House Calls Podcast

Can We All Be Healers?

With guest Dr. Rachel Naomi Remen,

Physician & Teacher 

Hello and welcome to House Calls. I'm Vivek Murthy and I have the honor of serving as U.S. Surgeon General. I'd like to introduce you to Dr. Rachel Naomi Remen, a physician teacher and my longtime mentor. Today, we'll be talking about the role of the heart and soul in medicine and healing. My guest today is someone I love and deeply respect. Dr. Rachel Naomi Reman is a physician renowned for practicing both the art and science of medicine and for sharing her philosophy with generations of medical students around the world. Rachel was born into a family of doctors and nurses. She's old enough that when she decided to become a doctor, she was the only woman in her medical school class. Rachel became the head of pediatrics at Stanford, co-founder and medical director of the Commonweal Cancer Health Program, and she taught medicine at UCSF and Wright State University. In 1991, she started The Healer’s Art, a course for medical students that focuses on compassion, service and love. The course had humble beginnings, as you'll hear, but has since reached more than 36,000 students in more than 90 medical schools in the U.S. and abroad. I'm one of those 36,000 students. In true Dr. Remen fashion, we connected deeply, and she has remained a mentor and a friend, someone who has helped me know who I am, as a doctor and a human being. I'm delighted we were able to do this House Calls recording in-person at Commonweal in Northern California. And I'm now excited to share with all of you this conversation with one of the wisest people I know. Thanks to all of you for joining us here today. We began "House Calls," our podcast, in order to have conversations just like this in spaces like this, where we could talk about issues that really matter for us to live a meaningful and fulfilling life. And at the center of that is the importance of human connection, and many of our conversations center around how we can rebuild our relationships, our sense of connection, and community in our lives. I am particularly excited for this conversation. I'm so grateful, Rachel, that you agreed to have this conversation with me. You know, Rachel, you've heard about Dr. Remen's background, but you have, in my mind, some additional titles, which are, as a mentor, as a teacher, and as a source of inspiration to me over the years. And I've just been blessed to learn from Dr. Remen over the years through conversations with her, through her two wonderful books, her two first books, I should say, "Kitchen Table Wisdom" and "My Grandfather's Blessings," which I still have to this day on my shelf and which I turn to from time to time when I'm looking for inspiration and when I need a reminder of what really matters in the world. In so many ways, Rachel, you have been my compass in the world, in a world that's moving and changing quite a lot, and so thank you for that over the years, Rachel. And I'm so glad that we will get to share so much of your wisdom with the world through the conversation we're gonna have today, and I'm excited for it to be shared more broadly. I want to start though, Rachel, you know, you and I are, obviously we've been connected for a long time, and I know you told me before we started this conversation that you wanted to tell the story of how we met. So the floor is yours. 00:03:41,400 --> 00:03:43,733

