Oncology Times:
doi: 10.1097/01.COT.0000358143.99185.38
Simone's OncOpinion

Robert Coles, MD

Simone, Joseph V. MD

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It would be a mistake to conclude that Coles is speaking only to those in psychiatry or sociology or religion. He is speaking to all of us.

Robert Coles is a child psychiatrist best known for his five-volume series on the life of children, Children of Crisis, for which he received a Pulitzer Prize. In these books he explored by interviews the moral, political, and spiritual sensibilities of African-American children in Louisiana at the height of the 1960s civil rights movement. And contrary to the prevailing Freudian canon of the time, he found most of these children to be not only psychologically normal, but often demonstrating great depths of character despite the stress of racism, injustice, and poverty.

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He says of his interviews at New Orleans schools, “I was looking for psychopathology in those early years of my residence in the South,” but he found remarkably little mental illness. Instead he was impressed and moved by their moral sensitivity, by how they reflect on the moral significance of their lives.

Coles eschewed not only the traditional approaches of psychiatry, but also the quantitative methods of social science. Of his approach he said, “I am not a survey social scientist. I can claim no definitive conclusions about what any ‘group’ feels or thinks…one can only insist on being as tentative as possible, claiming only impressions, observations, thoughts, reflections, surmises, speculations, and in the end a ‘way of seeing.’”

In those works he was a listener above all, a listener of stories who found a way of seeing further than most. (Much of the two preceding paragraphs are extracted from A Bibliographic Essay, by Scott London www.scottlondon.com/articles/coles.html).

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Renaissance Man

But Coles is a renaissance man: author of many books on a very wide scope of topics, teacher of literature at Harvard, avid volunteer and proponent of volunteerism. However, my favorite Coles's books deal with special interests of mine. For The Moral Life of Children, one of the books in his Children of Crisis series, Coles interviewed in-depth hundreds of Jewish, Christian, Islamic, and agnostic children, ages eight to 12, living in North and South America, Europe, Africa, and the Middle East., The children's comments along with Coles's accessible explanations describe his fascinating conversations with children struggling to understand God and the contradictions of their religious teachings, often in an environment of poverty and injustice.

In effect, he wanted to learn what meaning terms like “conscience” or “moral purpose” held for malnourished, sick, poorly clothed children in Brazilian slums or South African hovels, children whose main goal is to survive another day.

The children's insights are sometimes profound. Coles shows how children in the most trying circumstances manage to maintain their moral dignity. Using field notes on poor black and white families in the South, he convincingly argues that kids don't merely respond to parental promptings but also fashion their independent sense of how the world works or ought to work (partly from Publisher's Weekly).

Coles illustrates how difficult it is to completely understand or delineate morality (or ethics) however it may seem to become manifest since it is affected by and affects its social context. He presents a fascinating description of the significance and malleability of religious beliefs in the lives of children.

His respect and even reverence for the children he meets and describes is a beautiful thing. While the focus of the world is always changing, this book's discussions of the civil rights struggle, poverty in Brazil, and nuclear weapons are timeless.

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A Physician with a Physician's Sensibilities

But Coles indirectly has something to say to everyone about how one understands and delineates these moral and intangible issues. He is a physician with a physician's sensibilities; for some of his works, I feel that he is talking to me as a man and as a physician.

He goes deeper on this topic in his book, The Secular Mind, where he explores the boundary between the secular and the spiritual through history, or more broadly, between the world, its attractions, and human constructs, versus the perpetual human search for meaning in life and justification for one's acts, whether the search is called moral, spiritual, or sacred.

Importantly, Coles provides many examples in which organized religion behaves as a basically secular entity (think of the essential tie of the Protestant Ethic to capitalism, the statism and war-making of the medieval Catholic Church, or some amoral or frankly evil behavior today justified as “religious.”

In these cases, churches fail as a fruitful source to aid one's search for a satisfying, “higher” meaning, a justification for living. In fact, a subtext of the work is the tension between sacred values and organized religion. In a sense he is saying to the reader, “This is an important issue. Here is what I see and understand; what do you see and understand?”

This struggle for meaning is as old as Biblical history, and Coles underscores many more recent examples. Kierkegaard was a resolute Christian, but Coles points out that his essay “The Present Age” sharply satirized the Danish and European bourgeoisie of his time: “The restless yearnings of people who may go to church on Sunday for an hour or so, but who live strongly attached to a shifting assortment of possessions, projects, plans: things to own, things to do, things to dream of accomplishing. He notices the boredom that attends such activity, as if the secular world, in itself, provides little real inspiration to those who live there. Yet the alternative, a thoroughgoing commitment to the sacred, is beyond the imagining, let alone the aspiration, of most of us, including the multitude of professed Christians.”

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Kierkegaard calls them Philistines, part of the prosaic secularism he disdains.

This may sound like a curmudgeon with a beard standing on a street corner holding a sign saying, “The end is near.” But Kierkegaard was seriously questioning the hypocrisy of his fellow countrymen, of their co-opting the core values they profess on Sundays with secular values in their everyday life.

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Opposite Approach: Dietrich Bonhoeffer

A more recent and stunning example of the opposite approach is Dietrich Bonhoeffer. While Luther criticized Rome's moral corruption, that eventually was followed by Lutheranism as an even more secular pillar of the nation-state's authority. Bonhoeffer saw his fellow Lutheran pastors embrace Hitler's hateful brand of secularism and in the end he “not only took aim at Hitler but at Lutheranism as it came to such easy terms with him.”

Bonhoeffer criticized Hitler publicly and had an easy opportunity to remain in the US as a visiting scholar. However, he chose to return to Germany to witness against Hitler and the secularization of his church. He had left churchgoing for the “Christian Life,” to serve as a witness for his non-secular (or anti-secular) core values. And he paid for this with his life, knowingly and willingly, for “the sanctity of faith in the here and now of life.”

The scope and depth of Coles's writing is truly amazing. One can sense his own “search for meaning” throughout his works. He is a physician-writer I admire greatly because the issues he addresses are of timeless interest and importance.

Furthermore, they have something to say about our medical profession. The intangible values that we profess and the faith that we and our patients would like to have in our being selfless and conscientious servants of the sick and dying are often compromised by secularism, ranging from churning diagnostic tests today to joining the Nazi atrocities in 1944.

It would be a mistake to conclude that Coles is speaking only to those in psychiatry or sociology or religion.…he is speaking to all of us.

© 2009 Lippincott Williams & Wilkins, Inc.

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