I am the daughter of a physician and a nurse. My mother taught me that a doctor cannot function without the help of a nurse, and my father taught me that a doctor must treat patients with compassion. When I was a child, I often accompanied my father when he made house calls and hospital rounds, and I watched him care for his patients with love, and humor, and compassion. I would spend hours studying the contents of his black doctor’s bag, inhaling the medicinal and antiseptic scents emanating from it, fascinated by the vials, and syringes and instruments that lay within its dark interior. So medicine and healthcare have been part of my life since I was a kid. And then I became a doctor myself. I am also a person with a chronic disease, asthma, for which I have been hospitalized multiple times. So I have witnessed healthcare from both sides. And over all this time I have been thinking about medicine and healthcare and life and death, and never had the opportunity to put my thoughts together. Now, in retirement, I have that opportunity.
Limits of the Current Healthcare Debate
I am not going to take on the current debate about healthcare in terms of the Affordable Care Act (ACA) vs the most recent and cruel iteration of the Republican plan. I am not denying that there are significant differences between the two, which can give or take insurance coverage from tens of millions of people and profoundly affect those lives. Nor am I suggesting that we should not fight for healthcare as a right for all, my own preference being universal health care. But I consider that most of these current plans, including the ACA and even parts of Medicare for All, do not fundamentally challenge the culture in which healthcare is delivered. They are not transformational models that can deliver health care that is compassionate, and which provides meaningful work for caregivers. The “debate”, typified on the liberal side by Paul Krugman, remains about insurance--who will be covered, at what cost--and reduces healthcare to issues of access. Important as access is, it nevertheless narrows our thinking about what we should expect from healthcare. These plans, because they limit our vision of what care of health could be, are the mitzrayim of modern medicine, and represent the exile and alienation of healthcare.
A Kabbalistic View
I would like to suggest an alternative way of seeing healthcare; that we look at healthcare within the context of a dialectic struggle between the Kabbalistic concepts of Tohu (chaos) and Tikkun (healing or wholeness). I propose that right now, we are in the midst of chaos, manifested by current models of the healthcare system.
With chaos, there is a lack of balance and order, the system is fragmented into smaller and smaller pieces, and therefore moves toward collapse. In Lurianic Kabballah, this collapse refers to the breaking of the vessels of holiness. These vessels, also known as sefirot, or emanating spheres , contain the values of wisdom, understanding, power, love, mercy, endurance, judgment, beauty, etc. The values, or holiness, carried within the vessels, are dispersed into an infinite number of holy sparks, and brings about a world of disharmony and unbalance, of spiritual and physical exile. Our work is to unite these sparks, hidden within the most mundane and sometimes the most challenging and painful experiences, thereby bringing about Tikkun Olam, a healing of the world, and in this case the healing of healthcare.
Aspects of Chaos
The chaos of modern healthcare is characterized by the absence of the values carried by the sefirot, the loss of compassion, understanding, etc. It is rare to find someone who has not suffered the profound consequences of this chaos. Here are just some aspects of chaos in current healthcare systems:
You or your loved ones may have been treated in a rushed and cursory manner, as a disease and not as a human being.
You may have been led to feel shame about your disease.
You may have suffered from the lack of quality and safety in hospitals, getting a hospital acquired infection, or been the recipient of an adverse drug reaction or a medication error.
Maybe you’ve seen a loved one suffer the effects of neglect and negligence in a nursing home, or
Maybe you are taking so many medications you can barely keep them straight, if you can even afford them all, and no one has told you about possible drug interactions or side effects.
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Tikkun 2018 Volume 33, Number 3:10-15