The dream of reason did not take power into account. - Paul Starr
Something I have been thinking a lot about lately (besides the fact that we are about to have a kid) in working on the dissertation is the place that power and authority plays in our interactions with other people. We all have what Peter Berger call 'typification schemes' that allow us to quickly process, make sense of, and project our experiences of reality. We get used to understanding certain actions of others as meaning something always - hugs show affection, yelling communicates heightened emotions, etc. We use these cognitive tools to make sense of everything we experience and 'assign' meaning to it; we make sense of it. We then assume that other people generally assign the same meaning to shared experiences, and on this basis are we able to have generally predictable interactions with other people.
Sometimes, however, we are unable to make sense of some experiences. When this happens we seek the help of someone we think can help. This is what a physician is, essentially - a professional whose job it is to make sense of the experiences of others and ameliorate those experiences, assuming they are adverse ("so what do I have doc..."). Another dude, Talcott Parsons, once wrote about how illness is essentially the result of any given person shifting their self-perception to that of an 'ill' person. This makes sense if you think about it - two people could both have a cold, and one asserts that they are 'fine' and goes to work while the other asserts that they are 'sick' and stays home from work. One has shifted their identity while the other did not.
Parsons asserted that one of the jobs of a physician is to re-integrate 'ill' people back into society as 'normal' people.
What happens when a patient does not listen to their doctor though? For example, someone may have trouble breathing but refuse the advise of their physician to stop smoking. Starr, the dude who said the quote at the start, would say this is an instance where the physician has not successfully asserted their authority over the patient. He thinks that one of the jobs of the doctor is to asses the nature of reality, which in this instance is the patient's experiences and needs. The physician needs to interpret those experiences and the needs of the patient and literally create the conditions under which the patient thinks their advice is appropriate.
This is where the interaction between a patient and a physician gets interesting though. What if the patient is religious and makes sense of their world and experiences through a lens tinted by an engaged God? The patient has a 'broken' identity when they are ill, and they are in need of being brought back to a state of 'normalcy'. This requires that their physician successfully interprets and assigns meaning to their reality, but very often in a medical setting this meaning invoked by the physician does not include religious beliefs. So we have a professional whose job it is to bring a state of normalcy back to a religious patient, but that 'normalcy' and meaning introduced by the physician is devoid of religious beliefs and meaning.
Is it really possible for a religious person to be 're-integrated' with who they are in a setting that implicitly rejects religion? Often this just leaves a bit more work for the patient to do on their own time, but recent changes in medical practice have gravitated more towards understanding patients in a wider sense than just a broken machine that needs to be oiled. This is likely a good thing, but just as before, the interpretive work of the physician is a big challenge. Cheers to you doctors who fully dive into the work you do. Short cuts are easier, but they don't always get you to the same place or even where you wanted to go.