Yeah, well, it's a fairly long story, but let me start by saying it started with two medical students at our very famous medical school in San Francisco, who decided they wanted someone to give a lecture on the role of the heart and soul in medicine. So they went to the Associate Dean of Education, and they asked if one of the faculty could give a lecture on the role of the heart and soul of medicine. And actually they asked if he would give the lecture on the heart and soul of medicine, and he realized that this would be professional suicide. (audience laughing) And he said, well, he was a busy man, but he would recommend so and so. So they went to see this other faculty member with the same request, and the faculty member had pretty much the same reaction, professional suicide, and referred him to someone, them to someone else. So they had gone through several people, right? And finally they got to a man who was Jesuit and a physician and a faculty member, and even he felt it was too great a risk professionally to actually stand up there and talk about the heart and soul and its role in medicine. This is a while back, by the way, of course, maybe almost 30 years ago, right. But he knew me, (laughs) and we had sat on a board together. So he called me up and he said, "You know, would you be willing to give a talk?" And I had been involved in another project on my own, which involved Commonweal. And I brought groups of doctors here for four days at a time, and we talked about the role of the heart in medicine. We talked about the role of the soul in medicine for four days. We talked about- And we began looking at medicine as something more than drugs and cure and back to an old tradition where medicine was a spiritual practice, right? And I said, "Perfect. (laughs) And I'll give a talk and you just give me a place and a time and let the students know, right." So I met these two young men, and they were thrilled. And they gave me a place to give the talk, and I arrive to give the talk and discover the place is in the sub-basement of the medical school. Not the basement, but the sub-basement, where all the broken wheelchairs and the broken gurneys are in the corridor, right. And we go down there in the elevator, me and two of these doctors that have been studying this expansion of medicine, and we're met by 10 medical students and the janitor, who opens a storeroom for us. And we go into this room that's full of boxes, and this is the room we're supposed to teach in. So the students sit on the boxes and we give a- We begin to discuss with them, you know, love and its relationship to medicine and, you know, the soul and its relationship to medicine. And they start telling their stories, and we start telling ours, and we have a perfectly wonderful time. And then at the end, one of the students says, "Could you come back?" And I said, "Sure, when would you like us to come back?" And they said, "Next week." So we say, "Sure, we're coming back." And we come back and we go down in the elevator, and we open, the door opens, and the corridor is full of young people. And I say, "Oh, somebody else must be giving a lecture down here too." (audience laughing) But no, they're here for us, and we don't fit into the storage room. So they open a bigger storage room. (audience laughing) And we have another lecture, and then we come back for a third time, and we have the entire freshman class. And I realize we're doing something important. We've stumbled on something important. So we started teaching secretly. I mean, you couldn't do this in the middle of the regular curriculum. So we would do it at six o'clock at night, from six to nine o'clock at night on a Monday evening, about every two weeks for three months, right? And we would do it in this building that the school owned, but it was basically vacant. So here we are in this vacant building, right? And we're doing this year after year, and year after year, we're getting the whole freshman class. And we're doing all kinds of things. We're doing imagery, we write poetry. We tell stories. We use symbols. And we basically talk about what it means to be a healer and what it means to be part of a tradition of healing that goes back to the cave, you know, millenniums ago, and all of this, right? (laughs) And maybe, what, the fourth or fifth year we did this, right, at the end of the last session, a young man comes up to me, and I can tell you exactly where he was standing. He was standing on my left. He wasn't wearing his uniform. (audience laughing) His hair was a different color. (audience laughing) But it was him. (laughs) And he thanked me for the course in his very gracious way, and I thanked him for attending it. And then he said, "You know, I just want to say, you know, I'm not a medical student here." And I say to myself, oh my God, you know, 'cause we're not even taking attendance, right? (audience laughing) Maybe he's a nursing student. And I say, "Oh, what do you do?" And he said, "Oh, I'm a medical student." And I said, "But where do you go to school?" He says, "Yale." (laughs) And I say, "Are you on leave?" And he says, "No, no." He said, "My freshman roommate up in college told me about this course. He took it last year. He said it was very important. So I thought I would come and take the course," right? I said, "Well, why you want to do that?" And he said, "I want to bring it to Yale." And something in me goes click. (audience laughing) And I say, "Oh, no. This is a California thing. (audience laughing) It wouldn't work in Yale. I mean, you know, all these imageries and the poetry and the drawings, and, you know, all these meditations. It would only work here in California, you know." And I go on and on and on in telling him how it would never work in Yale, et cetera. Besides, Yale is so far away. They speak a different language. (audience laughing) And I hear myself going on and on and on and on, and I finally finish. And he's very respectful. He's listening very carefully. And when I finish talking, he looks at me, he says, "Well, we're going to try, aren't we, Rachel?" (audience laughing) And I was ashamed. I was ashamed. So I flew to Yale and I taught them. And I remember telling them, the Yale faculty, they don't even see patients anymore. They're all researchers, right? We taught the researchers how to do the imagery and how to do the meditations and the prayers. We taught them everything, and then they did it. And the Yale class has exactly the same reaction as our class did. And I realized we had stumbled on a great wound in medicine and something that would heal it. And that was the reason why we are in 90 medical schools today is because of this man. (audience hmming) And his whole attitude of, "Well, we're gonna try, aren't we? We're gonna try to do the right thing, right?" has changed the world. So I thought I'd make my introduction to you, my dear friend, yes.

Well, thank you for sharing that, Rachel. We were just saying before that life is so interesting in how we come together and cross paths with one another at the times we're supposed to. If I had not come to visit my friend who was in medical school and who were taking Rachel's course, if I had not come on that particular week, I would have missed the course. And it just so happened I was there at a time where he was attending a session where I could come and join in. And so, you know, I like to believe there are no accidents in the world, and I feel very blessed to have had that encounter because it's certainly changed my life. And, you know, we were talking, you know, in this about medicine and about training. And that's where I'd like to actually start our conversation, Rachel, because this is a time where many people are suffering in the world. Yes, that's true.

