March 4, 2008
Thank you for that kind introduction. And thank you all for the extraordinary welcome you have given me on my first visit to India. I can certainly understand why local legend says that the founding of Bangalore—when an old woman gave food to a lost and hungry king—is based on an act of hospitality.
I am especially grateful to Fr. Thomas Kalam for his kind invitation to join you today…and it is a privilege to be here with John Galbraith and Archbishop Moras. Georgetown was honored to host all three of these distinguished individuals in January for a strategic planning workshop with leaders from the Catholic Bishops’ Conference of India—including Cardinal Toppo—and various Catholic partners from across India.
I have no doubt that the discussions we held will eventually lead to innovative projects that will help promote access to quality health care throughout India. We at Georgetown are enthusiastic about the progress made at the workshop, and we look forward to continuing—and deepening—the collaboration we have begun with St. John’s.
Finally, it is a pleasure to be here to help recognize and celebrate the achievements of this year’s graduates of St. John’s Medical College. The commitment to the welfare of others that is inherent in the philosophy and practice of this Medical School reminds me of the remarkable Indian leader—Asoka the Great.
As most of you are aware, more than 2,000 years ago, Asoka—the first ruler of virtually the entire Indian peninsula…whose symbol appears in the center of the Indian flag—was also the very first ruler in world history to preach a radical notion of government: One based on the idea of social compassion and service to humanity. As Asoka noted in one of his most famous Edicts, “I wish that all men should be happy, always.”
With the aim of promoting the welfare of his subjects, Asoka established universities…built numerous hospitals…and was acclaimed for traveling through the rural areas of his Empire to address the needs of his people and alleviate their sufferings.
Undeniably, the spirit of Asoka the Great—of compassion and service—certainly lives on in this Medical School and its graduates—at least 25% of whom permanently serve in rural areas after receiving their degrees. Yours is perhaps the only medical school in the world that can boast such a statistic. That is one of the reasons that I am so honored to be with you today.
I am also honored to be here because St. John’s is an outstanding example of the difference—and the contribution—that the Catholic Church has made in healthcare in India.
From the very beginning of the Church’s presence here, service to the sick—both physically and spiritually—was an integral part of its mission and vision. St. Francis Xavier, on of the first Jesuit missionary to come to India, made caring for the sick a priority. In 1550, another Jesuit—Fr. Henry Henriques—established the very first Catholic hospital in Punnaikayal. More recently, we’ve had the extraordinary example of caring for the “poorest of the poor” set by Blessed Theresa of Calcutta.
Today, although Catholics only comprise between 2-3 percent of the Indian population, the Catholic Church provides approximately 25 percent of your nation’s health care. As you may be aware, the church operates more than 750 hospitals and over 2,500 health centers—with the vast majority located in rural and inaccessible areas where the need is greatest. This is certainly testament to the belief of the Catholic Bishop’s Conference of India—noted in its most recent statement on health care policy, Sharing the Fullness of Life—that the real meaning of Christian life is “To be at the service of the last, the least, and the lost.”
Finally, I am honored to be here because St. John’s and Georgetown share a common mission. I know that St. John’s is dedicated to “value-based training of doctors for the underprivileged”…and that you strive to ensure that your graduates take the ideal of “service and sacrifice” into the homes of their patients and into their communities.”
As the oldest Catholic and Jesuit University in the United States, we at Georgetown also embrace value-based education and challenge every member of our community to answer the call of St. Ignatius Loyola, the founder of the Jesuits, to engage in the world—to serve the world—in order to make it a better place.
In essence, both of our schools strive to be institutions, in the words of Pope Benedict XVI to the bishops of Brazil last year, that promote a “society founded on justice and peace.”
But how do we—as individuals and institutions—work toward such a society? I believe that the answer—which has special relevance for all of you about to embark on your medical careers—is to be found in the original mission of the Jesuits in India—individuals like St. Francis Xavier and Fr. Henriques.
For these early Jesuits, their most important mission was to first care for the soul of everyone they encountered. The idea of an immortal soul—the spiritual essence…animating force…and divine spark that exists in all of us—resonates through most of the world’s religions—including Christianity, Hinduism and Islam. And true care of the “soul” encompasses caring for the whole person—or in Latin, cura personalis. This ideal remains one of the Jesuit’s—and Jesuit institutions—most important values.
Unfortunately, in our increasingly interconnected world, the forces of globalization—which have produced unprecedented opportunities and possibilities—are also causing us to lose site of the idea of cura personalis—of the need to care for the soul of everyone we encounter.
We need only look at the facts. Globalization has produced staggering differences in wealth and well being. Three billion people live on two U.S. dollars a day…one billion on less than a dollar a day. Sixty percent of the world’s population exists on only six percent of the world’s income. Entire communities are being exploited, marginalized, and neglected. Here in India, a 2003 study by the National Council for Applied Economic Research reveals that the poorest 20% of the population—most often those in rural and inaccessible areas—has more than double the mortality rate of the richest 20%. Too many of the world’s people are not sharing equally—or at all—in the benefits of globalization. Their needs are neglected…their souls ignored.
