topics from the opioid crisis, CRISPR technologies, and compassion fatigue to mental illness, rural medicine, and euthanasia. In the blur of checking facts, requesting permissions, and hunting typos, one of the articles especially stuck with me and hinted at an answer to my questions: Mark Schloneger’s “Let Me Stand.”

Mark is a Mennonite pastor from Goshen, Indiana, whose adopted sister, Tricia, struggled with multiple addictions and eventually died from a heroin overdose. What I most appreciate from Mark’s essay about his sister’s life is his frankness as he outlines his own feelings of guilt for the times he tried to dissociate himself and his parents from Tricia, to prove that she wasn’t their fault. Several years ago, during one of Tricia’s stints in jail, Mark visited her in order to beg her forgiveness. He writes:

By appearances, I was a successful brother – a pastor – generously leaving his loving family to visit his failure sister – a felon – languishing again behind bars. In reality, our positions were reversed. She held all of the power, and I was afraid. I had no idea how she might respond.… We had never really talked on a deep level about anything, much less about how we had hurt each other.…
But then, with an aching lump in my throat, I choked into words the reason for my visit, spanning several decades of guilt. She listened as I asked for mercy. And then, she forgave me – immediately, completely, without minimizing my need. My sister, my confessor, granted me the absolution that she never fully knew.

In her fragility and brokenness, Tricia reminded me of Ada, Billie, and Ella– people who aren’t seen as “useful,” and who have been sidelined and forgotten as a result. What is the way forward? How can mere individuals change anything? Mark’s article gave me pause to consider how often I dissociate myself from those who are suffering, rather than standing up and struggling forward with them, in whatever form that takes. Thinking back to Fair Valley, I realized that maybe dancing with Berenice and singing with Ruby might in fact have been the best way to tackle those systemic injustices, even if it felt like a drop in the bucket.

For all those who’ve made it your life’s work to care for others, regardless of how thankless or frustrating the work might be, thank you. Your small services of love – an extra minute spent listening, a smile or joke, a hand on a shaking shoulder – are the real soul of medicine.

I only mentioned a handful of articles from the Plough Quarterly, but really, the whole issue is worth a read. If you like it, make sure to sign up for a free trial issue here.


About the author

Shana Goodwin

Shana Goodwin

Shana Goodwin works as an editor for the Bruderhof’s publishing house, Plough, and lives at the Fox Hill Community, with her...

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  • Thanks for the post! I enjoyed reading it as always. I like what you said about how unfortuanly efficiency can be prioritised over care. It makes me sad when people are forgotten for the sake of something other than what's best for them. It makes me more mindful of the people around me and how I can love them.

    Kristina Hartz