Peggy will soon publish her most recent scholarly article, entitled “Changing the paradigm: practical wisdom as true north in medical education”. It will appear in a special issue of the Journal of Medicine and Philosophy. In the article Peggy explores the intersection of neuroscience, philosophy, positive psychology, human factors research, and medicine. She has developed a new paradigm for medical education that brings practical wisdom back to the center of training doctors. She declares that doctoring is far more than having an expert grasp of knowledge and procedures. She claims, rightly, that being a doctor involves being a wise human being, someone who understands the nature of virtue, and makes the refinement of wisdom a lifelong practice.
Peggy’s scholarship does not need to be confined to medical education. Understanding a bit about practical wisdom, and the virtues that lead to wisdom, is good medicine for us all.
Wisdom is being able to do the right thing at the right time for the right reason. Wisdom may be difficult to fully define, but we know it when we see it. One of the essential components of wisdom is the virtue of compassion.
In her paper, Peggy is careful to unpack the differences between compassion and empathy, since they are often used interchangeably. We now know from neuroscience that they are widely different. Empathy involves our attempt to share another’s feelings. Compassion begins with an acknowledgment of the other’s feelings and adds the desire or intention to be helpful.
Writes Peggy, ”Understanding the differences between empathy and compassion in the neural-circuitry has important implications for training and practice. In a 2014 study, Klimecki et al. found that in response to videos depicting human suffering, empathy training… increased negative affect and brain activations in brain regions previously associated with… pain. In contrast, subsequent compassion training reversed the increase in negative affect and augmented self-reports of positive affect.”
Peggy continues, “Based on early evidence it is possible that our previous attempts to “teach” empathy might have backfired. By engaging the empathy circuit (located in the pain regions of the brain) without engaging the intention to be helpful, we may be leaving students in a state of vulnerability similar to their patients. Including an intention to be helpful, with the awareness of the other person’s circumstance, moves the experience from the pain circuitry to the reward circuitry.”
In other words, attempting to understand another person’s experience, partnered with the intention of being helpful, engages the reward center of our brain. Compassion, it turns out, is a scientifically proven, win-win virtue.
ALS has taken away my ability to do most things for myself. When people observe my limitations, they naturally offer to help. They hold the elevator door. They offer to cut my food. They ask to help Peggy transfer me from Jazzy into my favorite chair on the back porch.
People from all parts of my life often say, “Let me know if there’s anything I can do to help.”
Early on, I smiled and thanked folks for their kind offer. These days I am more inclined to ask what they might enjoy doing. People are truly eager to help, and each in their own way, people have been very kind. You might say they are offering me their compassion.
Neighbors now take care of getting the trash to and from the curb. A young man I have known since his baby was born and his best friend spent a Saturday morning assembling our new motorized bed. Another friend serves as my scribe so I can send personalized thank you notes to everyone who contributes to the Hummingbird Fund. Church friends drop off cut flowers in mason jars from their gardens. They bring homemade soup and ready-to-eat pasta from Whole Foods. Longtime friends have begun bringing the dinner party to us. Every act of kindness is a blessing.
This past March, William, Peggy, and I found ourselves at the South by Southwest Conference in Austin Texas. We joined many of our ALS friends for the screening of “No Ordinary Campaign”. This new award-winning documentary chronicles the lives of two former Obama staffers as they face the diagnosis of ALS. The staffers, Brian Wallach and his wife Sandra Abravaya created the revolutionary advocacy organization called I Am ALS. In a story for another blog post, Katie Couric signed on as one of the executive producers, and was scheduled to be one of the panelists after the screening. Katie reached out to Brian and Sandra a year ago. They became friends, and she offered to help. You might call this: Katie Couric Compassion.
While in Austin, it was our unexpected good fortune to be invited to a small reception prior to the screening, hosted by the Obama Foundation, primarily for people who had worked in the Obama White House. To say the least, this was a first for the Plews-Ogans.
We met Katie Couric while we each waited for the results of our covid tests. Katie casually introduced herself as Katie. She was as effervescent and authentic as you might imagine. We thanked her for becoming involved with the film, and her response was nothing less than gracious and humble. Katie smiled widely and said simply that she loves Brian and Sandra, and wants to do whatever she can to help.
