C. P. Snow and the Two Cultures of Medicine and the Humanities

We’re very glad to see such a good turnout. I’m not quite sure whether it’s because of Dr. Sonnenberg or because

the subject is C.P. Snow, but anyway,

C.P. Snow himself participated in some of the early sessions of British studies.

This was back in the late 1970s when we used to meet over in the Mosley

ROOM. We were a much more cozy group then than we are now.

And we found C.P. Snow to be very congenial, very willing to purchase split and discussion, to take

criticism, to offer his own views. Colorful use.

Doug Marr remembers him because he always wore red socks to

the dean of undergraduate studies. Brant Iverson, was his bread here?

Well, you’re supposed to be introducing our speaker. So would you like to come up, Brant?

So many people know who Dr. Sonnenberg is.

How do people do not? OK. I would have to say that I’ve known Dr. Sonnenberg

for four years. So I think I know all of that.

He’s one of the most remarkable people I have met because of his breadth of the things that he does.

And he came to me as a dance school graduate, studies with a concept for a new bridging disciplines

program. The only problem with virtually everything he talked about, it had to be

created from scratch scraps and get a lot of input from a lot of different people and a lot of excitement from a lot

of different people. So I said, that sounds like a fantastic idea. I’ll help support your thinking.

No one human being can pull this off. And so Dr. Sonnenberg comes to us with

a credible background and Madison in psychology, but really

just in being our overall smart person. I don’t know how else to say it.

And what has been amazing to me, this one person has pulled together people from all over campus,

very indispensable programs for undergraduates that are thinking about how they’re going to combine

a liberal arts type of critical analysis and thinking with Madison. This is so long overdue.

And I’m completely indebted to Dr. Steinberg for being able to pull this off because it takes

a heroic effort. You have actually done this. And so we are about to see

this launch. It’s going to be coming very soon. And I don’t want to advertise that

program other than to say it was an amazing effort by somebody who I have incredible respect for.

So without it, by way of introduction. Thank you, Grant.

Thank you very much, worth of share for you.

Dr. Sonnenberg, thank you. And

thank you, Brant. That was really very kind of, you know, as usual, my wife

of 56 years has declined to attend

talk I’m giving because she’s heard it all so many times.

That’s the truth. And but now that this has been audiotaped,

I can make her listen to it. So this is good.

Now, I. Going gonna go very fast because I want to do this in 50

minutes is a lot to say. And there are people here

who I talk about and they may want to comment after

the talk is over. And we do want to have time for questions and answers. So

bear with me. I’m going to try to do this quickly in order to understand this talk.

You need to understand that there are five themes

or goals, all of which intersect. But I want to just tell you what each of them

is. So this will make sense to you. First of all, this talk is

based on a memoir. Now, the memoir has been a book that’s

been in gestation for more than a decade. It didn’t start out to be a memoir,

but I will on September the 23rd, I will be closer to my 80th

birthday than my seventy ninth. So I thought, OK, now’s the time.

I will I will do this memoir. The talk also

reflects a theme that runs through the history of psychoanalysis.

And also it could be called a personal autobiographical

oral narrative history. Now, in fact, from a psychoanalytic

perspective, those those two terms or the long description

and the term psychoanalytic are really synonymous. So just to put this in historical

perspective, one of Freud’s greatest discoveries came

as a result of his self-analysis. He had analyzed a woman

named Irma. It didn’t succeed. He met a colleague who

informed him that the patient who had finished the treatment against

his advice was not doing well, and he had a dream that is referred to in

the dream book. In the end, the interpretation of dreams

as the dream of Irma’s injection and Freud self analyzed

his own dream. And he used that self analysis to define what he considered

to be the purpose of dreams, which was to fulfill wishes. And he was very open

in the dream book. This is my dream. Someone who was less open, but also

autobiographical. Was Heintz cohort who really changed the direction

of psychoanalysis by inventing self psychology. Now, the reason

he invented it is he had had a very unsuccessful analysis with a very famous

analyst and he was not happy about it. He had become a major figure

in psychoanalytic thought, and eventually he wrote about and talked about

the second analysis of Mr. Z. Now, he didn’t explicitly

tell the world that he was Mr. Z, but in fact he was

Mr. C, and he had analyzed himself, engaged in a great deal of self-reflection

to create a healing narrative that had not been created in his first analysis.

