Communal Medicine reflects the natural evolution of my inquiry into the field and profession of medicine. I was introduced to medicine by my uncle Pierre Girard, a talented and well-regarded clinician and pioneer in the field of immunology research. In my own studies, I was drawn to the intersection of my patients’ subjective lived experiences and emotions, and the physical illnesses that required them to seek medical advice. It motivated me to delve into psychosomatic and psychosocial medicine. With my studies in process-oriented psychology I deepened my understanding of mind/body medicine, coming to understand the body’s illnesses as expressions of holistic, dreamlike processes, full of personal and communal meanings.
In my book Health in Sickness, Sickness in Health I shared how illness carries information that advances both individual and community health, and how in return conventional aspects of our individual and communal notions of health are paradoxically causing illness. In my follow-up book Big Medicine, I consolidated my thinking with my professional experiences to form a unified theory of medicine. Based on the German philosopher Friedrich Nietzsche’s concept of “big health,” I described a form of medicine that transcends the usual purpose of curing pathologies or illnesses. Medicine instead becomes a tool for facilitating individual and community processes of health and sickness, only one aspect of which is therapy and healing.
With the recent development of a worldwide virus pandemic, and an exacerbated social pandemic of racism and health injustice, I feel strongly that medicine needs to reinsert itself into addressing public health in all its applications. Health is embedded in our social arrangements, and we already understand that trauma and systemic oppression cause sickness and premature death. We know that social injustice directly translates into increased death rates for disenfranchised and historically undervalued individuals and whole communities. Every health professional and organization, independent of their field of work, needs to apply a social and health equity lens to their daily practice. It is not sufficient anymore to treat individuals and communities independent of the lived experiences of their social circumstances. Systemic oppression due to racism, classism, sexism, homophobia and other factors are intrinsic to all dimensions of disease, health and healing.
Communal Medicine is an attempt to integrate health and social justice into the practice of all of medicine. The term “communal” is used instead of “community” to deliberately stress the relational elements. In addition to objective and factual knowledge of health disparities, we need relational and facilitative skills to process lived experiences, and to overcome ingrained biases and inequitable privileges. We poorly understand diversity and the rank and power dynamics across diverse experiences. Medicine needs to invest itself into studying and treating individual and communal bodies and minds, with awareness of their embeddedness in diversely lived experiences.
Communal Medicine deepens the investigation into health and medicine as part of our communal fabric, one that is fraught with the kinds of social and health injustices that kill more people than any traditional disease. Medicine must lead with equity as a core tenet of its practice on all levels.
Franklin Roosevelt said in his inaugural address: “The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little.”[1] The columnist Mark Shields quoted, in his fare well address on the PBS News Hour show, his parents who said: “Every one of us has been warmed by fires we did not build, and every one of us has drunk from wells we did not dig. And, together, we can’t do less for those who come after us. And, together, we can do so much more.”[2] These two quotes capture the basic values that Communal Medicine is about: A deep sense of equality and cooperation. It’s about a morally holistic way to think of medicine in its practice to serve both individuals and communities.
[1] Franklin D. Roosevelt, Inaugural Address. Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/209135. Retrieved Dec 20, 2020.
[2] Mark Shields. Shields and Brooks celebrate a lifetime in American politics. PBS News Hour, December 18, 2020. https://www.pbs.org/newshour/show/shields-and-brooks-celebrate-a-lifetime-in-american-politics. Retrieved Dec 20, 2020