Once inside Arlyn Studios we mingled a bit, found a beer, and in short order were asked to gather around an enormous concert grand piano. Soon, Rachel Platten and her percussionist were performing an intimate concert dedicated to Brian and Sandra. Rachel debuted songs from her newest album, and she sang songs especially for Brian and Sandra. Rachel’s music provides the soundtrack for “No Ordinary Campaign”, as a gift to the project. In her remarks during the concert she said she loves Brian and Sandra, and their two girls, and hopes to continue to do whatever she can to help. Here we have a fine example of Rachel Platten Compassion.
Like a small boat
On the ocean
sending big waves
Like how a single word
can make a heart open
I might only have one match
But I can make an explosion
(From Fight Song by R. Platton)
Shortly after Rachel had finished singing, and people in the audience had finished wiping away their tears, a number of Secret Service agents entered the room, followed by, none other than, President Barack Obama. Despite my limited mobility, I got to my feet, just like everyone else in the room.
The former president had flown to Austin that day solely to support Brian and Sandra. His remarks began with light-hearted remembrances of their time together on the campaign trail and throughout 8 years in the White House. President Obama reminded us that his administration had been one of hope, and fueled by young, idealist people like Brian and Sandra. As he spoke, the president’s remarks became more personal. He expressed his admiration and pride for Brian and Sandra’s accomplishments, and even more for the people they had become In the face of ALS. As he spoke, Barack Obama, the human being, stood next to Brian’s wheelchair, with his hand on Brian’s shoulder. Like the others, Barack Obama expressed authentic emotion when reflecting on Brian and Sandra’s life with ALS. Like the others, Barack Obama’s Compassion was manifest in a desire to help.
Sadly, ALS is a progressive, incurable, degenerative neuromuscular disease that will eventually cause every muscle in my body to stop working and become flaccid. Currently, I experience small daily losses in function, each with its own grief. ALS is a miserable disease, rife with grief, and learning to live with ALS means learning to integrate grief. Learning to integrate grief, for me, has meant learning to buoy grief with beauty.
My friend Nancy Galloway is an artist. Recently, during a small dinner party at our house, we found ourselves standing in front of one of my very favorite paintings. Nancy knew the artist and recognized the work. I told her the story of how I acquired the painting and how much I loved it. I mentioned that I have learned from contemplation to buoy grief with beauty.
The very next time Nancy came to dinner she surprised me with one of her paintings. I know this sounds corny, but It was love at first sight. I gushed and floundered for words like a teenager suddenly left alone with his secret crush. Thankfully, someone suggested I be specific about what I was seeing.
I realize today that this was my first invitation to give voice to my contemplative practice of buoying grief with beauty. I frankly do not remember precisely what I said on that evening when I first saw this painting. But I can offer my reflections now in gratitude for Nancy’s compassionate gift.
First, I see bold, fresh, exquisite color, in combination and in juxtaposition, making it impossible to look away. The teapot is extraordinary. The color of the object next to the teapot Is gorgeous and intriguing. Those sunflowers are real, and true. They convey the ordinary and ethereal connection to God’s creation.
Next, I am drawn to the geometric foundation of the piece. The lines and the corners and the spaces create the childlike comfort of a world making sense. Did you catch the image of a bird in the shadow of the teapot? This is an extra bonus, reminiscent of the hidden pictures puzzle, featured in the centerfold of the time-honored Highlights Magazine found in every pediatrician’s waiting room.
Then, there are the Curiosities. How did Nancy manage to create the water line in a clear vase? What is that beautiful object next to the teapot? Why do the sunflowers extend beyond the edge of the painting, and why do I love the fact that they do?
Finally, the subject of this beautiful art draws me in. I want to sit down at this table and continue the intimate conversation that started over a piece of cake and a cup of tea. I want to continue talking about the bliss of cradling a newborn baby. I want to carry on musing about our fantasy trip to Florence. Or, maybe we were sharing hushed stories of the last moments of life with our mothers. I want to nibble that cake and sip that tea and enjoy the silences between our words.
Do you see it? Nancy’s gift of compassion has become my inspiration for self-compassion.