These are just two examples. And many analysts will tell you that the greatest discoveries

in the field come from self-reflection. Certainly in

in a tradition of Plato and Socrates that Paul Woodroofe always

talks about. So you’re hearing something personal and

this is at least part of my discipline’s tradition. It’s also an intellectual

historical narrative because it really brings into focus

the power of an idea. Everything you will hear today

reflects the influence that CPS snowed had on me when

I was a junior and senior in college, which was right after his 1959

ready. lecture. There was a man at Princeton where I was an undergraduate, R.P.

Blackmer, a critic and a poet and super intellectual. And

he talked about snow all the time. Now, in my years at Princeton, the typical

pre-med did not major in science. For one one thing, there wasn’t nearly as much science

to learn as undergraduates as there is today. But in addition, we were really

encouraged to major in the humanities. So here we were,

about 100 young men in a class of 700, all men

about to embark on medical school. And we were hearing about C.P. Snow all the

time. And that certainly fit into the undergraduate tradition that I experienced at

Princeton. I majored in history.

So Snowe’s ideas were extremely important to me. They reinforced

ideas that I was experiencing all the time. And I’m going to talk more about that.

The notion that science and the humanities that scientists

and humanities scholars had to work together to solve the major problems of the world

was very clear to snow, and he particularly was concerned with

certain problems. He was concerned with disparities. He

was concerned with nuclear war. He was concerned with overpopulation.

He saw no way these could be solved if people from both fields couldn’t work

together in the sample evidence that he was right. Now, finally

or not, finally. But I also want to say that this talk is an educational commentary

because it shows the impact on me.

Of involved teachers and mentors. Encouraging

me to feel comfortable working on the cusp of my own discipline,

which I know, and other disciplines which I don’t. One of

the one of the things I think we are really emphasizing here

at Yuichi is encouraging students to be interdisciplinary.

And this was certainly, certainly something that you’re going to hear all about

today. And it’s certainly something that that is very, very important to me. On

a personal level as well as in my role as a teacher. So

and this kind of work really requires nurturance and mentoring.

And I’ll say more about that. But you’re going to hear about that. I also want to say one

other thing, too. Not not so much to the students, but to the the

older people in the room, many of whom are faculty members. I think at this

university, at its best, we mentor each other. We nurture each other. And I

think that’s how we learn. And there are people in this room who have done that for me,

and I hope I have reciprocated. So you’re going to hear about that in the talk.

And finally, this talk is about a naturalistic

experiment. Now, I am trained as a researcher, as

a as a quantitative researcher at the National Institute of Mental Health. But I have

chosen to do non quantitative research. I’m very interested in research

that that allows for the development of hypotheses and not and not just in the humanities,

but in the relationship of the humanities and the sciences within medicine.

So what what what writing this book and preparing this

lecture actually constitute is a naturalistic experiment

that leads to a kind of hypothesis which I hope we will test further.

And you’ll hear about that now. In order to understand

this, there’s a little bit of a prolog here.

First of all, I’m going to tell you the title of the book that

that that that began very differently, which is the really the

foundation of this talk. And this is the title Ten New Commandments

of Doctor Patient Communication and Health Care Practice.

And on a lighter note, the subtitle is A Doctor’s Adventure of Discovery

at an American Research University. And that is autobiographical. Now, when

Roger asked me to do this talk. He said, well, send me a blurb that we

can send out. Now, I want to read you the blurb that I sent to him. I think that’s,

again, going to be informative about what you’re hearing. My title

was R.P. Blackmer, C.P. Snow. And what I learned

after my sixty ninth birthday at the University of Texas at Austin.

