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Dr. Doolittle Interview

By Elijah Dahunsi '25

May 14, 2023

The coronavirus pandemic has caused immense suffering — patients have grasped for air while individuals have dealt with a debilitating isolation. We have seen conflicting ways of understanding this suffering in communities of faith and among medical practitioners. While medical professionals have used their scientific knowledge of the virus to restore their patients’ physical well-being, faith leaders have focused on nourishing the souls of their congregations with a spiritual hope. Drawing on his wide-ranging career as a physician, minister, and educator, Dr. Benjamin Doolittle reflects on the contrasts and similarities of these two approaches. Human suffering, Dr. Doolittle argues, can intimately connect faith and medicine, providing society with a more humanistic vision of healthcare.

Elijah Dahunsi: What initially drew me to you was how extraordinarily far reaching your career has been. You have been involved in medicine, ministry, and teaching. How did you decide to pursue a career that spanned these three fields?

Dr. Benjamin Doolittle: Well, thank you for that question. It is true that my job description is not a job I applied for. Rather, it is the product of a vocation or a calling that evolved over time. It's very flattering to hear you say such kind things about my career. Honestly, I followed my joy, my curiosity, and my sense of vocation. It's as deep as that and also as superficial as that. I really believe that if you love what you do, you don't work a day in your life. That's not my maxim. Someone else said that. But I feel very fortunate to have been well supported in pursuing these things. It hasn't always been easy, but I think that I have a sense of vocation that's deeper than a job: a faith and virtue based commitment to care. And the way I feel most called to care is in both ministry and medicine.

I guess the point at which both ministry and medicine meet is really education. To be helpful, I’ll specify all that I do. I'm a professor of internal medicine and pediatrics at the Yale School of Medicine. My main role at the med school is to run a residency program, the Internal Medicine and Pediatrics Residency Program. Residencies are programs dedicated to training medical school graduates in a speciality of medicine like surgery or pediatrics. I run a dual residency program. Additionally, I am also the medical director of our faculty resident clinic. We see about 10,000 to 11,000 visits a year. In this clinical setting, I work with a variety of patients ranging from babies in the nursery to elderly patients seeking treatment for pneumonia and congestive heart failure. In my outpatient practice, I take care of people with addiction issues, HIV, and hepatitis C. Most of the patients in my outpatient practice make less than $10,000 a year. So in a clinical setting, I am a physician to people who come from socioeconomically disadvantaged backgrounds.

In an academic setting, I write and teach about the intersection of medicine and religion. The Yale Program on Medicine, Spirituality and Religion, which I co-founded with Dr. Lydia Dugdale around eight or nine years ago, is central to this work. The program has four parts to it. Firstly, we invite a monthly guest to speak to an audience in the university. Secondly, we have fellows who are usually graduate students that want to work more deeply with faith and medicine. Thirdly, I teach classes in both the medical and divinity schools at Yale. The class I teach at the medical school is an applied philosophy class called Life Worth Living. In the class, students read tracts from many of the religious traditions around the world, as well as some major schools of philosophical thought. In the divinity school, I teach a class called Theology and Medicine. Fourthly, I conduct research in my role as professor of religion and health at Yale Divinity School. My research centers on medical education, burnout, and well being.

In my ministerial work – and this is really the fun part – I am the pastor of preaching and worship at Pilgrim Congregational Church, a small church here in New Haven. I preach three times a month or so. I am an ordained minister in the Reformed Church in America. Between my life in the church and in academia, I feel that I have a good space for my religious side.

And so you’re wondering how all of this happened? Well, after college I went to divinity school. I did a joint degree program at Yale where I earned a masters of divinity and a M.D.. I combined those two degrees after medical school. Afterwards, I was a medical missionary for a year, serving in India and Honduras. When I came back, I joined Yale in their Medicine Pediatrics residency program and subsequently joined the faculty. And I've been on the faculty for about 20 years now.

ED: You mentioned that across these different disciplines is a central calling to care for people. It seems, though, that in popular culture, medicine and ministry are often portrayed as starkly different disciplines. Whereas medicine is portrayed as more scientific, ministry is portrayed as more interpersonal. Have you personally ever felt a disconnect between your work in ministry and your work in medicine and in teaching? Or, do you think the popular categorization of these fields is wrong?

