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Faith in Practice

For others to judge

Hannah Kowszun

A consultant clinical oncologist in Gloucestershire, Samir Guglani is also the curator of Medicine Unboxed, an initiative for all faiths (and none) that searches for the imagination and philosophy within clinical care.

I was brought up a Hindu. My family's from the Punjab and came across to Bombay post-partition, so my parents grew up in post-independence India. They moved to London in the late sixties.

The stories, myths and sense of community within Hinduism was very important to me. As I got older the philosophy of it became really interesting, but around that same time, in my late teens and early 20s, I got really inspired by Jesus.

If you consider the figures and acts that pervade both religions, there's a stark contrast between Christianity and Hinduism. What was, and still is, inspiring to me wasn't so much the miracles of Jesus - because Hinduism is peppered with those - or his resurrection, but this notion of selfless, giving and fierce love, which culminates in the crucifixion and the power of that gesture. So if I were to name a figure that moves me spiritually, it would be Jesus, but not in any way that's formally Christian.

I was listening to Richard Holloway at Hay on Wye this year and I was fascinated by how he could ostensibly lose his faith and move away from the church yet he still says 'I'm still utterly moved by this figure of Christ the man.'
As a doctor you're in a strange position: you're indoctrinated from the age of 18 into being a material animal. As a junior doctor and through your training, because of the pressures you're put under and the situations you face, you become a problem solver. You see things around you and they become conceptual problems to be fixed. That's what doctoring does to you: you're made to see patterns in the world, to diagnose on the basis of those patterns and to respond by fixing. And working in the NHS there's the imperative to do it quickly and efficiently, whilst spinning various other plates.

This doesn't necessarily leave room in your mind for openness, wonder and a recognition of the fragility and poetry of life. So I find that I'm perpetually flitting between the two modus operandi: on the one hand as a doctor I know things need to be apprehended, recognised and fixed, on the other hand I'm increasingly thinking that although I know science has achieved enormous good, it can't be the whole story. Broadly speaking, I think ideas of morality, wonder, a sense of awe and human fragility have a cumulative effect, but I don't think this can quite be called faith because I don't know what it would be faith in.

When people ask 'Do you believe in God?' I'm not sure that we're asking the right question, I'm not sure our language is right for it. To me it seems secondary to the question 'What is the way to live a life?'. I think these two questions meet in the middle somewhere.

There's a lot of hubris that comes with a scientific or reductionist view of the world. You see this in medicine a lot because it makes you believe that all things are fixable, that things are knowable and therefore fixable; if not now, then soon.  Though we have achieved marvels, I think we have a fraction of the full view, a fraction of a fraction. But I don't have a name for all that we don't know. And I don't think it's the case we don't know it yet, I think much is unknowable through human reason alone.

Medicine Unboxed is an attempt to promote a perspective of medicine that asks: how do we recognise the patient's view in a way that genuinely enables engagement? How do we re-engage with the patient's, and indeed the doctor's, experience? If you approach it from a secular, moral philosophy, it's asking how we promote someone's autonomy to make a decision that's right for them, which means we have to go through the necessary hoop of getting to know them as people. This notion of empathy and identification with another is a basic spiritual and religious tenet: of knowing the other as we know ourselves, that we're all made of the same human stuff.

This year's event is on belief. Not necessarily spiritual belief alone, but also ways of finding truth or true beliefs, what imagination is for, why an understanding of the world and sickness may not be entirely achievable through reductionist views, what insights myths and storytelling afford us, exploring notions of doubt, faith and certainty.

As an oncologist, I'm inspired by the good care of someone with cancer, which for me means the right treatment clinically, but also the right care for them as a person and moral judgements over what we ought and ought not to do. There's a popular perception that there's an almost infinite amount you could do, but there's not the money available to do it. If we had all the money and all the resources would it then follow we should promote an unending chain of interventions for each patient, without honestly engaging with the realities of their mortality, the limits of medicine and trying to steer something that is good care? Stitched into this are the patient's values, the doctor's values, their individual biology, their hopes, their expectations, their fears - it's a million miles from simply 'tumour X' gets 'treatment Y'.

Being an oncologist is really inspiring, motivating and a privilege but also perhaps difficult to do perfectly. It is extremely important that I do it to the best of my ability and objective measures, but as to how good I am: that's for others to judge.

Samir Guglani was talking to Hannah Kowszun