A “white coat” ceremony functions as a rite of passage for students entering medical school. This comment provides a second option in response to the earlier, more enthusiastic, discussion of the ceremony by Raanan Gillon. While these ceremonies may serve important sociological functions, they raise three serious problems: whether the professional oath or “affirmation of professional commitment” taken in this setting has any legitimacy, how a sponsor of such a ceremony would know which oath or affirmation to (...) administer, and what the moral implications of this “bonding process” are. I argue that the initiation oath is morally meanignless if students are not aware of its content in advance, that different students ought to commit to different oaths, and that bonding of students to the medical profession necessarily separates them from identification with lay people who will be their patients. (shrink)

The white coat ceremony is a common practice at many American and European medical schools. Current justification for the ceremony is mainly based on the good will felt by participants and an assumed connection between the ceremony and encouraging humanistic values in medicine. Recent critiques of the ceremony faults its use of oaths, premature alignment of students and faculty, and the selective appropriation of meaning to the white coat itself. This paper responds to recent critiques by (...) addressing their misconceptions and arguing that the white coat ceremony is a contemporary medical ritual with a key role for students and faculty in developing a professional identity.Since its inception in 1993, the white coat ceremony has become a national and international phenomenon. It is now practised at the beginning of the year at more than 100 American medical schools and is supported by foundation grants dedicated to endorsing and encouraging professional development and humanism in medicine.1 While some literature addresses the symbolism and history of the white coat itself, few sources consider the meaning of the ceremony.2–4 A common appeal is to the emotion and good will felt at the event.1,5 Although feelings are important, a deeper justification is called for.Criticism of the WCC is more explicit, charging that the ceremony: uses the Hippocratic Oath inappropriately or, at best, prematurely; fosters improper student faculty relationships, and; interprets the meaning of the white coat selectively.6,7 Critics suggest either that students not be asked to swear an oath together because it might conflict with personally held beliefs, or that students not be allowed to take the oath until they have demonstrated competence as physicians.6 Some also say that the WCC aligns students with faculty and against patients.6 The third …. (shrink)

I shared Raanan Gillon’s1 surprise at Robert Veatch’s criticism of the white coat ceremonies,2 and I think that the points raised by Veatch were quite adequately countered by Gillon’s response. The provocative points raised by Veatch do stimulate some valuable critical thinking about the process, although I think Veatch was carried away a bit by hyperbole. To label the drama of the ceremony as “ominous” goes a bit far by any criterion.I should like to describe an oath (...) taking initiation ceremony in use at the Ben Gurion University Faculty of Health Sciences for almost three decades, its history, features, current practice, and conclusions. I believe that Veatch’s specific objections are addressed by our process and merit consideration by other institutions as well.When the medical school was founded in 1974 the then dean , Professor Moshe Prywes, met with the just entering class several weeks before the onset of the academic year during a summer preliminary orientation period . Professor Prywes, an imaginative, charismatic innovator with a flair for public relations and the dramatic, suggested to the entering class that they take the physician’s oath during the first weeks of the academic year, coinciding with their first exposure to patients . He explained that he wanted the students to regard themselves as already bearing responsibilities and duties, and not just rights. He saw them as “change agents” working to upgrade the medical care and the health of the patients and community, right from the first days of their schooling.I had just arrived in Israel as a new immigrant to assume the foundation professorship of medicine, coming from …. (shrink)

T. A. Cavanaugh's Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession's unique internal medical ethic - in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem -- injury caused by a physician -- and argues (...) that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections. (shrink)

During Abraham Nussbaum's first year of medical school, he participated in a white coat ceremony and was invested, literally, with a white coat that is symbolic of entry into the medical profession. He was also given a book, an anthology of writings on medicine that Nussbaum describes as having a "wistful quality" and being "engaging but reverential" ; the dust jacket featured a Norman Rockwell painting. He later went to a second-hand bookstore and traded the anthology (...) for Abraham Verghese's 1994 memoir, My Own Country, an excerpt from which was in the anthology. For Nussbaum, struggling to figure out what it means to be a doctor, Verghese's writing "portrays the physician as the storyteller of his... (shrink)