And this was what my. Too many words. But

this is what I sent him. Steve Sonnenberg, a medical doctor, psychiatrist and psychoanalyst

who spent the last 10 years writing a book about health care as he has learned

more and more as a faculty member at our university, the structure of the book and its narrative

have changed. The book began as an issue of a psychoanalytic journal

when it was to be a collection of essays discussing how psycho and psychoanalysts make clinical

decisions. But I will describe how during this last

decade, I developed deeply important relationships with several U.T. faculty

members who influenced me to continuously and alternating Lee

look backwards and I mean backwards in time, forwards in time and

also inward and in the end. This book is

kind of a personal history, a memoir that traces the development

of my thinking about health care starting during my pre-medical studies.

Now I’m going to I don’t think I need to go on with

this description because I’m going to cover that

ground in the rest of the talk. But the the

description you got much shorter and I think less personal, but nevertheless,

it got you here. Well, you know that and I don’t I don’t need to.

Go over it. So now I want to issue an apology in advance.

Some of you came expecting a talk where I would mention C.P. Snow

over and over again. I actually think every word reflects

the influence that that had on me. And again, I want to. I wouldn’t really want to stress this.

The power of of an idea can be life changing. And this is something

that we can do for our students. And this is something that the students in the room

really should be looking for. Look for those. It doesn’t have to be a single text. But look

for those texts that change your life. And they do exist.

And the ready lecture is not very long changed mine.

So I said this is a net. This this memoir is a naturalistic

experiment and involves the breaking down of silos.

That’s possible at a research university like this where one

can find a great deal of nourishment and mentoring. And I can’t

emphasize how important that is. So the talk is about the

evolution of a book from a psychoanalytic decision

making issue of the journal into a book that

really talks about breaking silos and mentoring. So I was

on the editorial board of this journal. One of my former teachers was the editor

in chief. And he made the mistake of saying to me, I want you

to put together an issue of the book on psychoanalytic decision making.

I recruited 10 psychoanalysts to write essays and then I realized I

really didn’t want to edit that issue of the journal.

So I I passive aggressively let it lie long

enough because I knew that these people who had agreed to to write for

for me were very busy and they were going to pretty soon have other

things to do. And they were going to forget that that I even asked them, which none of them

did. But when I finally got around several years later is saying, well, are you still interested? I

breathe a sigh of relief when they said, no, no, not not anymore. I’m too busy.

And that allowed me then to reread crute, a different group. There were a couple from

the original group, and I’ll tell you later who they were. So

then. Again, the book, the talk,

the the the message I have is about

how to learn how to break barriers, how to break silos,

how to receive and give mentoring and the value of that in

promoting learning at the university. And

I’ve already mentioned C.P. Snow and his three great problems.

I just want you to keep that in mind. Disparities, overpopulation,

nuclear war. In nineteen

fifty nine, when I encountered snow,

there actually wasn’t a lot of talk in the academy about

working in more than one discipline. In fact,

the department’s system that we’re very familiar with for all of its strengths and all

of its weaknesses ruled the day. That’s the way people

operated. And there was this guy out

in California who would write on the American Psychoanalytic

Listserv about the value of working in two

disciplines, one of which was your area of expertise. The other of which

was something that you were just learning about. And you dared to declare

that you weren’t an expert in that other field and develop

a relationship with a text, with texts and learn.

And, you know, I think one of the interesting things about.

Knowing a scholar who who you have a personal

relationship with and whose work you then read creates

a very interesting experience in your own mind because

you actually have a conversation with that scholar. You don’t just read what she

wrote, what he wrote, what they wrote, you you read and you absorb

and you imagine a conversation that you’re having with that other person, with that nourishing

source. With that mentoring source. And you actually experience a conversation

as you study. And of course, if you’re here where we really do have a university

community, you even then have the advantage of going to that person and discussing

your ideas and discussing their ideas and developing together a new

set of ideas. And that kind of a dialectical process, that kind of an innovative,

creative process is extremely important and we need to do

more of it. And I will say that

the School of Undergraduate Studies and the bridging disciplines programs and

the signature course programs really speak to that in a very, very

special way. So.

