The Other Side of Silence: Levinas, Medicine, and Literature

Irvine, Craig

doi:10.1353/lm.2005.0027

Cited by 29 publications

(10 citation statements)

References 2 publications

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“…While his writings have been explored in the medical humanities literature, [1][2][3][4][5][6] little has been writ-ten for practicing clinicians. Levinas's lens of the face-to-face can help us redefine our responsibility to patients and remind us why we chose this profession.…”

Section: The Face-to-facementioning

confidence: 99%

Finding Hope in the Face-to-Face

Edgoose¹,

Edgoose

2017

Ann Fam Med

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What does it mean to look into the face of a patient who looks back? Face-toface encounters are at the heart of the patient-clinician relationship but their singular significance is often lost amid the demands of today's high-tech, metricdriven health care systems. Using the framework provided by the philosopher and Holocaust survivor Emmanuel Levinas, the authors explore the unique responsibility and potential for hope found only in face-to-face encounters. Revisiting this most fundamental attribute of medicine is likely our greatest chance to reclaim who we are as clinicians and why we do what we do. W e had nothing in common. She was from a small indigenous tribe in Mexico called the Triqui. We couldn't find a Triqui interpreter and my poor Spanish was no better than hers. Her face belied her age of only 17, due to years of work in the fields and suffering at the hands of an older man. She made the arduous journey north, arriving pregnant and undocumented, and now I was to be her doctor. Our worldviews were so different that even her way of expressing pain confounded me. I reverted to closed-ended questions about where, when, how, and why, but still felt lost gathering only incoherent answers and gestures. We struggled together during her gestation period and, despite being an experienced physician who can usually connect with challenging patients, I came to feel my heart sink every time I saw her name on my schedule. Toward the end of her pregnancy, tired of our inadequate words, I looked into her eyes and tried to give her hand a reassuring squeeze as we parted. Then, in broken Spanish, she asked me what I thought of the name "Edgoose." I was stunned into silence and eventually mumbled that my unusual last name would really not be appropriate for her expected daughter… THE FACE-TO-FACEThe daily work of clinicians is conducted in face-to-face encounters, whether in exam rooms, homes, or alongside hospital beds, but little attention has been paid to the responsibilities and ethical implications generated by this dimension of our relational work. The term "face-to-face encounter," indeed, has been co-opted by the Centers for Medicaid and Medicare Services to mean little more than a billing requirement for goods and services such as durable medical equipment or home health care. Yet what does it mean to look into the face of a patient who looks back? We believe this simple act causes many of the frustrations of current clinical practice, but also many of its most precious rewards. These rewards must be better understood and appreciated now, when medical technology and pressures of productivity are diminishing face-to-face encounters.Lithuanian-born French philosopher, Emmanuel Levinas (1906Levinas ( -1995) offers a theoretical framework through which we can examine the essence of the face-to-face patient-doctor relationship. While his writings have been explored in the medical humanities literature, 1-6 little has been writ-

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Section: The Face-to-facementioning

confidence: 99%

Finding Hope in the Face-to-Face

Edgoose¹,

Edgoose

2017

Ann Fam Med

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“…Philosopher Craig Irvine (2005) eloquently describes the majesty of this call for physicians, but it certainly applies to all who work in palliative care: ''oriented to the ethical, to the call of the Other, they might attend to a finer sense of the ordinary on the other side of silence'' (p. 17). Another way to think about opening up to another's suffering is to strive toward thinking with, not about, a story: ''To think about a story is to reduce its content and then analyze that content .…”

Section: Narrative Competencementioning

confidence: 99%

Narrative Palliative Care: A Method for Building Empathy

Stanley

Hurst

2011

Journal of Social Work in End-Of-Life & Palliative Care

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We make meaning of illness, suffering, and death through narrative, by telling a story. In this article, the authors explore narrative and palliative care: how, at the end of life, narratives of patients, caregivers, and clinicians serve to connect to those still living, and how through each telling and listening, we honor and validate the experience of suffering. A discussion of narrative competence and the skills of attention, representation, and affiliation is followed by an outline of the format for a narrative medicine workshop and a detailed analysis of an experiential exercise in close reading and reflective writing.

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“…''For Levinas,'' Irvine explains, ''the priority of the Other is quintessentially manifest in my encounter with his suffering and death … In the Other's suffering, then, I face 'the inevitable and preemptory ethical problem of the medication which is my duty.' Indeed, 'wherever a moan, a cry, a groan or a sigh happens, there is the original call for aid, for curative help, for help from the other ego whose alterity, whose exteriority promises salvation … What lies on the other side of silence, a silence that envelops the suffering of the Other, is a call-in fact a demand … It is a call so powerful, so fundamental, that … To answer the call of the Other is to give one's very self, for this answer is the very essence of the self'' (Irvine 2005).…”

Section: Face To Facementioning

confidence: 99%

Face off: searching for truth and beauty in the clinical encounter

Shannon

2011

Med Health Care and Philos

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Based on Lucy Grealy's memoir, Autobiography of a Face, this article explores the relationship between gender and illness in our culture, as well as the paradox of "intimacy without intimacy" in the clinical encounter. Included is a brief review of how authenticity, vulnerability, and mutual recognition of suffering can foster the kind of empathic doctor-patient relationship that Lucy Grealy sorely needed, but never received. As she says at the end of her memoir, "All those years I'd handed my ugliness over to people, and seen only the different ways it was reflected back to me."

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The Other Side of Silence: Levinas, Medicine, and Literature

Cited by 29 publications

References 2 publications

Finding Hope in the Face-to-Face

Finding Hope in the Face-to-Face

Narrative Palliative Care: A Method for Building Empathy

Face off: searching for truth and beauty in the clinical encounter

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