Two years ago, like many of my peers, the years of preparation to become a medical student culminated in one single act: the white coat ceremony. After awkwardly lowering myself before my dean with arms extended behind me, my ephemeral initiation into medicine passed as we both wrestled the coat on. I did not think much about the white coat after the white coat ceremony, but something began to itch my neck every time (...) I wore my coat. It was not the tag, but the words printed on it; ‘Made In Pakistan’. The tag was not bothersome because of a jingoistic need for American-made goods, but instead because of the incongruity between the Oath of Geneva’s pledge to ‘maintain the utmost respect of human life’ and the known human rights transgressions of the Pakistani garment industry. In 2012, a factory fire in Karachi claimed the lives of nearly 300 workers.1 Nearly 3 years after the fire, many families are still awaiting long-term compensation for their losses.2 Unfortunately, these poor standards are globally pervasive in the garment industry. The garment supply chain is so convoluted by subcontracting that production may …. (shrink)

What is medical progress? The answer to this question is often associated with advances in diagnostic technology, with greater understanding of disease or pathological mechanisms particularly at the molecular level, or with the discovery of drugs and the developmental of surgical procedures to treat diseases. However, this facile answer can be problematic. In a New York Times Magazine article, for example, Lisa Sanders (2003) recounts a lecture delivered to her first-year class, at a "white-coat" ceremony, by the medical (...) school dean. Half of what we—the faculty—teach you—the students—is nonsense, she was told, but we don't know which half. She illustrates what the dean said, with the following change in advice for .. (shrink)

IN DEFENCE OF MEDICAL COMMITMENT CEREMONIESI confess to an overwhelming astonishment on first reading my friend Bob Veatch's attack on white coat ceremonies. Surely, I had thought, everyone who considered the issue would want doctors to commit themselves to the basic moral goals of medicine and especially that ancient Hippocratic goal of working to benefit the health of their/our patients, and only risking or doing harm with the intention and likely outcome of producing their net health benefit? (...) Surely, too, it's a good idea for the new medical student—or at least the new clinical student about to encounter and interact with real patients—to commit himself or herself to those goals? But as usual Professor Veatch is an incisive and thought-provoking critic and his three criticisms require careful reflection. Those criticisms were: that the oaths or affirmations were not legitimate, especially because the students were unlikely to understand them or their implications; that it is not clear which of the competing candidate oaths or commitments should be chosen and why, and that the “bonding” aspect of the ceremony in which the new student is welcomed as a student member of the medical profession is undesirable in so far as it tends to remove medical students from their own cultures and place them instead in a medical culture “increasingly isolated from the people and cultures from which they have come”.Too ill informed, too young, too coerced to commit?As for the first criticism, I suppose a sensible development of the white coat ceremony would be to send each medical school applicant a copy of the commitment that he or she would be expected to make on joining the medical school so that he or she can study, reflect on, and discuss it with family and friends. On the other hand if the white coat commitment I saw is typical of others, such …. (shrink)

IN DEFENCE OF MEDICAL COMMITMENT CEREMONIESI confess to an overwhelming astonishment on first reading my friend Bob Veatch's attack on white coat ceremonies. Surely, I had thought, everyone who considered the issue would want doctors to commit themselves to the basic moral goals of medicine and especially that ancient Hippocratic goal of working to benefit the health of their/our patients, and only risking or doing harm with the intention and likely outcome of producing their net health benefit? (...) Surely, too, it's a good idea for the new medical student—or at least the new clinical student about to encounter and interact with real patients—to commit himself or herself to those goals? But as usual Professor Veatch is an incisive and thought-provoking critic and his three criticisms require careful reflection. Those criticisms were: that the oaths or affirmations were not legitimate, especially because the students were unlikely to understand them or their implications; that it is not clear which of the competing candidate oaths or commitments should be chosen and why, and that the “bonding” aspect of the ceremony in which the new student is welcomed as a student member of the medical profession is undesirable in so far as it tends to remove medical students from their own cultures and place them instead in a medical culture “increasingly isolated from the people and cultures from which they have come”.Too ill informed, too young, too coerced to commit?As for the first criticism, I suppose a sensible development of the white coat ceremony would be to send each medical school applicant a copy of the commitment that he or she would be expected to make on joining the medical school so that he or she can study, reflect on, and discuss it with family and friends. On the other hand if the white coat commitment I saw is typical of others, such …. (shrink)

Over the past century, six studies – the most recent data from 2000 – and one review have comprehensively examined the content of medical oaths and oath-taking practices, all focusing on North Amer...