And we can get into, you know, later on the conversation, the reasons for why that may be, but it feels like a time where healing is more important than ever before. And you've made a beautiful distinction between curing and healing, and I was wondering if you could talk a little bit about that, what that distinction is, and how should we be thinking about that distinction as we seek to care for others?

Hmm. Well, how would you define healing? Say healing is enabling things to fulfill their natural wholeness, yeah. And you could have a disease and be healed, has nothing to do with, you know, the body. It has to do with a life really and a life that has made a difference in some way to not just yourself, but to the people around you. Yeah, yeah. I myself, as you know, have had a chronic illness, a very serious one. Wow, it's 70 years now. (laughs) 70 years. So I have never been, quote, a healed person, but I am, of course, a healed person because of my illness. I think I am a much larger person because of my illness and that… Yeah, much wholer person because of my illness. You can be wounded and whole. In fact, many people are. Most people are actually. Is that the sort of thing you had in mind? Yeah, and in fact, you've spoken about people in medicine and in fact about all of us as wounded healers. And when first time I heard you use that term, I thought it was so powerful and so honest. Because we are all suffering from our own wounds, and I think historically, in medicine in particular, we have tried to hide those wounds, and we've thought that they make us weak and less able to help those in front of us. And I think one of the things you've helped me realize over time is that those wounds can be a source of strength, a source of perspective, and we can use that to help those around us.

I think even more than that, in a funny way, they're a source of connection.

Hmm.

That the fact that we too are wounded, that we too are afraid in the dark means that no one has to be alone. And, you know, this thing that you're doing here of looking at loneliness as our national illness as it were, I think, is right on. Because, you know, we've thought of independence as the strongest of human states, and it isn't. Interdependence is, yeah. And loneliness is easily cured, I think. And I think that for me, the cure of loneliness is service, is you find some other people who have needs and you begin to fill them, and then you're not lonely anymore. You're living something meaningful. I remember when I, and, you know, in the day, the idea that a woman would want to become a doctor was a little bit weird, you know. I remember going to tell my grandfather, I was seven, just the same age as your little boy, that I was gonna be a doctor when I grew up. And I remember his reaction. He said, "Oh, that's wonderful, Neshume-le," which means little beloved soul. "That's wonderful, Neshume-le. You'll never be alone."

Aww.

Aww.

And the medical students are alone. When you talk to medical students and you say, "How are you, how are things?" when they trust you enough to tell you the truth, which takes a while because they are being evaluated every minute of the day. Records are being kept on their performance every minute of the day. They feel very deeply unsafe and not at all accepted for their individuality and who they are. They feel a need to be perfect, and so they isolate themselves from each other. I think that's why the course took off like that. Because we heal loneliness in this course, and we heal it by making it clear that only human beings can heal other human beings, yeah.

And I can attest to that sense of community and connection that you created with the course 'cause when we, when I took it, you know, at Yale, I felt that sense of community at a time, and that was at the beginning of medical school, but the sense of connection and identity starts to be stripped away early on in medical training.

Very early.

And that course gave me a community. And one tradition you started, which was a beautiful one in the course, is that people who participated would get a small stuffed red heart that they would put in their pockets and carry with them.

Yes.

And I remember when we got later in medical school to third and fourth year when we were in the hospital taking care of patients and feeling the throes and challenges of the medical culture at that time and all the demands of patient care, we would sometimes see another student pull their heart out of their pocket and just hold on to it, and we would know, ah, they're a member of our community as well. So that was a very powerful antidote to loneliness, as you put it. And you said, you know, something very interesting in an interview some time ago, which in talking about Maimonides and how Maimonides and his text was an inspiration for you to join medicine. This beautiful quote, which I wrote down because it touched me, where you said, "Medicine is a special kind of love. It is befriending the life in others."

Mm-hmm.

And I found that so powerful, and to me, it was a lesson even beyond medicine. That as we look around us and encounter others who are wounded or may be in distress or in despair in their own way, that we can be healers as well. That we don't need medical degrees alone to be able to reach out and to befriend the life in others.

You know, Maimonides, what's that? The sixth century. (laughs) Mm-hmm.

