Running in Place: Stasis and Change in "Amodernity"

"What if a biography were to tell about desire, not achievement...?

—bell hooks, Outlaw Culture: Resisting Representations

i. The Catalytic Converter

For the past several years I have run a nonprofit the purpose of which is to make possible mentoring opportunities for undergraduates in areas not easily served by traditional liberal arts colleges. ² Though I had been arranging such opportunities for nearly two decades, some health-care research I conducted for my state medical society in the early 1990s ³ had enabled me to meet a special group of physicians who, once identified, turned out to be excellent teachers and loyal mentors to my students. What made this group of physicians so unusual—as well as so helpful—was their independence and a concomitant willingness to thrive in remote areas. These were individuals whose conditions of work necessitated some ability to survive without the accolades that are regularly poured upon their professional peers who cannot exist outside of the academic networks that regularly reward them.

Among the many things that this group of physicians shared was the value they universally placed upon health-related experiences occurring early in life. Though these experiences varied enormously—volunteer work, a family illness, a traumatic event—they unanimously attributed their ability to survive and be happy enough to work independently to some early, sensitizing, emotional moment. In other words, what they shared in common was the fact that they each could recall a problematic or otherwise moving event much earlier in life than one might have thought relevant to a career decision made later on—sometimes, in fact, decades later.

It took a few years of part-time work to complete follow-up interviews with doctors, but I was eventually able to speak with more than forty physicians about these early experiences and their career decisions, and to confirm my findings in multiple interview and informal settings. About half way through the interview process what clearly emerged was not that one needs to commit oneself early in life if one is to have the stamina for potentially difficult professional work—i.e., that one had, as it were, to be "born" into the profession—but that these early experiences had been important because they were destabilizing. Repeatedly, the doctors I spoke with threaded their interview narratives with descriptions of how they had been moved, sometimes even against what seemed their preferences, to an illness encounter that they would remember again and again—some moment when they saw themselves beginning to be influenced, even changed, in the face of a sensitizing and even trying moment. This distinction—between deciding early and being sensitized early—is subtle, but it is also crucial; for it allows us to focus both on what really matters in these experiences, and on why we have thus far failed to address with much success the problem of how we get medical students to commit themselves to working independently, and often alone, in remote areas. Their views of how they changed, we will see, also provide us with some useful insights into the nature of human transformation in contemporary life.

Perhaps most obvious in these interviews was the shared perception that early experiences were important because they had been, if you will, "inoculating." That nervous hospital volunteer standing helplessly observing some uncomfortable procedure had actually been moved in a way the importance of which would only be validated by a professional decision some years—perhaps many years—later. Moreover, whether or not these early experiences had been good or bad, what was more significant was the fact that they were enough destabilizing to produce some degree of sensitivity. What these experiences gave rise to, in other words, was a limited destabilization that was powerful enough to induce a transformation. They were powerful catalysts, but not so powerful as to be wholly defeating...