I was deeply moved and inspired by Jason Dubroff’s article1 objecting to the source of the white coat distributed to the entering medical students at his school. The article stimulated me to ponder its implications and led to some thoughtful discussions with colleagues. Here was a busy medical student who was appropriately disturbed at what he regarded as a kind of ethical failure at the very ceremony, which was meant to exemplify and emphasise the values of humanism. However, (...) unlike many of us who notice evidence of ethical insensitivity, react with a sigh or a comment, and go on with our lives without significant alteration in our normal activities, Jason initiated an investigation of the issue, researched it in his own time, and even proposed remedial actions—a remarkable, unusual and impressive course of events. His article reinforced some of my personal prejudices. To those of my colleagues who nostalgically bewail the alleged decrease in idealism in today’s entering medical students, I can point to Jason as an example of the kind of ethical sensitivity, …. (shrink)

What does it mean to wear the white coat? I began to grapple with this as an internal medicine intern. I trained at Duke, where the dress code was more formal than at my medical school. Other than...

The idea behind Lauren Slater's book is simple but ingenious: pluck 10 leading experiments in 20th-century psychology from the pages of the scientific journals in which they were first published, dust off the painfully academic style in which they were written up, add some personal details about the experimenters and retell them as intellectual adventures that help us to understand who we are and what our minds are like.

The idea behind Lauren Slater's book is simple but ingenious: pluck 10 leading experiments in 20th-century psychology from the pages of the scientific journals in which they were first published, dust off the painfully academic style in which they were written up, add some personal details about the experimenters and retell them as intellectual adventures that help us to understand who we are and what our minds are like.

There is a debate regarding the use of the white coat, a traditional symbol of the medical profession, by students. In a study evaluating final-year South African medical students' perceptions, the white coat was associated with traditional symbolic values (e.g., trust) and had practical uses (e.g., identification). The coat was generally perceived to evoke positive emotions in patients, but some recognized that it may cause anxiety or mistrust. Donning a white coat generally implied (...) a responsibility to the profession. For a few, without the coat, patients would not cooperate, resulting in some perceiving no need to be distinguished from qualified practitioners. There was thus some evidence of entitled (vs. earned) respect. In the light of the underresourced health care setting in which these students learn clinical medicine, we recommend that students be able to recognize the potential for unprofessional or unethical behavior. Students should also be able to identify role models. (shrink)

This volume contains contributions on different aspects of practical conflicts by: Peter Baumann Monika Betzler Ruth Chang Jon Elster Barbara Guckes Christine M. Korsgaard Isaac Levi Alfred R. Mele Joseph Raz Henry S. Richardson Peter Schaber J. David Velleman Nicholas White.

The funeral procession of Sheng Xuanhuai – the renowned Qing scholar-official, financier, and “father of Chinese industrialism” – meandered through the streets of Shanghai on 18 November 1917. The funeral was a grand event, one that was purportedly documented in film, later to be distributed as the first “news short-film” in China. TheNorth China Heraldreported on the event in some detail, at times in rather florid language, and suggested that “the cortege was splendid and impressive, bringing back the days of (...) the Manchu emperors. The ceremonial costumes, the musical instruments and much more of the accoutrements dated back to the days of the Empire”. And indeed, the procession included a variety of ritual customs and insignia from Qing times: imperial banners, ancestral tablets, Buddhist and Daoist priests, paper artifacts, and much more. Simultaneously, nonetheless, other kinds of participants and objects – new and not of imperial pedigree – were part of and intermixed with the older materials: certificates of rank were carried on cars; boy scouts and college students marched alongside the priests; many of the participants arrived by train ; and as the Shanghai portion of the procession ended, it continued by steamer to Suzhou. The conclusion of theNorth China Heraldaccount, however, seems to have emphasized a dichotomy of old and new rather than a joyful mix of the two:Hundreds of men, dressed in the ancient costume of the old dynasties, bore a strong contrast to the eight behind them, sons of intimate friends of the deceased. They were on horseback and wore high silk hats, frock coats and white breeches tucked in riding boots.Truly the passing of the old and the entering of the new. This view – the old giving way to the new – was not just an off-hand journalistic analysis; it was part of a larger discourse about the nature of modernity, about progress, and about the relationship between East and West. By the early twentieth century, China was often perceived by most Westerners and Chinese alike as traditional, backward, and weak. It was, thus, commonly stated that the old was giving way to the new, should be giving way to the new, or was bound to give way to the new, if China was to survive. This kind of discourse was put forward by both Western and Chinese writers, who embraced this linear, progressive, view of the relationship between the old and the new, well before Sheng's funeral or the Qing's demise. In the aftermath of that demise, the New Culture Movement began to grow and seek solutions for the old-new nation's crisis. The Movement's rhetoric in particular advanced the need for the triumph of the new, and journals, such as New People, New Tide, or New Youth served as media for extending such views. (shrink)

