One of my best friends rotated through a cardiac intensive care unit during residency. On rounds one morning, he was discussing the problems of a patient who had an infection, in addition to his heart troubles. The attending cardiologist stopped him, raising one finger in the air, and then motioned across his chest with his hands, as if to make a little frame around the heart. This was the cardiac ICU, and if there was a problem with an infection, the residents could clearly solve it themselves or call in an infectious disease specialist.
This didn’t sit well with me at all. Healing was supposed to be complete healing, healing of the soul and healing of the body. It wasn’t supposed to be tweaking the dials on different organ systems, so separate from one another that they may as well have been different people. And sometimes the focus wasn’t even on individual organs, but on processes taking place at a molecular level so far removed from the human scale that I couldn’t even recognize them as such. People didn’t seem like people; everything was programmed into their genetic code, reduced to numbers. I was learning that there was no room for the soul in the medicine.
Even in psychiatry, “the doctoring of the soul,” this reductionist approach holds sway. We manipulate the serotonin receptor, the dopamine receptor, and the norepinephrine receptor in the brain, so that we can relieve depression, quell anxiety, and quiet the voices in people’s heads. This is as close to the soul as we get.
Psychiatrists, in most settings, no longer have couches, no longer ask people about their earliest memories of their mothers, and no longer sit silently for hours waiting for the patient to get to the point. My father-in-law, a psychiatrist who actually spends an unusually long time talking with most of his patients, once said to me, “Every time we discover something really good, the neurologists take it over.” It was all about the brain, not the soul.</p
Until intern year. Every intern has a “first night on call” story. Mine was spent squeezing breath into the lungs of a very gray-looking premature baby, just delivered and not engaging in “lusty, vigorous crying.” Her APGAR score was a 1 (normal babies are usually a nine, out of a possible 10, and nobody is supposed to get a 10). So, the first things past her newborn lips were not a breast or even a bottle but a metal laryngoscope and a plastic endotracheal tube, through which I spent the next five minutes squeezing air, and then color, and ultimately life into this tiny little girl. Adam was created this way, with God breathing life into a body fashioned out of dust as gray and lifeless as that baby was before we pumped her pink with an Ambu bag. Breath is life, so much so that even in this era of life-saving technology and brain death criteria, a call from my answering service to alert me of a death still says “CTB”—ceased to breathe. Breath is soul, so much so that the two words in Hebrew are identical save for one vowel sound. And soul is the kiss of God, the thing that takes dust, matter, flesh—and turns them into something Divine.
