Skip to main content

Doctors as Priests, Providers, and Protectors - Part 2

Ron Pies and I ask similar questions.  Well, I never asked Is Suicide Immoral?  But maybe I should let that one go...  In addition to being Professor of Psychiatry at SUNY and Tufts, Pies is a bioethicist and Editor in Chief Emeritus at  So while he writes books like Clinical Manual of Psychiatric Diagnosis and Treatment: A Biopsychosocial Approach, his philosopher, poet, and novelist vocations are expressed in other works, including The Myeloma Year: And Essays on Mind and Spirit.

The kind of guy I'd love to meet for coffee and conversation, Pies added to my fascination an article reflecting on his role as a doctor, Priests, Providers, and Protectors: The Three Faces of the Physician.  See, my senior thesis reflected on my own future role as priest, the ordained kind, Is the Holy Spirit an Equal Opportunity Employer?  Both of us take on the notion of priest as Father.

"Yes, Father, I've been taking my medicine."  A patient's slip of the tongue led Pies to recall the ancient connection between the roles of healer and holy person.  It's a natural connection, if you consider the divine will to be for healing.  It doesn't matter what faith tradition you examine.  The two roles were originally one.

Alas, early Christian writers introduced the Father metaphor into their reflections about priesthood.  Monasteries used the title for the Abbot.  Then over time, the role of parish priest followed the monastic model.  Quite ironically, I might add, since Father is the one title Jesus told his followers not to use.  But subsequent generations have never been able to relinquish the implied power over, even since the last century when the title became problematic in the face of women clergy and in the Episcopal Church, women priests.  The newly ordained guys this century seem to cling to Father all the more.

And with the title came paternalism, a system based on the concept of women and children as a man's property.

Pies rightly rejects the paternalism of the medical system.  "The priest-like status of doctors historically encouraged paternalism to which patients readily acquiesced... We are not priests, and we should not lay claim to the 'God-given' power or authority of priests -- which, as we well know, may be subject to abuse and exploitation."

Indeed.  And yet...  Healing is not mediated solely through the application of a doctor's medical expertise.  The worst, most harmful thing a psychiatrist ever said to me was, "I don't do relationships.  I use pharmacology to treat psychological illness."

It's the paternalism, not the priesthood itself, that is the problem.  When the roles were originally one role, it was that of witch, witch-doctor, shaman, druid.  These words do not sit easy in our modern minds for good reason -- there was all out assault on these healers by Church and a modern scientific establishment that enforced its own paternalism.

Next week I will publish an excerpt of a book to be published next year, Prozac Monologues: Are You Sure It's Just Depression?  In the excerpt, a doctor who does do relationships used the spiritual power of her role.  She didn't call herself a witch-doctor.  But the priest sitting in her office and in need of that power recognized the spell.

Other posts in this series:

Doctors as Providers
Doctors as Priests - The Look
Doctors as Protectors

book cover from
photo of stained glass St. Luke the Physician by author
photo of various pills used under Creative Commons license
Condemned Witches Burning in St. Peter's Port from the 1800s, in public domain


Popular Posts

Loony Saints - Margaret of Cortona Edition

Every once in a while, Prozac Monologues reaches into my Roman Catholic childhood's fascination with saints, especially the ones who today might be assigned a diagnostic code in the DSM.  Twice, Lent Madness has introduced me to new ones that I share with you.

A few years ago it was Christina the Astonishing.

Today it's Margaret of Cortona.  If you're a Lent Madness regular, you'd expect Margaret to be a shoe in for the first round of voting, where her competition is a stuffy old bishop/theologian, because Margaret became a Franciscan and, more significantly, her story features a dog.  Lent Madness voters are suckers for dogs.

Giving thanks for Jerod Poore

Jerod Poore is the walking, talking, tweeting, posting wikipedia of all meds psychiatric and neurological. His manifesto: At Crazymeds[his original website] we make psychiatric and neurological conditions (AKA brain cooties) our bitches with evidence-based medicine and a healthy dose of gallows humor.

When I caught brain cooties fourteen years ago, Jerod was the first person I found who gave me genuine information. When the docs turned my brain into a chemistry experiment, Jerod told me what was happening to it.

That's the sketch I drew of my brain on drugs. Not the drugs they warn you about, but the drugs they scold you for refusing to take. Prozac, Celexa, Remeron, Cymbalta, Effexor.

Now, these are fine medications and do help people, notwithstanding the fact that they did not help me. It took years to figure out that my diagnosis was wrong, so these were the wrong medications for me anyway. If they help you, TAKE THEM.

But my mind was mush. The docs gave me precious little inf…

Antipsychotics and Loss of Brain Matter

What are antipsychotics doing in your brain besides preventing psychosis? This is a report on a study conducted from 1991 to 2009 that looked at that question.

Here is the context:

Progressive brain volume changes in schizophrenia are thought to be due principally to the disease. However, recent animal studies indicate that antipsychotics... may also contribute to brain tissue volume decrement. Because antipsychotics are prescribed for long periods for schizophrenia patients and have increasingly widespread use in other psychiatric disorders, it is imperative to determine their long-term effects on the human brain.

Before I get to what the study revealed, here is the investigator, National Medalist of Science winner, Nancy Andreasen.

Note: The interview was recorded twenty-five+ years after the study began and reflects a development in the questions pursued.

Objective of the study:

To evaluate relative contributions of 4 potential predictors (illness duration, antipsychotic treatment, ill…