Person-centred care and self-love

I remember, maybe ten or eleven years ago, my children introducing me to the ‘Golden Rule.’

Do you know it?

It’s age-old and runs along the lines of do unto others as you would have them do unto you.

At the time I thought, ‘I know that, was it Jesus? Didn’t know it was a rule.’ And moved-on.

Fast forward a decade and I have just finished reading Irvin Yalom’s The Spinoza Problem.

Spinoza, for those of you who don’t know, was a 17th Century philosopher.

I was going to call him Jewish philosopher (he was) although things went awry for him in his mid-twenties.

At the time, his thoughts were so radical – claiming there is no supernatural god, no life after death, no heaven or hell, no miracles – life only consisting of matter that is one with nature.

This was when they were burning people at the stake for heresy, so you can imagine it went-down like a lead-balloon in the religious exiled Jewish Portuguese community living at the time in Amsterdam (they had previously been booted out of England (burned alive in York), then Spain (Queen Isabella of Columbus fame & the Inquisition) then forced to convert or die in Portugal).

Spinoza was subject to a ‘Cherem’ (חרם) which is a Hebrew word meaning exclusion. He was ejected and rejected by the community, he was made as if never to have existed and not to exist. If a friend or relation walked past him, he would be blanked, send him to Coventry, as it were.

Spinoza went on to write books that were centuries ahead of their time, an early precursor of the Humanist movement which sees the goal of life as caring for and supporting other people (viz the Golden Rule).

(As a clue for what is coming, years ago I used to teach a course to the medical students – ‘Humanistic Geriatrics’)

In the novel, Yalom recounts Spinoza telling the tale of Rabbi Hillel.

Hillel lives in 1st century Israel, dying around 10 AD/CE, famed for his intelligence and compassion.

One day, a Roman soldier came to Hillel and said he would accept Judiasim only if he explained the Torah to him whilst standing on one leg. (No idea why he asked this, also uncertain if it was Hillel standing on one leg or the Roman); Hillel responded, ‘What is hateful to you, do not do to your neighbour. That is the whole Torah’ (all the Jewish rules and commandments and narrative)’ (or words to that effect – I paraphrase).

Yes, the Golden Rule.

And yes, Jesus (or whoever wrote the Gospels) borrowed this theme.

The Golden Rule runs through most religions, East and West.

As a reciprocal concept, it is a fundamental of society.

You can’t live with others without this philosophy.

There is a neo-Nazi idea that the rule is wrong. Say no more.

What does this have to do with Person-Centred Care?

If you know me, you will be aware that Person-Centred Care is my central philosophy; it certainly applies to the way I support patients. That is, seeing the person, not the disease, seeing the whole, not the parts.

It is, I recently realised, one and the same as the Golden Rule.

Care for others as you would have them care for you.

Voila.

And so, we have a congruence of this gargantuan idea and the way to practice care.

There is a critique of the Golden Rule in that, what you might want to do to you – perhaps whipped with nettles if you are of that mind-set, is not necessarily what others want. And, yes, this is true.

Another principle of Person-Centred Care is the person is the expert.

I, as a doctor might know all about diabetes or asthma, you as the person with the condition know all about you. What you know about you is always far more than I can know about the dry technicalities of disease, even with a lifetime of experience.

My life, my experiences have come full circle as, I discovered, when my kids talked about the Golden Rule, and I was surprised to hear it was a thing. I hadn’t realised that I too had received the same teaching when a child.

It was in bible class in Israel; the quotation ‘Ve ahavta le-re-echa ca-mocha’ (ואהבת לרעך כמוך) (Leviticus 19:17-18) – was drummed-into us. I never fully understood the words, despite the drumming. I knew that ‘Ve-ahavta’ meant, ‘and love’ and the final segment, ‘ca-mocha’ meant ‘like yourself’, I didn’t know what ‘re-echa’ meant, and so the phrase was obsolete (as a Jewish child you learn by rote lots of obsolete phrases you don’t fully understand).

And now, thanks to Google and technology, I have learned the ‘re-echa’ is your ‘friend, peer or companion.’

And so, I too was taught this at a young age.

Without full understanding I adopted the principle and can recall as a precocious 13-year-old dreaming about ideas of love and hate and beauty and conspiring a theory of universal value.

Without understanding the phrase, I had been indoctrinated.

No bad thing.

Ironic however when you look at the Land of Israel today, as it struggles with democracy, led by a right-winger who, if the narrative plays-out will be left with Iran as its closest ally.

How odd the twists and turns.

I talked with my brother last night; he lives in Israel. He too is worried about the situation. He sees the country sleepwalking towards right-wing religious totalitarianism. ‘We had Brexit and Boris’ I empathised.

‘At least we still have tomatoes and cucumbers,’ he replied.

Life is a circle without circumference.

Avoy.

Genug.

Published by rodkersh1948

Trying to understand the world, one emotion at a time.

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