That was a long time ago. He asked for the strength to be a physician, to be surrounded with suffering and pain and loss for, you know, your whole life. And then he says, "Inspire me with love for all of thy creatures. May I see in all who suffer only the fellow human being." And, you know, that's where it's at. That, especially as a person who's been hospitalized, my God, hundreds of times, literally 100 times, I'm sure, and operated on at least 9 or 10 times, right, the people who were fellow human beings were the ones who really helped me. And, you know, medicine's become technical. You know, it's become very intellectual. They're great and all of this is helpful, but this isn't enough to restore people to their full efficacy as human beings. This restores the body, but often people carry the wound of an illness in other ways that have nothing to do with the body. And then if their physician is there as a full human being, that other way can get healed as well.

Hmm.

Yeah, yeah.

And what an important lesson, I think, to remember as we look at artificial intelligence and the dramatic expansion of artificial intelligence's footprint, if you will, and with all the discussions about how it will change healthcare. And in some ways, I think it may change it for the better, but what you're pointing to is that there is an enduring role for our humanity, for people to be a part and a source of healing for each other, and I think that is such an important lesson to remember.

Well, that's how we belong. We belong to each other. I think the loneliness that many people talk about today is because they don't feel they belong anywhere. And the way you belong is through service. That's the only way I know to really belong. And, you know, if you think even of your family's situation, those are relationships of deep service, your husband, your wife, your children. And then you extend that out to your neighbors, to your patients, right, and you're never alone, yeah. you've spoken very thoughtfully about two experiences you had in your life, which perhaps made you feel like you didn't belong initially. The one was, as you mentioned, that experience of illness, of being diagnosed with a serious illness very young, at a very young age and having to contend with that. But the second was also being a woman training in medicine at a time where there were very few women training in medicine. And when I was, when I heard you talk about that, I thought, gosh, you felt like an outsider at a time when you were growing up and trying to build a career and learn medicine. How did you deal with that lack of belonging, and how did you finally find a place where you felt like you truly belonged?

I think my patients healed me, really. You know, I used to tell stories. I'm full of stories so I used to tell stories. And people made fun of them. My fellows made fun of them because they only happened to one person, so how could they have any significance? I did not research, right? But the patients would tell me their stories, and I would tell them mine. And I saw what happened, you know, when we told each other our stories. Not about our diseases, but about the strength we found in the experience of disease that helped us not only to live past the disease, but to live beyond the disease and also to help other people to live.

Hmm.

Yeah, yeah. And I mean, you want stories about what it was like to be a woman, really?

Yeah, yeah.

Okay. (laughs) I'll tell you a couple of hair-raisers.

Sure. (laughs) You want a hair-raiser? Okay, so I was… We started with a section that was the- I think imagine this. They don't teach this way anymore, but the very first day of medical school, you go into a room, and there are a whole bunch of dead people lying on tables, right? You're assigned a dead person. And then you will be, and three of your colleagues, your medical, and the four of you are gonna be operating on this dead person six days a week for six months, right? You're gonna learn anatomy this way, right? So there's the whole class, men and me, right? Nobody wants me as a partner. Every time we had to break up into groups, I was always standing there, and whoever was the professor would have to say, "Would you go join that group over there?" right. And I was not welcomed by that group over there ever, right? So I was late one morning, I forget why. And this was a room, a large room, and it had hooks on the walls, and we had our white coats that we wore when we dissected hanging on the walls. And for that reason, they smelled of formaldehyde, and so did we, and it was an awful way to be introduced to healing, right? And I'm late and I come running in. There's my white coat and I whip it off the wall, and I put my jacket up there, and I put the white coat on and I button it, and I put my hand in my pocket to get my dissecting kit, and there's something in my pocket. And I pull it out and it's a penis. (audience gasps) And I realize the room is very silent, and it's because everybody's watching me. Everybody knows this is going to happen, right? And something in me snapped, and I held it up and I said, "One of you guys lose something?" (audience laughing) And everything changed. I was in. (audience laughing)

Oh my goodness. (audience laughing)

It was tough in the day. It was really, really tough. I'm 85, right? And I can still get tears in my eyes over some of the things that happened. You know, it was cruel. It was cruel. But yeah, I think… It's interesting. I didn't fit in. You know, I didn't fit in, and I was wise enough to know something that my grandfather had told me was true. That sometimes when you don't fit in, it's because you belong to the future.

Hmm, wow.

And I've told many, many medical students that. "You don't fit in, how wonderful. You belong to the future. You're going to build the medicine that you fit into. Don't leave medical school."

God, that's so beautiful. I will say, as somebody who has struggled with feeling like an outsider my entire life, that means a lot, and to me, it resonates very deeply.

Yeah, yeah.

