Sunday, July 28, 2013

Francis W Peabody : agape starts in the mind and moves to the heart

In the mid-1920s a busy dean of medicine, among many other things, briefly addressed a student body.

And then a year or two later he died, the early victim of fatal sarcoma.

Normally a dean of medicine from 80 years ago is remembered, if at all, only as one name among many underneath the long lines of dusty portraits in the hallway leading up to the office of the current med school dean.

But in fact Francis W Peabody lives on, bigger than he ever was in real life, because of a very short phrase he spoke to that student assembly, just one of the many things he did in the course of a short but very busy, productive life.

Fame into Posterity, indeed, is ever a case of quality over quantity.

In his talk, Peabody suggested a re-boot of the traditional common sense definition of charity and agape altruism : it was not enough to be 'open' to the needs of someone in pain or trouble --- to be agape with your heart.

It isn't even likely to be medically effective.

One , first, needs to be agape with your mind  : to be open to others' activities, to them as individuals, individuals with an inherent dignity , even when not needy.

"Caring for an individual really begins when we first care about them as individuals," said Peabody.

He emphasized that the main satisfaction in the medicine life is through the forming of brief but intimate bounds with patients and their families, even if the medical staffer fails to obtain a medical cure.

Dawson and Peabody, not Dawson and Cole ?

Now it is well known that Dr (Martin) Henry Dawson was a 1926-1927 NRC Fellow at the Rockefeller Hospital in New York, becoming the first to ever work with DNA in a test tube, before moving on to Columbia Presbyterian Hospital and his equally pioneering work with Penicillin.

But his arrival at Rockefeller was not his only choice - dare I suggest, perhaps not his first choice as a NRC fellow ?

The journal SCIENCE records in May 21 1926, that Dawson could take his fellowship at Rockefeller under Dr Rufus Cole or at Boston's Thorndyke Lab under Dr Francis W Peabody.

But, alas, Peabody already had terminal sarcoma and so was too ill to take on new fellows - he died later in 1927.

It seems like a tragically missed opportunity, because I see very little of Cole in Dawson's character while he and Peabody could have been soul brothers.

In October 1940, for the first time in his medical career, Dawson's heart was fully open (agape) to helping save the lives of the many young people facing certain death from the dreaded SBE, subacute bacterial endocarditis.

(SBE was in a section of medicine about as far from his medical day job as a disease could be, so he won't have normally had an opportunity to exercise whatever agape his heart might have felt for the SBE patients.)

And his was hardly the only heart open to helping the SBEs, the "4Fs of the 4Fs".

(Admittedly , when he did get involved, he went much further than anyone else to save them in wartime when the Allied governments had collectively ordered that they to be abandoned to a certain death.)

But Dawson's mind was also agape, that rare scientist in 1940 who was truly open to taking in all that that life's small and the weak were capable of, whether in need or not.

So as a result, he was intellectually ready to understood what the other doctors and the rest of humanity circa 1940 could not, that a lowly fungi mold (among the "4Fs" of non-human life) could indeed be capable of saving the SBE and many others as well, when the best of human chemists had repeatedly failed.

His intellectual agape made his emotional agape medically effective.

Dawson's intellectual courage in seeing natural penicillin could cure the SBEs and then having the emotional courage to continue to apply that cure, against stiff wartime Allied government opposition, is the best example we have of Francis Peabody's dictate in action...

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