In Quest of Profound Courtesy: A Chaplain Enters the Anatomy Lab
by Donald G. Shockley
Dr. Shockley is university chaplain at Emory University in Atlanta. This article appeared in the Christian Century, September 24, 1986, p. 808. Copyright by the Christian Century Foundation and used by permission. Current articles and subscription information can be found atwww.christiancentury.org. This material was prepared for Religion Online by Ted & Winnie Brock.
When the Emory University School of Medicine opened for the fall term, I was in the survey course in human anatomy -- for the seventh time. By the end of the term, I still won’t be able to answer any of the questions on the first quiz. My attention is focused on the human spirit, not the human body, for I am attending not as a medical student but as a campus minister.
My presence in the anatomy course is the result of a promise I made to myself when I became university chaplain in 1979. As a veteran of ministry, I knew that routine chores could quickly fill my time. I was determined to shape my ministry by a process of listening, which would enable me to identify felt needs rather than impose an agenda on others. As it turned out, I did not have to wait long for the listening to begin.
Among the first students to visit me was a beginning medical student who had graduated from seminary the previous spring. He had some important things to say and I listened eagerly. He told me that he and his classmates had begun to dissect human bodies on their first day of medical school and that the experience had produced strong emotions which had no outlet.
It was not just the firsthand encounter with the coldness and finality of death that was unsettling, although that alone could be disturbing enough. Students were also concerned with how they felt about how they felt. "If this experience bothers me so much," some wondered, "should I even be in medical school?" After all the students had achieved and endured to get where they were, such a question is troublesome indeed.
Dissecting the human body is not pleasant work, and it teaches students right away that much of what physicians do in a normal day is not altogether pleasant. Heretofore, perhaps, students have thought only of the glamour, the power, the science, the adventure and the rewards of medicine. But now the students must wonder how they will cope with the seamier side of medical practice, the blood and gore and uncertainty and frustration. And later, after the first few days in the lab, the students may be surprised at how quickly they have adapted to working with cadavers. The question that often arises next is, "Will I also insulate myself from the pain of my patients, and come to see them as so much plumbing and chemistry, not as persons?"
This theologically trained medical student and I were not concerned about medical ethics, as important as they are, but about the personal dimensions of medical education and the long-term personal consequences of that experience. We decided to propose that the first-year medical class plan a completely voluntary liturgy of some sort to be presented at the conclusion of the course. We envisioned the liturgy as providing something like a rite of passage for the students, a kind of leave-taking from an extraordinary experience, a corporate act of closure. The service would be designed to bring to consciousness the feelings it had been necessary to suppress in order to get on with the course. And the controlling theme of the event would be the expression of gratitude to the people who had donated their bodies to medicine.
To be effective, such an event needed the support of the faculty members involved. A meeting was arranged with the chairman and key members of the department, at which we described our concerns and what we wanted to do. I am somewhat embarrassed to admit that I did not expect the medical school faculty to be quite so open to the concerns that I brought to them as a university chaplain. I realize now that professional reticence was my problem. Before we were finished that day, I had an invitation to speak to the next entering class prior to their encounter with the cadavers. Furthermore, it was agreed that my presence in the labs on a regular basis would be useful and would help us to integrate the planning of the service with the educational process. I would also have the opportunity to get to know every medical student. Suddenly, I was given occasions for ministry that I had never imagined possible.
In the six years since that conversation, more than 600 medical students have participated in "A Service of Reflection and Gratitude’’ at the conclusion of the human anatomy course. The hours I spend with the students, in class and out, continue to teach me important things. I want to draw from this highly specialized experience some insights that are relevant to ministry in general and campus ministry in particular.
My experience with first-year medical students has taught me that what makes a good poet and physician also makes a good minister. My weekly visits to the dissection labs were very difficult the first few years, primarily because my role in the situation was not clearly defined. Eventually, however, I understood that this was more problematic for me than for others. I felt I should be doing something, but for the students my being there was what counted. Now I know that creative ministry must pass through a zone of professional uncertainty where one relies on the most primitive pastoral instincts: watching and listening.
My experience in the anatomy lab has made me reconsider the lampooned notion of "the ministry of presence." Many will remember the time, not so long ago, when campus ministers said they did not need an office, just a place to hang their coats. We were not into program development and poster printing; instead, we would spend our time creatively hanging out in the coffee shops and student centers. We would simply be present. The truth is that the primary motive behind the ministry of presence is essential to campus ministry and probably to all other forms of ministry. By itself, it is not enough of a ministry, but without it, nothing else is enough either.
Many times I am tempted to skip the weekly visit to the labs. There are reports to write, budgets to balance, sermons to prepare, appointments to keep. But then I remember a student saying to me, "It is important just to look up from the dissecting table and see that you are there. It helps." And after those occasions when I have not shown up, a student will say something like, "Welcome back."
Ministers, especially campus ministers, often try to minimize the significance of their ordination, and rightly so. We do not want to be seen as a separate breed, set apart, unapproachable. But the office of ministry is extremely important, perhaps more so to others than to ourselves. Like it or not, we carry what has been called "the burden of the Lord." Whether that burden is easy and its yoke light depends upon how one chooses to carry it, but carry it one must.
Just at that point in the term when the academic pressures seem unbearable, around 20 per cent of the first-year medical students volunteer to plan the service. They are Christians and Jews of several varieties, an occasional Muslim, and religiously unaffiliated and nonreligious persons. They plan a service that is broadly inclusive and that calls for the active participation of faculty and students. Singers, instrumentalists and poets emerge in the process, and their shared gifts are crucial to the experience. When the day finally arrives, virtually everyone associated with the course attends the service: students, faculty, technical staff, secretaries and administrators. When people elect to become body donors, they give the last gift of which they are capable, and they do so for the benefit of persons they will never see. Our collective response of gratitude is a deeply spiritual experience that transcends all humanly contrived barriers among us.
In those high moments, it seems natural to hope that, as their careers develop, these young physicians will discover the true meaning of charity and therefore come to understand what the word "profession" is supposed to signify. Richard Selzer, that most articulate of surgeons, says that such realization comes, if at all, only after one has dressed wounds without number and touched countless sores, ulcers and cavities for the sake of healing:
In the beginning it is barely audible, a whisper, as from many mouths. Slowly it gathers, rises from the streaming flesh until, at last, it is a pure CALLING -- an exclusive sound, like the cry of certain solitary birds -- telling that out of the resonance between the sick man and the one who tends him there may spring that profound courtesy that the religious call Love [Mortal Lessons: Notes on the Art of Surgery (Simon & Schuster, 1976) , pp. 47-48].
One may not hear that pure sound in the beginning anatomy course, but it is not too soon to learn how to listen.
My experience in the course suggests that the world is far more ready to receive our ministry than we are to offer it. Ministry is too often diminished by ministers’ reluctance to go where we fear we will not be well received. I know that a lot of doors are closed to campus ministers only because they do not have the audacity to approach them and knock.
Our reluctance betrays an insufficient confidence in the grace of God, mysteriously present in all situations. The key is to put oneself in an unfamiliar environment and muster the courage to wait, watching and listening intently all the while. Once we have mastered the impulse to explain ourselves, someone will help us understand why our presence matters. Then will come the surprise, the gratitude and, eventually, the profound courtesy.