On the Web site, Pilo Enberg wrote about how

new ideas emerged when people worked on the cusp

of two fields. That’s not my phrase. That’s his. And

I didn’t know him, but I decided I was going to get to know him

and as soon as I could, which was 2005 when a conference

on the relationship of architecture and psychoanalysis took place

here. And I’ll say more about that when I had the opportunity to work

on putting that conference together. I. I saw it. I

made sure that he was one of the invitees and one of the

invitees to write an essay in the book when I

reconfigured it. Now.

Let me let me tell you

about the memoir again. It’s

it’s not a typical memoir. First of all, there

are 10 essays by eleven really, really generous

contributors, one of whom is as is louis’

and. I’m going to say something about

Louise’s contribution. Louise Weinberg’s contribution in a little while.

But in order to understand my relationship to C.P. Snow,

my relationship to this book as it evolved, this

a typical memoir which includes 10 contributions from eleven other people.

I want you to I want to read to you a letter that I wrote to

President Fenris and Provost McGinness at the time of the Fine Arts

Library crisis. Now, who here knows about the

fine art? Who here doesn’t know about the fine arts library crisis? Oh, well,

I will tell you about the fine arts library crisis.

One day. People on the faculty became aware

that a proposal was made to ship a large number

of fabulous fine arts volumes to a depository

somewhere near College Station. Students would be able to get them.

They simply would have to say that they wanted them and request

them, then presumably within a week or so they would get them. Now,

you know, I don’t know if anybody here is in our history, Major, but can

you imagine what is lost when an art history major doesn’t have access

to stacks filled with books, with buit with beautiful images in them? And

that student can’t go through those stacks and have adventures of discovery all

the time? No, I have to know what I want and I have to ask for it. Well, so

Steve Hall sure was the chairman of American Studies at the time. And

he he and I had gotten to know each other and I had become an affiliate member of his faculty.

And I discussed an idea I had with him because they were soliciting letters from faculty

members to protest this. And when when Steven I talked,

he said, you know, write that and and we’ll see what we’ll decide

to do with it. And what he decided to do was to have me send it to the president and to the provost,

along with with other letters. But I think this says a lot about C.P.

Snow and me. And some very, very

nurturant, nourishing, nourishing mentors that I had as an undergraduate.

Here’s the letter I’m writing because my own life was changed by an experience with a real book

which I read, held, touched and looked at repeatedly and related

to so magically, viscerally. So already, you know, you should be able

here in this if you’re a doctor. You would be sure of it. When I start talking

about the visceral and the somatic, I’m talking about medical science. And when I talk about

the experience of reading, I’m talking about something that has more to do with the mind and the brain.

That’s where the humanities come in. When I learned of the effort to remove

books from the Fine Arts Library and store them in an off campus location, I felt concern.

As an undergraduate, I explored the open stacks of my university’s library, pulled books

off the shelves, had unexpected adventures with them and discovered so much about

the world in myself. I was also motivated by that experience to purchase

hard copies of many books so I could hold them and read them without concern

for a library return date. And marked them up now. One adventure

stands out. I was 20 years old when I first read Melville

and I was privileged to have as my professor, the legendary Larry Holland.

He was my lecturer and he was my seminar teacher. The course I was taking

was very advanced undergraduate English majors. It was like organic chemistry for

pre-medical students. It was the one you took to prove you were on the right track

if you aspired to a career as a literary scholar. And parenthetically, one of my

classmates became the chair of the English Department at Harvard. I don’t think he got an A in the course.

I think he got an A-minus. It was a really tough course.

So I was a history major and a pre-med as well. And I hadn’t taken

an English course since I studied Shakespeare under the guidance of Alan

Downer as a freshman. And one good friend who went on to a very distinguished career as

a Victorian scholar dared me to take the course. And I think that propelled me to do it

now in the book. I may say a little bit more about. There may be people in this room who know

him. And he was always very arrogant. And so, you know, he dared me and well,

what could I do? You know, I took the course, but he did have. He’s retired

now, a very, very distinguished career. Under Howard’s instruction, I became passionate

about Faulkner, James Twain and Melville and explored the library stacks

focusing on that, on those four writers being and the thoughtful reader.