I argue that popular understandings of white nationalist double speak strategies do not fully represent the practice of these strategies, and identify a linguistic tactic used by white nationalists that I call sugar-coating. Sugar-coating works by packing an otherwise unacceptable utterance together with some kind of reward, thereby promoting uptake. I contrast this with existing notions of double speak, such as figleaves (Saul 2017, 2021), dogwhistles (Haney-López 2014), and bullshit (Kenyon and Saul 2022). I argue that sugar-coating more (...) accurately reflects the practice of white nationalist recruitment rhetoric, as described in the Daily Stormer Style Guide. (shrink)

The White Coats for Black Lives and #ShutDownSTEM movements have galvanised biomedical practitioners and researchers to eliminate institutional and systematic racism, including barriers faced by Black researchers in biomedicine and science, technology, engineering, and mathematics. In our study on Black–White funding gaps for National Institutes of Health Research Project grants, we found that the overall award rate for Black applicants is 55% of that for white applicants. How can systems for allocating research grant funding be made more (...) fair while improving their efficiency? (shrink)

This article investigates the structure of racialized conflict experience. Embarking from a conflict event in Ta-Nehisi Coates's autobiography Between the World and Me and contrasting the work of Maurice Merleau-Ponty and Alfred Schutz with insights from Black phenomenology, I argue that Coates's experience discloses conflictual, but intertwined, modes of being-in-the-world. Further, it presents an instantiation of a particular kind of conflict, i.e., corporeal conflict. Corporeal conflict applies whenever the body is politicized, i.e., when it becomes the marker for traits representative (...) of a rival political group. Understood this way, racialized conflict is always political. I conclude the article with some remarks on the shortcomings of two dominant conflict theories in political philosophy and the potential for an alternative, phenomenological approach that enables new ways of engaging the other in conflict. The analysis is preceded by a meditation on the role of the White researcher in critical philosophy of race. (shrink)

