Being-Opposite-Illness: Phenomenological Ontology in Medical Education and Clinical Practice

Abstract

Issue: Phenomenology has proven to be a very useful tool for medicine. Descriptive, first-person accounts of patient experiences can reveal new and unique insights. These insights can inform renewed approaches to medical education and practice. However, comparatively little research has been done on the other side of the clinical encounter. This leaves the lived experiences of doctors diagnosing and treating illness unaddressed and the ontological transformation of medical students through medical education unexplored. Evidence: This paper provides a phenomenological description of the clinical encounter and ontological transformation of the medical student into the doctor. I argue doctors have a unique ontology, rooted in the objectification of the patient, for which I use the term being-opposite-illness This is achieved, through phenomenological examination of my experiences as a medical student and through descriptions of three distinct types of face-to-face encounters: the basic encounter with the Other, the encounter with illness, and the clinical encounter, which I argue are all metaphysically distinct. Finally, textual analysis of popular first-person accounts from two doctors, Henry Marsh and Paul Kalanithi, provide an illustration of being-opposite-illness in clinical practice and how this ontological transformation occurs through medical education. Implications: Together, the phenomenology of the clinical encounter and textual analysis of Marsh and Kalanithi reveal clinical practice and medical education be an ontological transformative process. This paper attempts a new understanding of this experience of doctors by accounting for their unique ontology. In sum, I suggest being-opposite-illness can represent a new lens for analyzing the experience of doctors. Through this, I hope to promote new medical education and practice approaches.

Keywords:

• Phenomenology
• medical humanities
• medical education
• student perspective

Acknowledgements

I would like to thank Gregory Artus and Dr Tina Williams for their guidance and support in completing this work.

Previous philosophy in medical education instalments

Mario Veen & Anna T. Cianciolo (2020) Problems No One Looked For: Philosophical Expeditions into Medical Education, Teaching and Learning in Medicine, 32:3, 337–344, DOI: 10.1080/10401334.2020.1748634.

Gert J. J. Biesta & Marije van Braak (2020) Beyond the Medical Model: Thinking Differently about Medical Education and Medical Education Research, Teaching and Learning in Medicine, 32:4, 449–456, DOI: 10.1080/10401334.2020.1798240.

Mark R. Tonelli & Robyn Bluhm (2021) Teaching Medical Epistemology within an Evidence-Based Medicine Curriculum, Teaching and Learning in Medicine, 33:1, 98–105, DOI: 10.1080/10401334.2020.1835666.

John R. Skelton (2021) Language, Philosophy, and Medical Education, Teaching and Learning in Medicine, 33:2, 210–216, DOI: 10.1080/10401334.2021.1877712.

Zareen Zaidi, Ian M. Partman, Cynthia R.Whitehead, Ayelet Kuper & Tasha R. Wyatt (2021) Contending with Our Racial Past in Medical Education: A Foucauldian Perspective, Teaching and Learning in Medicine, DOI: 10.1080/10401334.2021.1945929.

Chris Rietmeijer & Mario Veen (2021) Phenomenological Research in Health Professions.

Education: Tunneling from Both Ends, Teaching and Learning in Medicine, DOI:10.1080/10401334.2021.1971989.

Madeleine Noelle Olding, Freya Rhodes, John Humm, Phoebe Ross & Catherine McGarry (2022) Black, White and Gray: Student Perspectives on Medical Humanities and Medical Education, Teaching and Learning in Medicine, 34:2, 223–233, DOI: 10.1080/10401334.2021.1982717.

Camillo Coccia & Mario Veen (2022) Because We Care: A Philosophical Investigation into the Spirit of Medical Education, Teaching and Learning in Medicine, 10.1080/10401334.2022.2056744.

Tim Fawns & Sven Schaepkens (2022) A Matter of Trust: Online Proctored Exams and the Integration of Technologies of Assessment in Medical Education, Teaching and Learning in Medicine, DOI: 10.1080/10401334.2022.2048832.

Anna MacLeod, Victoria Luong, Paula Cameron, George Kovacs, Molly Fredeen, Lucy Patrick, Olga Kits & Jonathan Tummons (2022) The Lifecycle of a Clinical Cadaver: A Practice-Based Ethnography, Teaching and Learning in Medicine, DOI: 10.1080/10401334.2022.2092111.

Associated podcast

Let Me Ask You Something (iTunes, Spotify, Google Podcasts and https://marioveen.com/letmeaskyousomething/).

Funding

The author(s) reported there is no funding associated with the work featured in this article.