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Medical school chaplain promotes a curriculum of caring

Yale Medicine Magazine, 1998 - Winter/Spring


It's a rare medical school that has its own chaplain, especially a chaplain who frequents the anatomy lab and writes about Albert Camus. But at Yale, that personage is Alan C. Mermann, M.D., M.Div. '79 who trained and practiced as a pediatrician and is now a clinical professor of pediatrics. He's also an author whose varied writings include a new book of essays entitled Some Chose to Stay: Faith and Ethics in a Time of Plague, published in December by Humanities Press.

Ordained as a minister in 1979 after 25 years in pediatric practice, Dr. Mermann says that he often visits the first-year anatomy lab, "just to be there." He knows how hard it is for young medical students to deal with that first cadaver. His essays describe his own experiences in finding a foundation on which to build a life of conviction and commitment. This is the focus of much of his work at the medical school, where he teaches, listens, counsels and involves students in eye-opening activities.

He points out that at Yale, where students may hold any, or no, religious beliefs, his work usually has little to do with formal religion. It has everything to do with helping students understand what it means—and what it takes—to be a good doctor.

Students want to become "caring, compassionate physicians," he says, but they worry about losing compassion as they train in hectic hospital settings (where the patient may seem less a person than the subject of clinical laboratory reports). He aims to help students keep on caring.

One essay in his new book deals with Albert Camus' 1956 novel, The Plague. A major character is a physician who never abandons the plague victims, and Dr. Mermann points out that a major theme is how important it is to be with and for people. "This is something that can be taught," he says. "You can learn how to do it, and it's something that should constantly be a part of medical education." His essay goes on to describe his seminar in which first-year medical students are paired with seriously ill patients—often, people who are dying. It's a seminar with much to teach about being with and for others. "The patients teach the students," he says. As chairman of the pediatric bioethics committee at Yale-New Haven Hospital, Dr. Mermann also includes students in meetings where parents and physicians discuss painfully difficult decisions—for example, how long to provide extended life support when a 3-year-old has suffered serious brain damage in a car accident. "We just sit and talk, until all comments and opinions have been voiced," he says. "It can take a while." Students learn that in medicine, there often are no easy answers.

He also hopes to show students that medicine is not something to practice competitively. Collegiality and the sharing of knowledge are most important. "We're in this together," he tells them. His essays touch on many books—including the Bible, Walden and Cry, the Beloved Country—that along with various experiences have shown him what needs to be done. He tells of his decisions to become a pediatrician and a minister, and to take action amidst such plagues as disease, poverty, racism and war.

He hopes that his work can help students awaken to what lies around and before them. "Physicians," he says, "need to be alert."