And I suspect a lot of people have also felt like outsiders, that they don't belong, especially in a world, Rachel, where it feels like, and young people tell us this all the time when we travel around the country, that it feels that the world is telling them who exactly they need to be. That they need to be dressed a certain way. They need to have a certain list of accomplishments, a certain amount of money. Be famous, you know, be powerful. Like all of these things in order to belong or to be accepted. But I can see and feel in these conversations with college students and high school students around the country when we have them, that creates a sense of despair and stress and anxiety among people because that's just not who everyone is. So I think your message is really beautiful, that there is something, that perhaps we belong to the future, and there's also perhaps something beautiful about what is different about us that we can bring to the world.

Absolutely. I mean, each of us is one of a kind, and we're one of a kind in a way that is spectacular. I mean, just think how many human beings have existed since we first came into being in some caves somewhere millenniums ago, you know, thousands and thousands of years ago. And no human being has ever been like you. That's how unique you are. That's how uncomparable to anybody else you are. That's how much of a gift you are to the whole human race. That's just an- And, you know, I think we should be telling children this in kindergarten. Because that's how old you need to be in order to begin to think about such a thing. You are unique in the history of the human race. And you feel you're not good enough, what? It doesn't even connect. Unique is different than good enough. Unique is one of a kind. And now what are you gonna do with that? You know, yeah.

Well, I'm gonna go home and tell my children that actually today. (audience laughing) It's such a beautiful lesson.

You showed me the picture of your little boy. I think he knows he's one of a kind.

Aww.

I think he knows it. I can see in his eyes that he knows it. (laughs)

I hope so. Dr. Rachel Naomi Remen] Oh my goodness.

But I think your point though about telling kids in kindergarten is right because these messages settle in so early in life.

Yeah, yeah.

So I think we have to talk to our kids early. You know, speaking of your journey, Rachel, you've also had to deal with a tremendous amount of loss, you know, loss of patients, but also loss of loved ones, and you have spoken and written so beautifully about your grandfather and what a powerful, powerful role he played in your life.

Yes, he did.

As a source of faith, as a source, as a moral compass, and as somebody who just loved you unconditionally from the earliest of times.

Yeah, that is the piece. Because as a Jewish child, it's very difficult to be loved unconditionally. (audience laughing) As a Jewish child, your parents have plans for you. (laughs) So does everybody else. But, yeah, it's interesting. I forgot my grandfather for a long time. He died when I was seven, which is a very significant time in a young child's life, by the way, I think. I was surrounded by all of my relatives who were doctors and nurses. That's what we did in our family. We grew up and we became doctors and nurses. And I forgot my grandfather. And he came back to me, and his teachings have never left me really, and I ended up following them for most of my life. Yeah, yeah.

I was thinking about your relationship with your grandfather because I've found that as I've gotten older, I find myself worried about losing certain people in my life as they get older, and I find myself worrying more about their health. And there's this beautiful quote that I wrote that you said about your grandfather's passing, which I kept close to my heart, which is you said, "I had learned to see myself through his eyes and learned also that once we are blessed, we are blessed forever." We are blessed forever.

That's true.

And that, it just helped me remember that the love we get from others is not just love for that moment, but it's a blessing for a lifetime.

It is.

And it totally gave me a sense of peace in terms of my worries about losing people.

