Re-imagining Our Mortal Stuff: Finding Dignity Amongst the Matter of You (And Me)

By Bernard Leuthart

Wise man lookin’ in a blade of grass

Young man lookin’ in the shadows that pass

Poor man lookin’ through painted glass

For dignity.

 

Sick man lookin’ for the doctor’s cure

Lookin’ at his hands for the lines that were,

And into every masterpiece of literature

For dignity.

                        ~Bob Dylan

“Don’t go all timid on me, now! We’re only just getting to know where we are both going here and we ain’t there yet. Look, take my pulse. I know you are gonna work me out.” (Juanita J.) 

When I met Juanita early in my medical novitiate, I was terrified. Juanita was a Texan with Texan self-assurance and a state-sized understanding of her own diagnoses and the appropriate ways to keep her well. This had me on the back foot: she would tell me so kindly what was going on and what was to be done to hand her back to herself. But the gift with which she dignified my learning, ostensibly allowing me to do the doctoring, was her coming often to consult me and her ability to invite me into the personal space of her relapsing, remitting, interminable suffering. She got me amongst her stuff. When she died, I felt broken at the loss of that element of love that revealed more in me than I could reveal or heal in her. 

Generalists spend a great deal of time building their catalogue - episode after episode of care and delving into problems forming the skeleton of learning that informs the next consultation and the next. But Juanita had assisted me to something different, unfolding a map of possibility between us which pointed more to encounter than perfect solutions. 

Hungarian poet Miroslav Holub writes eloquently of a detachment of personnel sent into the Alps by an officer. Heavy snow falls and the landscape is obliterated. The group does not return. Seemingly, they have been sent to their deaths and their officer feels deep remorse. As if by some miracle, the group emerges unscathed three days later. How was it possible, they are asked. Admitting their initial despair, one of the number explains how he reached into his pocket and produced a map. Using this map, after the worst of the storm, they found their way out. On inspection of the remarkable map, it is discovered that it is not a map of the Alps, but of the Pyrenees

Taking this illustration, religious educator Maria Harris, whose work has had a profound influence on my role in general practice, makes the point that imagination brought to bear on our engagements has a power similar to the map of the Pyrenees. It has a prospective and explorative quality which can open possibility1 and delve down into the dignity dwelling at the heart of our encounters. And at this core is mortal matter - our frail human stuff that seeks the kind of transformation that can point us, we can imagine, towards the divine. 

Engagement that sets out on this footing, that cleaves to a disposition for encounter, can’t help but engender dignity. It invites quite naturally an emptying of the subjective ego and an imaginative opening of ourselves to the person present there. It recognises something between subjects (the subjects you and me and the subject matter) that perhaps approaches reverence; what Martin Buber refers to as perceiving ‘a thou’ there. It establishes, re-imagines and re-forms the covenant potentiated between each other there, through which trust comes and grace is allowed to work. 

I am reminded of a recent audience with 102 year-old Ken, in the locked dementia unit, who, across a corridor, beams his appreciation to the nurse who has just kissed his head and told him he is amazing. Grinning, he draws a harmonica from his pocket and plays for her and me a jaunty hornpipe. His dignity is renewed there. And, irrefutably, ours is too. 

Dignity emerges when, despite differentials of power, knowledge, mobility or well-being between us, we are both disposed to accompanying the other and making space for the other, especially when the matter is unwieldy and the outcomes elusive. The doctor and the patient, in a very real way, are tasked with making the stuff between them ‘something other’. We are, I believe, in our medical or ordinary encounters that matter, to become witnesses together to something being made holy: our frail human stuff dignified by a redemptive transaction that, as bioethicist Dr Michael McCabe has put it, “joins the dots on grace.” 

Attending to engagement, grounding ourselves, as Juanita did, in a disposition for encounter and rooting out the deep dignity made mutual there, can unfold the map on us. It can bring us to the transcendent value of human heartedness that helps us into gratitude and a eucharistic kind of openness to real presence in each other. It’s the matter of you and me. Bigger than Texas

Dr Bernard Leuthart is Clinical Director at Waiwhetu Medical Group in Lower Hutt. 

Endnotes: 

1. Harris. M. Teaching and Religious Imagination. 1987. Harper and Row, San Francisco.