Hildegard of Bingen and Medicine Today
I have just finished reading Fiona Maddocks’ book Hildegard of Bingen: the woman of her age. I chose this particular biography among many because it’s a documented and objective review of all facets of her life [1098-1179].
While Hildegard of Bingen was pretty famous in her day and age, she has developed a more recent aura of the exceptional. She was an abbess living along the Rhine having founded her own abbey at Rupertsberg. We have some 400 letters of hers; her theological and visionary works: Scivias, Liber vitae meritorum, Liver divinorum operum; her medical and scientific works: Liber simplices medicinae, Liber compositae medicinae (also know as Causae et Curae), physica; and her musical compositions.
Her musical compositions and medical works were largely overlooked until about the 1960s, coinciding with a broader interest in looking at the women in history, rather than focusing all the attention on men. Her theological and visionary works were always of relevance to the Catholic church and although the canonization process began in the 16th century for her, she only attained sainthood in 2012.
“A bat knocked senseless, tied to the loins of a human and left to die, is guaranteed to cure that person’s jaundice”
I doubt few people reading the above quote today would reach the conclusion that the medical advice within Causae et Curae is medically sound for our world today. And yet, I think Fiona Maddocks arrives at a very interesting conclusion upon reviewing the entire breadth of Hildegard’s medical treatises:
“The white coat may not be all that different from the black habit. In the language close to the terms Hildegard herself might have used, the late Poet Laureate Ted Hughes, interviewed by a British newspaper shortly before his death in 1999, explained his cancer of the bowel as the direct result of his own black thoughts affecting his immune system. This example is given not to suggest the validity of such views, merely to show the surprising modernity of medieval thinking or, conversely, the crude level of guesswork we continue to apply to the cause of disease today, in many respects little more understood now than in the twelfth century. After a similar lapse of time as that which separates us from Hildegard, one might guess that a large proportion of what we think and believe will seem ‘medieval.’”
Hildegard has been reimagined in our modern times as a forward-thinking feminist who, despite the times in which she lived, was her own woman who composed music, wrote both religious and medical texts, headed up a financially successful abbey and even franchised it with a second abbey down the river as well (or it could be upriver as I’m unfamiliar with the geography).
It's likely closer to the truth that Hildegard fell into, and leveraged, a successful niche within the patriarchal church system of the day. She was of her time, not ahead of it. What we will never know is whether her inner world completely aligned with what she presented outwardly or not.
I think that Hildegard has something to teach us as patients navigating the medical industrial complex today. Bear with me.
Minority Dissent and Whistleblowing
I have spoken of minority dissent in several posts on this site (Envirakido One and Set Shifting, Masking and Emotional Work in the Workplace Part Two, referencing the work of Charlan Nemeth. In group settings, there will usually be a minority who will disagree with the group’s conclusions and decisions. Nemeth’s work shows that in environments where that minority is encouraged to voice its opposing views, more creative solutions and better decisions occur in the end. In strong hierarchical systems, the minority’s dissent is hidden from the majority. Groupthink doesn’t just result in inferior solutions and actions, it also accepts outright damaging and criminal outcomes as well.
While we have Hollywood tropes of the lone whistleblower protecting the victims and ultimately prevailing, in reality whistleblowers are rarely alone but rather in a small minority or perhaps two to four individuals. They may or may not be vindicated, but the outcomes never generate changes that ensure the harm and infractions can never re-occur.
Throughout the ages, whistleblowers are burned at the stake — very literally during Hildegard’s time on earth. The reality of the existence for any whistleblower is that their lives are at best ruined and, at worst, ended.
If you have the time, I recommend this presentation [4:30-49:54 for the presentation itself] by Carl Elliott. I have mentioned his book White Coat Black Hat so many times before, but this lecture covers his most recent book The Occasional Human Sacrifice.
Carl Elliott posits that the motivation of a whistleblower is one of honour. He allows for the fact that many find that word uncomfortable, and so he suggests an alternate word might be “integrity.” Basically, the motivation for whistleblowing is that the whistleblowers need to be able to look themselves in the mirror, but they also need to be seen by the community as a whole as someone who upholds their moral code as well. Notably, they identify strongly with the organization in which they find themselves, and they view the unethical issue at hand as an aberration that sullies the organization and, by extension, themselves.
Here's the takeaway as a patient looking for treatment, or entering research studies: neither the whistleblower nor the empathetic and yet ultimately silent practitioner and/or researcher is looking at you.
I want to be clear that whistleblowers are not devoid of empathy but it is the fact of it being ethically wrong to harm patients that will drive their decision to speak up.
However, by the numbers, you’re highly unlikely to come across a whistleblower no matter how much treatment or how many studies you might endure. In the unlikely event you do and they have an interest in your case, then that will unfortunately suggest you’ve already been harmed in some way.
But what I really want to address here is the largely empathetic yet silent mass of employees across the medical and research industrial complex.
“The white coat may not be all that different from the black habit.”
People flocked to Hildegard in her time. They sought her spiritual and medical treatments from across Catholic Europe. She spoke authoritatively on all things. She had significant authority to the limit of what could be achieved for a woman at that time. She was a woman of the Church.
Today, replacing the black habit with the white coat, we swap the word “church” with “healthcare.” You do not partner with a healthcare practitioner today just as you would not partner with an abbess in the 1100s.
There are innumerable reasons why there could be poor solutions and decisions for your treatment in a healthcare setting, not the least of which is that minority dissent is silent in such a hierarchical system of practice.
Just as women today might wrongly project on to Hildegard some feminist ideals and gloss over the more likely scenario that she was well served within the ecclesiastical hierarchy and had no interest in doing anything other than protecting it, we can misconstrue empathy and keywords from a practitioner as reflecting proof of a transparent partnership and allyship.
You may have absolutely phenomenal care with exceptional practitioners. But they are the Faithful of Healthcare. Most will do what they can within that system, but they are not your people. Even that rare unicorn of a whistleblower is looking to hold Healthcare to a standard that they believed was woven into the fabric of the system, and not to rectify any wrong that might be specific to your experience. Your people look at you and protect you. Even if all you have is you and there is no one close to you to help you navigate your healthcare experience, you are your own people and that truly does centre you. It anchors you in the reality that those in Healthcare are not ahead of their time, they are of their time—just like Hildegard.
Maddocks F. Hildegard of Bingen: The woman of her age. Faber & Faber; 2013 Jul 2, p.151
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