While having a “sit-down-family-meal” with a son and his family over the recent holiday weekend–something that happens far too infrequently in families today—our six-year-old grandson attempted to leave the table during the post-meal conversations but was restrained by his mother. “Conversations are boring,” was his frustrated response to his unpleasant imprisonment. His response brought to mind a similar attitude in another 10-year-old grandson who refuses to talk on the phone—he will only text, because “talking is boring.” This appears to be a disturbing mark of the future generation, a generation that cannot and will not converse but only connect using sound-bites, ungrammatical phrases, and acronyms. One can only wonder: what will their future relationships be like?
This generation has more opportunities for communication than any in the history of the world, yet this communication lacks authenticity, for there is no sense of communing in such interactions, no sharing of stories or stepping into the story of another. There are faces and images, but no conversations–and no stories.
But we are a storied people. Whether that story is individual or corporate, stories are vital to who we are as individuals and as a society. Stories do more than simply recount—they create identities and engender meaning. It is stories that give meaning to our lives, for without stories there is no meaning.
As social beings, our personal identity is forged in the perichoretic dance of selfhood, a reciprocal encounter of the self and the other (and of course, for Christians, that ultimate Other is God). Our storied lives cannot be disentangled from the stories of others for our sense of self is determined by our narrative interaction with and response to the other–our self-understanding is shaped by our encounter with the stories of others.
This is no less true in medicine where our professional identity is fashioned in the encounter with the narrative of the embodied other. But scientific, business and industrial models of health care have distorted the professional model of patient care: the other is now dissected, systematized, quantified, and placed into diagnostic boxes and treatment algorithms. Narrative identity is lost in the binary operations of electronic medical records, where there are “faces”–but no story. Technocratization has objectified the other; and as Buber has stated, the I-Thou relationship of encounter has become the I-it relationship of experience. Strict reliance on experience to the exclusion of encounter induces interpersonal meaninglessness, angst, and loss of trust. And there can be no authentic relationship where there is no trust. The objectification of the other has also tainted the professional identity, impeding the necessary sense of response-ability of the physician to the other. The result is service, not care.
Industrialized modern medicine strives for efficiency; it seeks standardization and reduction, eliminating specifics, reducing all to generalities. It is, in fact, a microcosm of our social maladies. But narratives are not efficient. Narratives, like flesh and bones, do not fit into algorithm and template boxes. They cannot be standardized or reduced. They are racemose, intertwined, interconnected webs of experience that simultaneously serve to distinguish us as individuals and bind us together in community. And they are vital to the experience of empathy and compassion.
And so was my grandson’s retort merely childish bravado or a painfully prescient prophecy? Will relationships of future generations be based on experiential façades or meaningful encounters with the other? If there is no encounter of dialectical narratives, who will we understand ourselves to be? Will medicine be any different? Can the “care” in health care survive the objectification of the other? Most importantly, is there nothing that can be done to preserve our narratives and safeguard our stories, whether in health care or in life?