Some scholars read the black body as constructed by white consciousness or perceptions; Coates indicates, to the contrary, that violence against the black body and threats to black embodiment ground and make possible particular ideations of race and (white) American self-concepts. Coates takes an implicitly anti-Hegelian, anti-DuBoisian stance against any spirit or history that might redeem or affirm the black body as the grounding of black experience. Like repeated speech-acts, bodily violence is “world creating.” Although material treatment of (...) bodies and their conceptual signification are mutually reinforcing, Coates’s reversal of etiology signals a material foundation to concepts of race and to solutions to racial injustices. Only through the end of violence to the black body might white Americans change their ideation and achieve racial justice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Utopia on Earth?: Sustainability, White Tourism, and Neocolonial DesireRoslyn Fraser (bio)IntroductionSeveral scholars, and even a few journalists, 1have written about the figure of the international tourist who uses South Asia as a canvas upon which one can create and recreate the self. Perhaps the most discernable example in the pop culture imagination is Elizabeth Gilbert's trip to an ashram in India, documented in Eat Pray Love(2006), which inspired (...) a problematic succession of travelers who followed her footsteps to communities that simply could not accommodate the traffic. International travel and tourism from the Global North to places like India, Nepal, and Sri Lanka frequently represent a form of neocolonialism wherein destinations and the people who live there are imagined not as places with a complex history inhabited by humans with their own subjectivity, but as mirrors the traveler can hold up as part of their search for a personal identity. 2This imagining is perpetuated through imagery from film and literature (like Eat Pray Love), in tourism advertisements, on social media, and in spaces like yoga studios. These texts often objectify South Asian people as they beckon the middle-class Western traveler to the [End Page 226]subcontinent to embark on their own process of self-actualization and self-discovery. Specific to India, Rumya Putcha and Sangeeta Ballabhan explain the phenomenon in detail:In these stories, India is consistently described as a place where those from North America or Europe can "find themselves," "surrender," "find grace in poverty," "learn tolerance," "experience culture," or "withstand an assault on the senses." 3Whether the focus is a yoga retreat in India or a backpacking trip in Nepal, one need only look at a handful of online travel blogs to encounter these themes.One peculiar version of Western imaginings of South Asia is found in places like Auroville, a settler colonial utopia or intentional community near Pondichery in south India. In his 2021 book, Better to Have Gone: Love, Death, and the Quest for Utopia, Akash Kapur estimated that thousands of these utopian experiments were set up in the 1960s and 1970s. 4Focusing on the relationships and power dynamics inside Auroville, which still exists today, Kapur presents us with many reasons to question its idealism. But as a utopian experiment, Auroville continues to be praised as a model for sustainable living. 5Its site is protected by UNESCO and it receives funding from the Indian government. Auroville also receives aid from nongovernmental organizations (NGOs) and cash donations from individual donors, and supports itself through product sales and tourism. Photographs on their website highlight the 372 acres of farmland 6established at Auroville over the last fifty years as well as the community's commitment to "green practices." 7One cannot help but wonder how much of their success in reforesting land and sustainable living is a direct result of their economic resources alone.Colonial ResiduesThe enduring idea that South Asia is a space where utopia can be realized, experienced, or built has its roots in the era of European colonization of the subcontinent. In her analysis, Jessica Namakkal reminds us that Auroville was founded in the direct shadow of colonialism, twenty years after British Imperial rule ended and a mere six years after the end of French colonial rule [End Page 227]over Pondichery. 8Its opening ceremony was attended by an international cast of interested people, mostly from the Global North and West. A sizeable area for viewing the ceremony was reserved for people from the surrounding villages of Tamil Nadu, but with a barrier separating them from the rest of the crowd. 9Not exactly a great beginning for a place that was designated a cradle for a better humanity, or, as Aurovillians put it, "the city the Earth needs." 10For its part, Auroville addresses the issue of neocolonialism directly and succinctly in a section of its website for frequently asked questions, 11 question: Is Auroville sometimes accused of being neo-colonialist? answer:Very rarely; mostly by Westerners who know little about Auroville and how it functions, and equally little about the colonial era.How might we unpack the above statement? First, the... (shrink)

White-coated scientists versus black-robed preachers -- The images of evolution -- Doubts about Darwinism : an interview with Jonathan Wells -- Where science meets faith : an interview with Stephen C. Meyer -- The evidence of cosmology : beginning with a bang : an interview with William Lane Craig -- The evidence of physics : the cosmos on a razor's edge : an interview with Robin Collins -- The evidence of astronomy : the privileged planet : an interview with (...) Guillermo Gonzalez and Jay Wesley Richards -- The evidence of biochemistry : the complexity of molecular machines : an interview with Michael Behe -- The evidence of biological information : the challenge of DNA and the origin of life : an interview with Stephen C. Meyer -- The evidence of consciousness : the enigma of the mind : an interview with J.P. Moreland -- The cumulative case for a creator -- Appendix -- Deliberations : questions for refection or group study. (shrink)

In a White House ceremony on May 16, 1997, President Clinton issued an apology on behalf of the nation for the Tuskegee Syphilis Study, a forty-year research project in which African-American men were deceived and denied treatment in order to document the natural course of syphilis. Reflection on this occasion can give us pause to take pride in the progress made toward more ethical research with humans. The President's apology is perhaps the most public of a number of recent (...) events representing a renewed attention to ethics in research with human participants. Alongside it stand the efforts of treatment activists for people with acquired immune deficiency syndrome and the revelations of the human radiation experiments. In 1995, President Clinton called for the creation of the National Bioethics Advisory Commission, which was charged with a host of projects aimed at investigating the organization and function of the federal system for overseeing human subjects research in the United States, and giving guidance on specific forms of research. (shrink)

