MD James Raymond

In "The Soul of Medicine," James Raymond books a custom charter from Charon in which he extemporizes on the relationship between people and their demise in a medical setting.He takes the unconventional approach of intermingling narrative story and fictional discourse with direct philosophizing about what the medical community should be doing about death. Intentionally or not, this gives the reader some breathing room to digest a heavy topic. It also, however, leads into a rambling style with some loss of focus.

To me, the most important part of the book comes midway and has nothing explicitly to do with death. He quotes a clinical mentor -

"The major problem with today’s physicians,” he began, “is that they rely too much on science and technology to do their work for them. Somehow they have been deluded into thinking that these will relieve them of their primary obligation: listening to their patients."

This quote resonated loudly with me. However that it’s not clear why counseling is not explicitly stated to be the co-primary obligation. It is, after all, the desired output of listening and without it, listening eventually grows meaningless.

More immediate to his thoughts on death, he lays out some interesting starting points, although I confess to disagreeing with a few key ones. He perceives the ‘self’ as an unfolding process, rather than a mind within a brain. Having epilepsy, I am too familiar with the partitioning of processes within the conscious brain and the intermittent or near – permanent blinkout of some faculties. All of which is to say that the self can crumble and to view it as “unfolding” is to risk turning a blind eye to that issue. Evolving life experience should be called what it is – evolving life experience – or simply “my life”. That is not the self, though it plays a large role therein. I take a similar view of his desired perspective of time being a multidimensional space.

He proposes that pain and suffering are the closest thing in life experience to death. His justification for equating death with the physically unpleasant is unclear. In fact, I would argue that they are skew or quite the opposite. Pain and suffering testify to vivid life. Living death is a coma.

What I do like are his thoughts on the authenticity or inauthenticity of a life (actually a sort of paraphrasing of Martin Heidegger) :

Inauthenticity results when man tries to turn away from the inevitability of his own death. To shield himself, he distorts the unity of temporality and reverts to viewing it as three components. As a result, existence becomes focused on the present while the past and future are largely forgotten. Popular culture… is the major culprit here, with its emphasis on immediate gratification. And while this may confer some psychological security by masking the thought of death, in the end it distorts what it really means to be human.

Their pertinence to present day America is great, but he uses much too broad of a brushstroke in referring to pop-culture as the big culprit in distorting what being human means because, in his mind, pop-culture is about immediate gratification. Well, if immediate gratification is all about annual income tax reductions for the rich, then I guess that makes pop-culture. Rather than ‘pop-culture’ it might be more useful to single out some ethno-political demographic groups such as the top 1%. Similarly, if you want to find other agents of distortion, your best starting point would be fundamentalist religions which clamor for society to be bound up to some one particular scripture. Therein lay the culprits more than in pop-culture.

I think that his meaning of inauthenticity hearkens best to issues of environmentalism on both a global and social / local scale. Lack of focus on the future and ignorance of the past bring on wanton superficiality.

In truth, I think that where Raymond wants to go is into the arms of Ralph Waldo Emerson's "Oversoul"

This review remains a bit helter – skelter in some degree because the book is frequently hard to follow.… (mer)

Early Reviewer book.
This book annoyed me at first. I selected the book based on it's title "The Soul of Medicine." As a retired Physician Assistant I thought that this book would help me put my career in perspective. Alas, maybe a quarter, at most a third of the book is directly about practicing medicine. It seems that Dr. Raymond was unhappy with his career choice. The subtitle "A Physician's Exploration of Death and the Question of Being Human" reflects more of his interest. When I realized that the book became more interesting. It's more focused on a discussion of philosophy and myth and being a memoir(? many incidents seem made-up). Anyway, death remains as much a mystery as before I started this book. And I have a bone to pick with Dr. Raymond's goal: that medical practitioners become have more "authentic" lives. What does that mean?… (mer)