These are challenging times for the medical community. As I write these words, COVID-19 is traveling the globe, testing all of our creativity, persistence and courage. Even for physicians and nurses who have been in practice for decades, this situation feels unfamiliar. Like many of you, I'm sure, I find that unfamiliarity a bit intimidating. This pandemic certainly reminds me that no quality of character is more embedded in the practice of medicine than humility. Right now, we have no choice.
In his beautiful essay "'A Gentle and Humane Temper': Humility in Medicine," Jack Coulehan humorously recounts that in 1906 — somewhere between the flu pandemic of 1889 and the flu pandemic of 1918 William Osler "tried to whip up enthusiasm for humility in a lecture to University of Minnesota medical students, with these prescient words: 'In these days of aggressive self-assertion, when the stress of competition is so keen and the desire to make the most of oneself so universal, it may seem a little old-fashioned to preach the necessity of humility, but I insist ... that a due humility should take the place of honor on your list [of virtues].'"
In the current world interrupted by COVID, it's good to know that Osler's ideas still apply. Nature has simultaneously imposed humility on us and invited us into it. And in this time of great uncertainty, I think it could serve us well.
What is humility?
The word "humility" comes from the Latin root "humus," referring to rich, fertile earth or ground. The words "human," "humanity" and "humane" also stem from this root. As a gardener, I love these linguistic connections between humus, humble and humane. They highlight what I consider to be the best attributes of humility — an earthy groundedness, a fragrant gentleness, a quiet fertility — all of which underlie an attitude suited to compassionate action, be the particular circumstance what it may.
Genuine humility serves as the true foundation for self-confidence. Stop and think about the people you know. I'm sure you will have noticed, as I have, that genuine humility is often found in those with the most appealing self-assurance, while arrogance generally seems to belie underlying insecurity.
What is it that the truly humble have? It's not just a question of their being self-effacing, although there is sometimes value in that. Rather, they cultivate a certain attitude toward others. They recognize dignity in every life and give respect to each equal to every other, thereby uniquely equipping themselves for service to humanity.
How little we know
In this time of COVID-19, I can't help but notice how small I feel and how little we know. As medical students, we all contemplated the limits of humanity's collective scientific knowledge. Like many of you, I had that one professor who laughed, "Half of what we're teaching you today will have been shown to be wrong in ten years. Unfortunately, we can't tell you which half!" Little did we know they weren't necessarily joking!
I find it powerful to pause and think about the vast and complex nature of medical science today. When I then consider how much we do not yet know, the conditions we don't understand, the diseases we cannot yet cure, I stand in awe. In our attempts to practice medicine, we often find ourselves right on the margin between those two realities, bringing our best, imperfect though it is, to our attempt to care for another human being. It's an act of genuine courage.
Just as the experience of a pandemic reminds me of the limits of our knowledge, it highlights our interdependence. Truly, we are powerless to confront the situation without one another. It is empowering to see clinical knowledge travel from physicians in Italy to those in the U.S. or clinical innovations shoot from one physician group to others across the country, often via the unorthodox channels of social media. Carpenters, painters, tattoo artists and hardware distributors donate N95 masks and other gear. Microbrewers concoct hand sanitizer. Engineers and manufacturers retool their operations to produce needed ventilators or scale up our communal capacity for sterilization of necessary supplies. It can be humbling to know that we are as dependent upon many other professions as they are on us right now and inspiring to see them rise to our aid.
The whole experience brings my paternal grandparents to mind. Born shortly before World War I and the 1918 influenza pandemic, they came of age in the midst of the Great Depression and lived through World War II. While my grandmother raised two young boys under austere conditions in Indianapolis, my grandfather served in the Pacific. Neither of them must have wanted those difficult events to color their lives. And yet they and many like them were willing to commit themselves to a higher purpose despite adversity. They went on to become what some call the Greatest Generation.
I suspect that neither you nor I wanted this pandemic to humble us and color our lives, personal or professional. We will all experience loss. And if we survive, we may grow. Is it in us to become the next Greatest Generation? Only time will tell. For now, I can only humbly offer that I hope so.