At a White House ceremony in October 1995, the Advisory Committee on Human Radiation Experiments presented its Final Report to President Bill Clinton. The 925-page report and the over 2,000 pages of supplemental volumes summarized eighteen months of investigative research, debate, and deliberation on historical and contemporary issues in human subjects research. The Advisory Committee's efforts were aided by unprecedented support from the highest levels of the executive branch, including the heads of eight cabinet-level agencies and their departments' resources. (...) The presidentially appointed committee and its staff delved into long-forgotten Cold Warera government archives, listened to hours of public testimony, interviewed key players in the development of medical therapies and nuclear weapons, and studied ethical issues arising in today's research.In this article we focus on a critical, but narrowly defined, part of the Advisory Committee's Final Report: remedying harms or wrongs to subjects of human radiation experiments conducted or sponsored by the U.S. government between 1944 and 1974. (shrink)

In a White House ceremony on May 16, 1997, President Clinton issued an apology on behalf of the nation for the Tuskegee Syphilis Study, a forty-year research project in which African-American men were deceived and denied treatment in order to document the natural course of syphilis. Reflection on this occasion can give us pause to take pride in the progress made toward more ethical research with humans. The President's apology is perhaps the most public of a number of recent (...) events representing a renewed attention to ethics in research with human participants. Alongside it stand the efforts of treatment activists for people with acquired immune deficiency syndrome and the revelations of the human radiation experiments. In 1995, President Clinton called for the creation of the National Bioethics Advisory Commission, which was charged with a host of projects aimed at investigating the organization and function of the federal system for overseeing human subjects research in the United States, and giving guidance on specific forms of research. (shrink)

At a White House ceremony in October 1995, the Advisory Committee on Human Radiation Experiments presented its Final Report to President Bill Clinton. The 925-page report and the over 2,000 pages of supplemental volumes summarized eighteen months of investigative research, debate, and deliberation on historical and contemporary issues in human subjects research. The Advisory Committee's efforts were aided by unprecedented support from the highest levels of the executive branch, including the heads of eight cabinet-level agencies and their departments' resources. (...) The presidentially appointed committee and its staff delved into long-forgotten Cold Warera government archives, listened to hours of public testimony, interviewed key players in the development of medical therapies and nuclear weapons, and studied ethical issues arising in today's research.In this article we focus on a critical, but narrowly defined, part of the Advisory Committee's Final Report: remedying harms or wrongs to subjects of human radiation experiments conducted or sponsored by the U.S. government between 1944 and 1974. (shrink)