If we want to help change this situation, then I believe we must do three things. These are things that, I believe, are in the spirit of Asoka…things that will advance the care of the souls…and things that are inherent in the Jesuit ideal of cura personalis. As individuals and institutions, we must:
• Attend to all of an individual’s needs—spiritual, physical, and emotional;
• Respect their unique circumstances, knowledge, and concerns;
• And recognize the innate worth and dignity of every person.
This afternoon, I’d like to briefly discuss each of these ideas with you.
Attending to all of an individual’s needs
As educational institutions—guided by the heritage and tradition of the Catholic Church—both Georgetown and St. John’s must continually strive to meet the various needs of all the members of our communities.
…And for those of you graduating today, there may be no more important mission…
We know that among the defining features of medicine today is the continuing march of technology…of increased specialization…of broadening diagnostic and therapeutic avenues. At one time, a doctor had little more to offer a patient than quinine…kindness…and compassion. You will have at your disposal an ever increasing variety of new skills, devices, practices, protocols, and prescriptions for both treatment and prevention. But, unfortunately, today’s medical advances can also dehumanize patients—as we come to view our bodies as instruments to be diagnosed and debugged. The care of the whole person—of all of her or his needs—is too often forgotten.
As the Catholic Bishops’ Conference of India also noted it its most recent health policy document, we cannot simply view “the human body as a machine…disease as a consequence of the breakdown of the machine…and the doctor’s task to repair the machine.” You must always remember that it’s not a machine or an illness—but a patient—that has come to you…and that you are treating a life with physical, emotional, and spiritual needs.
Medicine isn’t just about curing—but caring. I know you understand this. But as you struggle, each day, with an unending array of professional and personal demands, it becomes all too easy to forget to truly listen to your patients…to forget to see a patient as a whole person…to forget to care for the soul.
Always remember that even with the remarkable strides that India has made in health and health care since independence, your country—especially its poor and underserved—certainly needs both your healing…and your humanity.
Respecting an individual’s unique circumstances, knowledge, and concerns
As you care for your patients’ needs, you must also remember to take into account their individual—and unique—circumstances, knowledge, and concerns. This is also true for institutions as we work to help those in our local community and the global community…as we strive to reduce the negative forces of globalization...and as we endeavor care for the whole person. Allow me to explain.
James C. Scott, in his insightful book, Seeing Like a State, examines why large-scale schemes to improve the human condition in the twentieth century have so often failed. He demonstrates that plans cannot succeed unless they take into account local customs, concerns, knowledge, and know-how—or the knowledge that derives from the practical experience that the Classical Greeks termed “metis.”
Additionally, even if a development project takes these things into account, its actual success depends on the response and cooperation of those it is designed to aid. That means that the plan must also respect local values, desires, and tastes. If they do not, then the plans and projects with even the best intentions may not yield results.
Recognize the innate worth and dignity of every person
As we work to respect the concerns and circumstances of all individuals, we must do one more thing—we must recognize the innate worth and dignity of every person. Such recognition can only begin with understanding. That’s why, as individuals, institutions and communities—we must work to build bridges of understanding to those people and groups who may not share our faith, or culture, or socio-economic background.
As doctors, you will certainly need to build bridges of understanding to your patients. You cannot truly care for a person if you cannot recognize her or his innate dignity—and humanity.
But educational institutions also have a particularly important role in this process—because building bridges of understanding is one of the things that the academy does best. After all, a university or a medical school provides a unique home for multiple traditions, cultures, disciplines, methodologies, and modes of inquiry—what I call “communities of interpretation.”
What distinguishes different communities of interpretation is the “horizon of significance,” the background of social practices, goods, morals, laws, customs, and institutions that provide meaning for individual members of that community.
Nowhere is the engagement between conflicting and competing communities of interpretation…between different horizons of significance…so constant and so part of daily life as in the academy. Providing the context where horizons of significance can be fused—where bridges can be built between communities of interpretation—is one of our continuing challenges…one of our greatest opportunities for accomplishment...and one of the areas where we can aid understanding—and through—it the recognition of the innate dignity of every individual. And I have no doubt that the growing partnership between Georgetown and St. John’s will certainly help us to build bridges of understanding and to fuse horizons of significance.
I truly believe, that as individuals and institutions, if we strive to
• Attend to all of an individual’s needs—spiritual, physical, and emotional;
• Respect their unique circumstances, knowledge and concerns;
• And recognize the innate worth and dignity of every person;
We can help reduce the negative forces of globalization…we can help advance and promote the ideals of “cura personalis”—and caring for the soul…and we can help honor the spirit of Asoka the Great—a spirit of compassion and service.
I’m reminded that the tangible legacy of Asoka the Great—the stone pillars he erected during his reign—still mark the Indian landscape. To all of today’s graduates, I have no doubt that if you always embrace the values of St. John’s Medical School…if you work to treat the whole person…and if you strive to care for her or his soul…then your legacy will be just as lasting and enduring.
I congratulate you on all that you have accomplished…I anticipate the difference and contribution you will make in your communities and the global community…and I trust that, in your hands, the profession of medicine will be forever noble.