See, this is the kind of thing we talked to the medical students about. We asked them who loved them, and why they were loved, why they felt loved, and what did that mean to them, you know? And you can see people struggling and then suddenly breaking through and remembering. And then the other thing that we learned from the students by asking them questions and stories is that, you know, most people or very many people have a calling into medicine, and it's a true calling. I think a calling is a set of values that are sort of, you're born with them. You didn't acquire them because you have them when you're very, very young. And we ask the medical students to tell us stories about this when they're very, very young. And we ask them, we do a wonderful exercise, and it's one of my favorite exercises to do with medical students. You say to them, "Okay, how old were you when you first realized that the needs of a living thing, an insect, a plant, an animal, or a human being matter to you? How many people were between 20 and 25?" Nobody raises their hand. I've done this in grand rounds when everyone's wearing a white coat too, you know, older people too. Nobody raises their hands. "How many people were between 15 and 20?" Very few people raise their hands, if ever. "How many people were between 10 and 15?" Maybe a few people will raise their hands, that that's how old they were when they realized that the needs of a living thing mattered to them. "And how many people were younger than 10 when they first realized that the needs of a-" The entire class raises their hands, So does the whole grand rounds, right? And then I ask them to remember the stories of the old days, when they didn't have all this information and all these tools, when they had to use what was handy to hand to serve with. And I have a collection of stories that are just incredible, and as they tell each other the stories, they realize what they mean. That this is a calling. This isn't an interest. This has very little to do with science and a great deal to do with something quite mysterious. That they belong to medicine in a way that is very profound and that they were born belonging to medicine. So if I can tell you a story or two so you get the picture, okay. I'll tell you two stories. First one happened to a young woman who was born in India to a very, very wealthy family. Very wealthy. And she was very- She had three governess, she says, and when she was about five, she was actually allowed to go to a school outside of the house, and she was driven in the big car to the school every morning. And the very first day she was there, they packed a little lunch for her. You know, they were told to do that. And the children went into the yard to have lunch, and they were sitting at their tables, all these little ones, right? And she opened her lunch, and she looked up and there was a iron fence around so to keep everyone out, right? It was an iron fence with poles like this, and they looked like spears on the top, right? And on the other side of the fence, there was a dog, and it was starving. It was skinny and awful looking, and it was watching the children eat their lunch. So she got up and went to the fence and fed the dog her sandwich. And the next day, the dog was back. So she got up and went to the fence and fed the dog her sandwich again. And the next day, the dog was back. And after two weeks of feeding the dog her sandwich, she went to the cook, one of the cooks, and asked if they could put an extra sandwich into her lunch. And the cook said "Why?" and she told her that, you know, she was feeding the dog. And her mother heard about it, and her mother was enraged that she was wasting good food and she had no respect for, you know, the gift of this food, and you must never, ever, ever feed that dirty verminous animal again, and she was punished for feeding the dog. And she's telling this story to a room full of medical students who were like, whoa, right? And I said, "So what happened?" She said, "So I kept feeding the dog my sandwich." And I said, "How long did you do that?" And she said, "Maybe two or three years."

Wow, wow.

These are the kinds of stories they come up with. And nobody realizes what these stories about themselves mean. They don't realize what these things mean, but when they tell the story and when they hear other people's story, they understand something about it, right? So here's another story. I'll tell you a story a little boy told us. He grew up in San Francisco and in one of these Victorians, right? And in the bathroom, there was a bathtub that he adored because it had lion feet. You know, it had animal feet, and he was sure at night when no one was watching, it actually ran around the house on those feet. And his mother would bathe him every day in this tub. And at the end of the bath, she'd stand him up, and she would lift the old rubber stopper out, right? And then she would turn around and she'd go to the wall, and she'd get the towel and she'd bring it back, and she'd take him out and put him on it and dry him, right? This routine, right? So one day, as he was standing there, he inadvertently stepped on the drain, and he cut his- The drain is old, you know, old metal drain. Cut his foot, and it was awful. It hurt, and there was blood in the water, and his mother was all upset. She says, she sounded angry and she said to him, "You must never, ever, ever stand on that drain again. Never." So every day after that, when she would stand him up and go to the wall, and he would look down to be sure he wasn't standing on the drain, right? And one day he was looking down, and he noticed something for the first time. The water was circling the drain as it went down, right? And he began to worry the drain was awfully sharp, and what if it hurt the water to circle the drain? So every day when she would stand him up after that, he would pick up his washcloth and drop it over the drain so the water wouldn't be hurt going down the drain, right? Lots of stories like this. This is a story from, he's two years old, somewhere between two and three, right? So, you know, this is what calling may look like, a certain set of values that people have that they didn't learn anywhere. They sort of brought them in with them. And there are many other value sets that are brought in with us, right? It's part of a mystery, yeah. That's the kind of thing we do do in "The Healer's Art." And we do other things like that. And, you know, I remember doing this and thinking, oh, everybody has the same stories as these medical students have, everybody, right? And then a friend of mine, Jack Kornfield, some of you know him, he was invited to teach an afternoon at the law school at Berkeley. And he invited some other people to come with him to teach the law students. So, (laughs) he invited me and I said, "What am I gonna teach law students?" He says, "You know that thing about how old were you? Why don't you do that?" And I say, "Oh, yeah, okay, it never fails. I'll do that," right? So we get there. And I forget, Father David Steindl-Rast, you know, and me, right, (laughs) are on the stage. And there's 600 people. The entire law school is there with the faculty. And Jack is doing his, he's a marvelous teacher. He's doing this wonderful teaching. And then he asked me to do this thing. And I do it and I say, "How old were you?" Just like I did it for you. And we get that, you know, 10 to 20, nobody answers, and under 10, and nobody raises their hand. 600 people are looking at me. (audience laughing) Nobody raises their hand. And I go into shock, and I look at Jack and he leans over and he says, "Rachel, try fairness." (audience laughing)

Ohh.

