DEFINING PRINCIPLES OF THE FELLOWSHIP
While medical education and practice has most recently been focused on the understanding of pathophysiology and treatment of disease, it is also a tradition that has long valued caregiving as a priority of clinical intervention (Kleinman 2020). Medicine has also traditionally been considered a healing profession, “but it has neither an operational definition of healing nor explanation of it’s mechanisms beyond the physiological processes related to curing.” (Egnew 2005)
Reclaiming both compassionate care and the alleviation of suffering as priorities in medicine is the Zen Center’s mission and is the goal of the Fellowship. The twelve-month training seeks to bring together the two streams of the participant’s clinical training and contemplative practice, finding their shared roots and creating a contemplative medicine. This rigorous training engenders radical compassion in both the clinician and the patient, acting as the healing agent of suffering and empowering clinicians to lead change in the culture of care.
The principles guiding the fellowship include:
Contemplative practice as the foundation for resilient and engaged compassionate action.
Experiential learning within the fellowship cohort, the context of one’s clinical place of practice—the “clinical site” for this fellowship—and the whole of one’s life.
Partnership-centered care that is grounded in contemplative care practices. While holding distinct roles and responsibilities, individuals in the care partnership explore intimately the nature of suffering as it arises moment-by-moment and the alleviation of suffering. “Healing is not the outcome of an interaction between an expert and a problem… It requires a relationship between two whole human beings who bring to a situation of suffering the full power of their combined humanity and all of its potential. When this happens, many things that cannot be cured can still heal.” (Remen 2008) Patients and clinicians are both nourished in the practice of medicine rather than care coming at the expense of the clinician’s well-being. Partnership-centered approach to care also extends to include cultivating relationships with family, friends, and loved ones to hold the clinician creating further ground of resilience.
Integration in and of clinician’s personal and professional life: Beyond the notion of work-life balance, contemplative practice in the context of community helps foster greater integration of oft-compartmentalized aspects of individuals’ identities and areas of their daily lives. In the context of healthcare, aspects of compartmentalization are widespread and dire, manifesting in structural, interpersonal, and intrapersonal ways, leading to realities of suffering that require unprecedented interventions. Thus these interventions must necessarily begin with a bedrock of community—a fellowship of clinicians of a new kind—and focus on the clinician as a whole person not just for fulfilling their role as clinician but also in living wholesome lives. Contemplative medicine addresses the quality and nature of time spent in one’s practice, rather than continuing to propagate the notion that if practitioners just had more time, they could address burn-out, isolation, and wellness through “self-care” alone. Integration is the alleviation of suffering.
Fellowship as a dedicated community committed to sustained and compassionate healthcare for generations to come: Within the roots of the Fellowship are multifaceted layers of training and support that center the importance of cultivating meaningful relationships and collaboration. Individuals come together in the spirit of communitas and are nourished by a shared ground of contemplative practice, challenge, and joy. This fellowship is intended to extend far beyond the twelve-month training.