It has been a little over three months since I returned. My day begins with an altercation with a new security guard who stops me as I drive up to the gate of the brand-new university hospital. He tells me that I am to use the other entrance, as only the chairman’s car is allowed through this gate. I inform him that I am the chairman. He peers at me suspiciously. The chairman sahib is a man not a woman, he (...) says. I put on a stern face and tell him that I am the chairman and he will get into trouble for not letting me through. He looks uncertain but eventually lets me drive in through the gate. I pick up my white coat and stethoscope from my... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Comme Elle Respire:Memory of Breath, Breath of MemoryFrédérique Berthet (bio)Translated by David F. Bell (bio)La poésie est un système de respiration, c'est fait pour mieux respirer.[Poetry is a respiration system, it's made for breathing better.]—Erri De Luca- Stop!- What?- I can hear you breathing!...- Stop!- Breathing?- Yes!—Paul Thomas AndersonLittle paper-fish cutouts have been placed on the ground, on the carpet.We're in the reassuring '70s stylishness of a doctor's office. (...) The carpet is soft and glistens like in interior decoration magazines, it's with it, in. We couldn't care less about what Dyson vacuum cleaners and "purifiers" boast they can eliminate several decades later: acarids, those microscopic domestic arthropods, human parasites (notably), and airborne vectors of infectious disease (colds, coughs, respiratory distress). No, in the spring of 1975, innocently and self-satisfyingly, the urbane doctor flaunts the opulent carpet with curly pile in his luxury apartment with its state-of-the-art waiting room.In this grand interior of a medical office, a man in a white coat plies his important trade. For example, that day a little girl is re-learning how to breathe. One might think that exhaling and inhaling is learned for life—je t'aime comme je respire, elle parle comme elle respire, il ment comme il respire1—from the very first cry at birth. But in fact, sometimes in life breathing gets stuck between the nasal cavity and the bronchial tubes, between the respiratory tract and the lungs. Progressively, imperceptibly, the organism is short of air, a malicious infection spreads and impairs [End Page 92] alveolar diffusion to the point of respiratory exhaustion: Is it serious, doctor? We must act quickly, very quickly. How to liquify what stopped up the system one day to the point of blocking it—the doctors know what to do.This doctor undertook long, arduous and learned studies. He knows functionally how a living being breathes, how a child lives organically. He can also re-teach the little girl what she no longer knows how to do: inhale, exhale using the full volume of the thoracic cage, regulating the ventilatory flow, solidifying the invisible membranes. In the child's family, everyone knows (and knows how to do) important things, but no one undertook extensive studies, much less studies of the aerial exchanges in the human body. This special knowledge possessed by the doctor (unless special means something else unspoken that would explain why this specific doctor was chosen rather than any other) surrounds him with a padding of respect that creates (and the little girl feels this) a sort of protective continuum between him and the walls within which he sees her, where he practices his kind of calm and slow urbane medicine. It's far from the formidable hospital she has just left, with its spherical apparatus next to the bed aspirating the red and yellow pleural liquid, the "treatment room" where the surgeon, the "butcher" as the nurses call him among themselves, manipulated the drain without anesthesia, with no regard for the child's suffering. The doctor, and his place in the elevated tower, even though they are not to be confused, make for a cozy reception space in which one is comfortable, even in passing.This doctor—who is, in truth, a massage-physiotherapist—is located in a designer high-rise building with a façade decorated by white, pointed features that manifest a will toward an architectural act. On the ground floor, the entrance hall is finished in dark-veined, clear brown marble, and the entry threshold between the exterior and interior is marked by large transparent glass panes that must be manipulated with care. The entrance hall has an intimidating sonority and a useless cold nudity from which one escapes in an elevator where one is surrounded by mirrors and gold buttons and in which one speeds upward silently toward floors, clouds.The designer high-rise is located at the outskirts, the outskirts of a city of recent Olympic stature, where several years earlier Olympic athletes were welcomed and trained to increase their respiratory capacity and... (shrink)

In our family medicine program, applicants' personal statements largely speak to the value of trusting, continuous doctor‐patient relationships. They give poignant examples of patient interactions that have allowed the applicants to experience the privilege of the intimacy with which patients relate to their doctors. Whatever their true motivations for choosing family medicine, the relational values expressed in the personal statement are the ones we celebrate and incentivize in the residency selection process. However, after donning their freshly pressed white coats, (...) new interns in family medicine hear different definitions of value applied to their chosen specialty. (shrink)

The brain in its plasticity and inherent 'sociality' can be proclaimed and projected as a revolutionary organ. Far from the old reactions which opposed the authenticity of political theory and praxis to the dangerous naturalism of 'cognitive science' (with images of men in white coats, the RAND Corporation or military LSD experiments), recent decades have shown us some of the potentiality of the social brain (Vygotsky, and more recently Negri 1995 and Negri 2000, Virno 2001). Is the brain somehow (...) inherently a utopian topos? If in some earlier papers I sought to defend naturalism against these reactions, here I consider a new challenge: the recently emerged disciplines of neuronormativity, which seek in their own way to overcome the nature-normativity divide. This is the task of a materialist brain theory today. 1. The setup: horns of a dilemma There is a lingering zone of what one might think of as sore cognitive muscle tissue in the area of materialism. It is an area of both contested territory and in some cases, a kind of pathos of distance of the 'Ugh! Keep that thing away from me!' sort. I have in mind the combination of materialism as an emancipatory socio-political project (which need not be construed in strictly Marx-Engels terms, if we think of Lucretius et al.) and as a cold-hearted 'spontaneous philosophy of the men in white coats', e.g. nefarious neurophilosophers. Faced with this rather massive alternative, this choice between two projects, I have stubbornly been saying since some discussions with Negri in the late 90s. (shrink)