I purchased many books so I can own them and mark them up when it came to

write the major essay that the course being a slow reader. I chose a short

story Melville’s Bartleby the Scrivener. As time passed,

I really dug into that story, turning pages forward and back,

reading sentences over and over, trying to figure out what it was

about. In those days and this was spring semester 1961,

my last in college students like me and I was not unique in my class.

We were like this. We did not run to the summaries of literature that might have been

available. We tried to come up with unique perspectives on what we were reading.

I wrote a first draft of an essay about the story, but even with Holland’s

critique of my draft, I felt lost. In fact, I believe

Holland wanted me to feel lost because he was at odds with Laurence Thompson,

his respected English department colleague and friend, over the nature of Melville’s

view of God. I think Colin wanted all his students to feel

confused by competing theories about Melville and develop their own points

of view. But as I work to understand Bartleby, I didn’t know that, at least

not until the close to the close to the very end of my effort.

So I remember looking at the increasingly grimy pages of my edition of Melville

short stories. The color changed by the sweat and dirt

that came off my fingers as I worked and reworked the story.

What I recall is that at a certain point in time, looking at the top margin

of a page, I saw the word job.

I was young and not all that self-reflective.

He knows something about me. I was a rugby player

and I. I didn’t ask myself how that form of visual

imagining had occurred. But while I knew that word was not printed

on the page in ink, but rather by my mind, I simply directly

and enthusiastically embraced what I had seen and started to think about what it meant.

Now I have to also emphasized that before college I had not spent a lot of time

studying the Old and New Testaments, and until just then I hadn’t thought at all about

the book of Jobe. That is, I want to emphasize until then,

and I really ran with Jobe and Job. I knew Melville

was very engaged in inquiry about the nature of God and that Holland was engaged

in an inquiry exploring just what Melville thought about God.

At that point I went to my friend, the future Victorian scholar, feeling I had

something to discuss with him. And we talked about Melville. Bartleby, Thompson,

Holland and the competing views of two distinguished professor at two distinguished

professors held regarding Melville’s views on God. I wrote my

paper and received very warm praise from Holland for my own

inquiry about what the story might tell us about Melville’s view of God.

Holland appreciated how I had focused on a concrete aspect of the short story

a person’s refusal to do his job. He appreciated how, from

there I inferred another dimension of the story its relationship to the Book

of Job. Even more importantly, this experience intellectual and

tactile, somatic, visceral. I’d say this

neurological. This allowed me to make a career decision. I decided I wanted

to go to medical school because I had learned something about physical human experience

handling that book over and over again. There was something I

wanted to learn about the human body and what it can teach us. I came to think

that there was a relationship between mind, brain and body that I wanted to explore.

I wanted to know more about how my own mind and body had work to create that experience

with a book that appearance of a word on a page I was touching and

looking at. That told me so much about a short story. The next year I started

medical school and discovered psychiatry in psychoanalysis. I realized that I

had a special attraction to words and they’re different, often hidden meanings.

These words might come in the form of free associations by a patient in psychoanalysis

or in the form of what a participant observer might generate as an imaginary capital.

J. Became a lowercase J. And then back again in my mind’s eye,

removing books and placing them in the depository and depriving students of the opportunity

to handle them is throwing out the baby with the bathwater looked at within the framework

of a research university. I personally think it is almost like burning books.

It is disrespectful of the art and craft of writing and creating a book and using

it in the service of scholarship and teaching. Finally, for the record,

I appreciate the value of the computer because they wanted to digitalize all these books.

I know it is very useful in academic teambuilding. I know it has many

advantages as a tool in the hands of scholars who perform valuable

research and teach and students who learn. I know did utilizing books,

photographs, paintings has enormous value today. In fact,

it allowed me to download Bartleby the Scrivener and run a word check

just to be sure. Neither job nor Jobe appears

in the text. And then there was a if I can be of further service.