And I said, "Excuse me, I misspoke. Let's do this again. How old were you when you first realized that when someone was being treated unfairly or when something was unfair, you wanted to change that? How many people were between 20 and 25?" Nobody. Between, you know, 10 and 20. Nobody. And my heart is in my mouth, and I say, "And how many people were younger than 10?" And 600 people raised their hands. And he looks at me and he says, Jack, "Different ashram, Rachel." (audience laughing)

Those are beautiful stories, Rachel.

It was wonderful.

Rachel, is there a time- Just coming to a close and before we do some Q&A.

Oh good. (laughs)

I wanted to ask you about the other spectrum of life. You've cared for and taught and inspired so many medical students. But early on in your career, you also left academia and ended up focusing on caring for patients with cancer, often patients who traditional doctors at that time felt that they had nothing left to offer.

Nothing to offer, yeah.

But yet you encountered these patients and found that there was still a lot to offer, and I was wondering if you could speak a little bit about what those patients taught you about healing.

Well, this is what, the beginnings of Commonweal, you know, of course. And Michael was… (laughs) Michael is such a wonderful man, and this was his dream, to have a place where people could share their wisdom, share their, heal each other, that people who had very serious illness could heal each other. And I remember meeting Michael at a luncheon. And we started talking and we looked up, and all the people at lunch had left us because we had been talking for an hour (laughs) to each other. And I remember driving out here for the first time. And Michael's a very thoughtful, cautious man in many ways, and he said, "Well, what do you think? We should maybe do a thing for people with cancer. We could do a retreat." And I had a practice, a psychological practice with people with cancer and their families, and I said, "I've got all the people. I mean, we can do this. We certainly can do this." He says, "But first we have to figure out how we're gonna end it." I said, "Michael, we haven't started it yet." "Yes, but we have to figure out how we're gonna end it, how we're gonna leave each other in a way that is not hurtful." So we planned out this whole way of how we would leave each other. The program is still happening. It's, what, how many years? 20-some odd, right?

Almost 40.

Yeah. But we know (laughs) how we're going to say goodbye to each other, Michael and I. We just haven't done it yet. He's 80 and I'm 85, right? But it was such a funny, wonderful thing. And I remember thinking, wow, I haven't listened enough to people. I've been talking too much to my patients. I haven't asked them questions. And I haven't allowed them to share their wisdom both with themselves, because by sharing it out loud, they realized what they had discovered, and with me. And so we started, and Commonweal's been doing this ever since. Yeah, how many people have been through the program? A thousand, I'm thinking. Even more, many more actually, yeah.

And that power of listening, Rachel, you're speaking to how therapeutic that can be. And I'm trying to think, for people out there who are gonna be listening to this and who find that there's somebody in their life who may be struggling for whom they want to be a source of healing, what advice would you give them on how to listen well in a way that can help others heal?

Well, first of all, no one is broken, so you don't have to fix anybody. That's always a… That always leaves people feeling really small somehow. I think just listening, asking people, you know, what's this been like for you? What have you learned? What are some of the- Well, when we open the discussion, I'm sure you're gonna get, we can ask that question out there and get some wonderful suggestions. But, you know, this is a radical thing that happens for people. I'm just thinking of a patient of mine, a very, very successful businessman who developed cancer and who found himself lying on his couch being treated with chemotherapy in the company of his cat. And he hadn't been in a place of silence like that for many, many years, and he was lying there for months, and after a while, he looked across the room and he saw the Bible that had been given to him and his wife by the preacher when they were married. And so he got up off the couch, and he went and got it and opened it for the first time. And he read the words with which the world starts, "Let there be light," right? And he realized that those words were not just being spoken in this Bible. They're being spoken to him. And that now that he had cancer, he could live his life in a different way. He could live his life in a way that ensured that there was more light that came into the world, and that that would be the legacy he would leave his children, not a million dollars each, yeah. So there's something transformative. I think it stops us. I think significant illness stops us, and it forces us into a reflective place, and then we can hear ourselves for the first time. And I think what is required is simply to say I'm listening, however you say that to someone. What's this been like for you? What's been the hardest part? What's been a good part? How has there been change that you feel is important? You know, what did you discover in this? That's another good question. What did you discover in this process? You discover, many people discover that they're worthy of love for the first time. Not too shabby.

