Teaching and Learning Moments
Perakis, Charles R. DO
Dr. Perakis is now retired and living in Maine after 40 years as a family physician and medical educator; e-mail: firstname.lastname@example.org.
If you could be any cell in the human body, which one would you choose and why? I found this question in a letter to the editor in the New England Journal of Medicine in the 1990s. The authors posed this question when interviewing medical students because they felt that it offered insights into the students’ motivations.
During orientation, I used to ask all new students in the family medicine rotation at my hospital to consider this question. The neuron is an unsurprising, popular choice and is often selected by those students who like to be in control or at the center of things. Since the liver is versatile and capable of regeneration, some choose the hepatocyte. Nowadays, the stem cell is another frequent choice. Maybe some students are indecisive and others don’t like limiting their options. Some choose the lymphocyte, the erythrocyte, or the myocardial cell. Still others choose the ova or spermatozoa, cells capable of creating life. My favorite answer, however, is from a medical student who quickly indicated her choice was a cell in the islets of Langerhans because she responded well to sweetness.
It is only fair that my students in turn want to know which cell I would choose. Over the years, I have had lots of time to contemplate my choice. I finally decided on the soul cell, which leads to the question about its location. Is the soul located in one cell, all the cells, or beyond mankind somewhere in the cosmos? The answer to this question continues to elude scientific inquiry.
My choice of the soul cell was inspired by Leonardo da Vinci’s anatomical drawing illustrating the soul as located behind the eyes in the anterior ventricle of the brain. da Vinci believed that “the senso commune (sense of community), phantasy, and imagination originated in the anterior ventricle.” In this drawing, he connected the soul to the eye, which we often refer to as the window to the soul. Here, all the senses converged where judgment formed. Consciousness was the soul. da Vinci felt that to see was to know and to know was the soul.
One can view the soul as spiritual and immortal or as material and mortal. This dichotomy is a great starting point for a dialogue about what the soul is and what healers need to know about it. For students who have been studying the basic sciences, pathology, and textbook diseases, considering the soul may be a reach. After years of caring for patients as a general practitioner, I realized that medical education should pay more attention to the soul.
During their family medicine rotation, students often are faced with patients who have medically unexplained symptoms. These patients’ lives are complicated by poverty, abuse, and hopelessness. They lack meaning. They are demoralized. When we treat these patients, I introduce my students to the diagnosis of soul sickness. We discuss how the prescription for a drug or the overinvestigation of symptoms is counterproductive. The treatment for soul sickness is often just listening.
How can we encourage healers, then, to attend to the needs of the soul as well as the needs of the body? How can doctors sort through the symptoms a patient presents to recognize their underlying beginnings? These questions should prompt a dialogue between students and their teachers about the influence of the mind, body, and spirit in treating patients.
What better way to introduce students to the humanities (philosophy, aesthetics, history, literature, and ethics), which provide insight into the human condition and the nature of suffering, than to discuss the exact location of the soul?