Now, if you can’t hear snow in that

and appreciate that now at nearly 80,

then at nearly 21, that those ideas

really were were formative, foundational

in my thinking and in the way I’ve lived my life. And I’m talking here about

the way I live my life on this campus. But it’s also the way

I live my personal life. Now, I want

to talk here about catalyst’s and enzymes.

I wasn’t sure you were going to come, but I figured, you know. So I’m going to tell you about three,

actually. You know? I actually think they’re enzymes, not

catalyst’s. I mean, the enzymes have a catalytic function, but

they’re different. So I know a little science. I’m going to

be careful. And I know I’m going to get graded on this. So I’m I’m trying very hard.

First, Elizabeth danzy, who is the interim dean of the School of Architecture, who would be here, but

she’s with students in Europe. She and I met because I

was submitting an essay to a book in psychoanalytic annual volume that she was guest

editing. And we conceived of the Space in Mind conference

in into 0 5. We the conference was held in 2 0 7. And

eventually we created space and psyche, which Fritz

Steiner, the former dean of the School of Architecture, says is the most says it is the most beautiful

book he has ever seen. And I’m just telling you that I’m very proud of it. And

I’m very proud of the work Elizabeth and I did together. And she was the enzyme,

the the the book. I was responsible for the text. She

was responsible for the images. And we work together. And it’s won several awards, especially because

of its design. But we did something else that was particularly unique. We encountered

the model of development, Erick Erickson, who’d been analyzed by Anna

Freud. He had no p_h_d_ a fact he’d only gone to school. I think is a Montessori

teacher, but he was a professor at Harvard and an Erickson

had created this model of human development. And he himself said

this shouldn’t just be two dimensional on the printed page. But it was

so Elizabeth and I decided we were going to create a three dimensional models so we could better appreciate

the relationship of development at different stages of life over

time. And if you can just imagine a three dimensional model, it really

it really depicts time in a way that you can see in a very concrete

way. So we thought we could do this in two weeks. It took us three years, but

we did eventually presented it some scientific meetings. We got an eye Arby approval to use

it in working with students at the university to assess their own development in the course

of courses we were teaching together. And and the article

about it was published that we wrote, which was published in the Journal of the American Psychoanalytic Association.

But during that process, I realized something more vividly than I ever had before.

That I had been trained to think in very linear,

exclusively linear ways by various authoritarian

teachers using a very positive list, almost 19th

century model, and that hadn’t changed much. When I was learning to be a psychoanalyst,

when I was learning to be a doctor, and I if we had two hours, I could give you some vivid

illustrations. And what my relationship with Elizabeth did,

and this is really remarkable. It changed the way I saw it.

Because she taught me to to think. In relationship to time

in different ways, and I have to use spatial models

to describe this process. She taught me to think in circles.

She taught me to think in in in spheres. She

taught me to think in swirls. She taught me to think like a helix and not a

straight line. Just to put this into perspective,

I was finishing college and starting medical school

when Watson and Crick told us about the structure of

DNA, the double helix. And I can tell you that the notion

of a double helix was was all abroad.

Was was greeted with wonder and all by people in science.

By the way, just for the record, and I can’t remember her name, but they never gave

credit to the woman they worked with. Who was it? Who was it?

Yeah. Thank you. And of course, they wouldn’t have done it without her, and I would

not think this way were not for Elizabeth. But I mean,

we were wowed by the idea of the double helix.

And that, I think, speaks to the fact that we were really trained to think so linearly. And

that has its disadvantages. It’s it is it’s restrictive. And

if this lecture seems to be moving around in different directions, I hope it doesn’t.