Yeah.

Yeah.

Those are beautiful questions.

Yeah.

Those are really good ones.

And, you know, most questions that are worth asking are about three words long.

Hmm.

Yeah. Anything longer than that is a question about me, not about you, right, you know. Yeah, yeah, yeah. And I think that most of the people who have been part of, been privileged to be part of the cancer retreat have grown deeply and greatly from it and have been healed by it in one way or another. I know I have been, yeah. I think loneliness is the illness of our nation. We're independent. I mean, we even have an Independence Day. We're so proud of being independent. Independence isn't the highest form of human relationship. It really isn't. And there are much other forms of relationship that are, that lead to wisdom. I don't know that independence leads to wisdom. It leads to autonomy, which is sort of boring. (audience laughing)

Well, our relationships certainly are so much, as you've said, about what makes life rich and meaningful and worth living. And you know, one of my concerns, Rachel, has been just how many people are struggling with loneliness, with a sense of despair? How many people look out at the future and feel like the future's not bright for them or for their children? What is your sense of what's driving this despair and suffering that we're seeing, in some ways, at heightened levels in the world right now?

Well, you know, there's certainly things that are happening that are not from the best and highest in us. There are some very, very cruel and ugly things that are happening in the world right now, yeah. And I think it's very difficult for people. I also think that people are struggling towards a goal that is not as worthy of having as the goal that is within their reach. I think people would rather be wealthy than be loved. Just thinking of people I know and young people, this I want to be a success, rather than feel that they've made a difference. That's a totally, these are totally different goals. And I think you're only as happy as your goals are rich and rooted in real possibility, yeah. Yeah, what do you think?

I think what you said is spot on. I think also the fact that we are more disconnected and lonely makes it harder to deal with those moments of adversity or those times when we fall into pits of despair or where we lack inspiration. Because often then we lean on other people, and we can help each other, support each other until we get through that difficult time.

Mm-hmm.

But without others, it can be incredibly hard. I also think that there's a tremendous amount of negativity that people are surrounded by all the time now. You think about…

Yeah, that's true.

You turn on the news these days, or if you're receiving it 24/7 on your devices, a lot of the stories are stories about what's broken about the world. But I think that when you're constantly surrounded by that, it can make you feel it's representative. And I think it's so important that we not let what is broken about the world blind us to what is beautiful about the world. And there's still a lot of beauty out there, and we find that most reliably in one another.

Yeah. I have found that in service.

Hmm. Dr. Rachel Naomi Remen] I have found that most of the people I've met that I think of as teachers, I've met through service, and people who make me proud to be a human being, through service, yeah.

And I think that's beautiful. It's a theme that you have woven so beautifully through this conversation about the power of service to help us connect and to help us heal. And this is one of those moments, Rachel, where I feel like though our country and the world are in need of a moral reawakening that's centered around service, around kindness, around our connection to one another. And that brings me back to so many of the beautiful stories you have told over the years. Because when I think about those nights as a medical student, when I was feeling like I was burning out, when I felt disconnected from my purpose, when I would pick up "Kitchen Table Wisdom" and look for a story there to remind me of what mattered, that was the reawakening that I needed. It was re-rooting me in these core values around service and around kindness and reminding me that our humanity and wholeness is the goal. You've said that we shouldn't be chasing perfection, we should be chasing wholeness, and I think you couldn't be more right. So, Rachel, I want to just thank you for being not just a source of wisdom during this conversation, but for being truly a source of inspiration to so many of us over the years.

Oh, God bless.

Your wisdom really is timeless, as your grandfather's was, and continues to be. And that's why I think that these stories and these lessons you have shared are in fact more important now than ever, at a time where people look to the future and ask themselves the question, is the future really brighter than the past? And I think it can be. That it depends on us and what we do and what guides us and whether or not we pick up the moral compass that I fear we have lost at times and use it to guide us toward a better day. So Rachel, thank you so much for this time together.

Oh, thank you.

I'm so grateful for your friendship, for your mentorship, and just for your inspiration over the years.

Everyone, Dr. Rachel Remen.

Thank you, dear one. (audience applauding) Yay!

Thanks for joining this conversation with Dr. Rachel Naomi Remen. Join me for the next episode of House Calls with Dr. Vivek Murthy. Wishing you all health and happiness.