But it’s because I don’t think as linear as linearly

as I used to that I have more than one way of thinking. Now, I also want to talk about

somebody who’s in the room. And I will not embarrass you, Pauline. But Polly Strong,

the director of the Humanities Institute and a very, very distinguished cultural

anthropologist and expert in Native Americans and women and gender studies,

took me under her wing. I was at first a guest fellow at the Humanities Institute because

I had an appointment at Baylor Medical College. And eventually our relationship

grew and I became the first fellow in residence in the Humanities Institute.

And I’ll tell you what you taught me, Polly, because you are a consummate

scholar, but you are also a public intellectual.

You are a very committed person committed to using your knowledge,

not just to write a wonderful book that I know that I’ve read, but but also

to change the world. Now, psychoanalysis, even though Freud, of course, was

very much attention getter, psychoanalysis

taught us that we shouldn’t even give a talk to the PTA.

We were supposed to be anonymous. We were supposed to be very secretive behind

a screen. So and that was my field and that’s how I was trained.

And since I was trained to think in very linear ways, I certainly didn’t think about

having a major influence, major public presence. But

in the in the seminar and Dave Edwards was there, we studied intellectual life at moments

of crisis. And I actually learned that there was such a thing as a public

intellectual sub. Subsequently, I learned there was such a thing as medical humanities.

And actually, as a result of all this, Art Markman once came up to me and said,

you know, you have a life’s work and your life’s work is to blend humanities and science,

to fix a broken health care system and teach this to the next generation of

of of future health care providers. And this is all part of the Yuichi

community. So, Polly, I realized that I had been working in

medical humanities for decades, that the field had no name. There was no organization

to bring us together. But a long, long time ago, I wrote a paper

pointing out that Hamlet did not suffer from an edit this complex. He had post-traumatic

stress disorder. This this was this was heresy. But of course, I was right

as he did not. Not not always. But that time. So thank you, Polly.

And finally, Brant Iverson, who really is an

educational visionary. And I will tell you that, you know, you talk about how sometimes

I’m walking around that track late at night all by myself. Well, you’ve

been my partner, and that is very important to me. And that’s mentoring.

So the book, The Talk, all of this is

about culture at the university. A culture that produces

ideas. Now.

I’m going to lie. I can’t do all this. What I’m going to tell you is, is

that I have come up. As a result of those essays,

those 10 essays with 10 new commandments

of patient doctor communication and health care practice,

now only one person who submitted an essay has been exposed

to the way I used their essay because it’s not what they intended.

And that’s Mike Starr Byrd, who I happened to see at lunch today. Not entirely

by chance. And because we’re on a committee together and along with with the British studies lunch.

That committee was meeting. So I popped over there at the end and figured I’d better get an

idea about how Stauber would feel about what I did with his essay. And he he he thought

it was OK. So I’m just gonna talk about Louise Weinberg’s essay.

Now by the book, you

can read all about all of them. But I’ll tell you about Louise. Louise

has a secret ambition. I know this. She really wants to be a mystery

writer. You

won’t deny that, will you? And she wrote a wonderful,

wonderful paper for this book, which I was supposed

to use to talk about decision making in

different fields. And she talked about Supreme

Court Judge Justice McReynolds, who was a cantankerous guy.

And and he he did he made a decision that nobody could

understand. It was a mystery. But Louise

solved the mystery in this paper. Now, I also, by the way, happen to have used

Sherlock Holmes in one of my medical humanities papers to talk about high functioning addicts.

CONAN Doyle also was a mystery writer

and a doctor. And so I you know, I am very interested

in mysteries. But here’s the seventh commandment of doctor patient communication

and health care practice. Investigate a mystery.

Every clinical encounter is a mystery. Every patient is

hard to understand. Empathy is a skill which must be continuously

practiced and honed in every clinical encounter.

You must see yourself as an explorer of new territory.

Can you put up with that, Louise? Thank you.

Well, that’s what I did with the nine other essays, too, so I’m going to bring this to

a close because I’ve actually got about four minutes.

Now let’s go back to snow. And by the way, you were

promised that I would tell you about how psychoanalysts thought and made decisions. And what I’ve tried to convey

is that they were by the book. They were linear. There were rules

of engagement. And I can tell you, the contemptuous exchanges

that I have witnessed take place between two psychoanalysts who had slightly

different basic orientations arguing about why one

was blasphemous because she broke the rule. And this

is not a great way to conduct intellectual discourse, but that

that that’s how I was trained. So.

When Snow spoke of the two cultures and the world’s great problems.

He listed, as I’ve said, disparities, overpopulation and nuclear war.

He suggested that scientists and humanities scholars need to work and think

together. I would add there are two more threats.

Two more huge problems, and one is

global health as a human right. There’s no there’s no such thing anymore

as local health. It’s all global. Germs fly on

planes and. If we don’t recognize

that health is a human right and make sure that everybody has

it, we are endangering the species, that may be an exaggeration. I’m not sure.

Maybe Jeremy, sorry, will tell us at the end whether that’s an exaggeration.

And the other great, great challenge is climate change. So we’ve got five now.

Now my experience obviously is much more mundane. But it does add a dimension,

and it is when a scholar in a particular field, humanities

or sciences. Reads in another field,

especially when he or she knows the creator.

Of the idea that she or he is studying

and can imaginatively elaborate on that text. Have a conversation with

that colleague. In one’s mind, imagine it. Think about

it. And then, of course, go to that colleague and talk about one’s ideas.

New ideas can emerge, unique ideas can emerge. This

is this is a more mundane version of what Snow was writing

about with a broad, much broader brush. And given what I’ve told you about the

authoritarian, linear, linear thinking in medicine, in psychoanalysis,

what you’ve heard is how new ideas that involve non-linear

thinking. Can emerge when silos are broken

down and mentoring occurs. So, Louise, you may

think, well, you know, we’ve had dinner together many times. You didn’t know you were mentoring me, but I was trying

to soak it in and hopefully I was successful. And

I say it’s non linear thinking because I am preoccupied with the health care crisis.

But why? When I’m reading her essay, if I’m reading it in a more conventional way, am I

going to translate that into something about how I think, how I deal with patients

and that I would call kind of think of as as thinking in

a swirl. Also, the

speak to one of Snow’s great problems.

Disparities. What snow refer to as disparities,

and today we can say good health.

Good, good health and health care as a human right is a fourth.

We can say that we can combine the notion of disparities

and health as a human right and recognize that we have

a tremendous crisis because of health care disparities.

So if we’re going to think about health as a human right, we have to think about health care disparities both

on and on the national level and on on the local level. And so that’s

a concrete contribution. And I do believe it, again, reflects Snowe’s

influence. And finally, I think the project that I’m talking about, the

book, has added another possibility to what can emerge from breaking down silos

and unexpected. So, Madoc.

On it. I’m sorry. An unexpected, unanticipated possibility,

but really a predictable possibility. With snow in mind, the idea

that new perspectives emerge from working on the cusp

of two disciplines or three or four and having the humility

to work in a discipline where you aren’t an expert. So I want to close

by thanking Roger, who really? We met a year and a half ago and he’s been very

kind to me and I thank you for giving me this opportunity. And they also want to mention Zachary

surgery now a little while ago. Jeremy Saari

invited me to talk about health care at his on his podcast.

And I had met Zachary, but I didn’t know he was a poet.

And at the at the podcast every week, Zachary writes a poem.

He’s 14 years old and he really is good. So

just. And at the podcast, his his poem really became

the the theme of what I had to say. So by chance,

unless you believe in a higher power. This very day,

I received another poem by Zachary. Sorry

about. Our problem with guns and

killings. A great poem. I think

in commenting on this lecture, Jeremy, I’d be interested

to know if you agree with the speculation of mine.

I think you’ve managed to. You and Alison have managed to raise

Zachary. Thinking out of the box, not thinking

linearly, I doubt as smart as you both are that you are.

You deal with him in an authoritarian or positive fashion. I suspect

you really give him a lot of space to grow and a lot of mentoring and a lot of love. And I think

that’s what we all have to do here at the university with each other and with

our students. So thank you.