Dr. Doolittle: That's a good question, and I've thought about it a lot. I've been a pastor for 30 years, and I’ve practiced medicine for 28 years. And the answer is yes and no. The two worlds are very different in many ways, but both worlds meet in the space of human suffering. And this is what I mean by that. So the great power of modern medicine is that we do our very best to follow the evidence when treating illness. We ask questions like: What’s the best chemotherapy? How can Lipitor save a life? The power of modern medicine is that it is evidence based. Physicians use data to fix illness.

This approach is really important. This is why we don’t pack wounds with mud anymore or use certain herbs to adjust the imbalance of our four humors. The power of science is very good in so many ways. Likewise, ministry and religious life is also a gift. It rescues us from the anxiety and doubt of the modern world and makes our joy all the greater.

Yet, ministry and medicine do not share the same language. The language of faith is relational and the language of medicine is scientifically based. In medicine we describe phenomena with very specific terminology. We would describe rashes, for instance, as palpable purpose or macular popular. In contrast, the language of religion and faith tries to embrace big, rich concepts like communion, redemption, transcendence, and heaven. The richness of religious language and the specificity of medical language intersect at the bedside in the human experience of suffering.

I teach my residents all the time that the first rule of medicine is that the medicine is easy and everything else is hard. By this I mean that, for example, you can easily prescribe pharmaceutical treatments for HIV. But it is difficult to ensure that a patient takes that medicine every day and comes to appointments. They have to have insurance. They have to believe that the medicine makes a difference. They have to trust their doctor. They need adequate transportation. They need to have food to eat and stable housing. So while the medical aspect of medicine is quite easy, the psychosocial side of medicine is always very tough.

And of course, when I say medicine is easy, I’m talking tongue in cheek. The second rule of medicine is that sometimes the medicine is hard as well. But it does seem that what makes medicine difficult is the doubt and suffering which no amount of evidence can alleviate. Rather, it takes a moral vision to reach out in kindness and love to support people in their suffering. This is the work of ministry. Once again, this is a good question that sparks alot of thoughts.

ED: I want to follow up on that. You mentioned that while suffering is crucial to the intersection between medicine and ministry, it is conceptualized differently between the two fields. Generally, medicine takes a more specific approach to suffering while ministry tries to interrogate the broader implications of suffering. Society has witnessed a great deal of suffering in the past two years, especially during the pandemic. In your experiences with your colleagues and residents during this perilous period, do you think that medical professionals have grown an affinity for the more specific approach in dealing with suffering that is offered by medical and scientific thought?

Dr Doolittle: That's a good question. There is a difference between pain and suffering. Pain is the physiologic experience of what happens when our bodies are injured. Suffering is the interpretation of this physiologic experience. I think we in medicine do our best to alleviate pain. We are moderately successful at alleviating pain because we have drugs for that. I am not sure how well we as medical professionals alleviate suffering. Perhaps in medicine we do not differentiate between pain and suffering. I think the language of a face captures the anxiety, isolation, and angst that comes from suffering.

Part of what made the suffering so hard for people during the pandemic was the isolation and the loneliness. During the height of the pandemic, entire hallways in my institution were converted into negative pressure wards where people with COVID were in isolated rooms. Patients used video monitors to communicate to us because so many people were getting COVID. I remember that we would gown up with protective clothing when we would see patients. When we opened the door to the ward, the suction of the negative pressure would produce a slurping sound. Everytime we opened the door, people were alone and afraid in their beds, and they couldn’t or had trouble breathing. This air hunger is a scary, horrible way of suffering. And what made this suffering worse was that people were suffering alone. This is so hard for individuals and our society.

In medicine, we intensely experienced the suffering of people at the bedside. But we also experienced this suffering within our own medical communities. We quarantined in our apartments and homes. We would go on video platforms, which quickly got old. So there was a great deal of individual and corporate suffering during the pandemic.

My final thought on suffering is that love and suffering are very much the same. We suffer because we love. Without love, we would have apathy. The only way to get through our suffering is to love one another. As a person of faith, I believe that God suffers alongside us. And our God is a loving, suffering God because love is suffering.

ED: I want to expand on this relationship between love and suffering in medicine. You mentioned how the only way to deal with suffering is through loving others. Do you think it’s possible for medical schools alone to instill this love in physicians? Or, must a physician’s love come from different sources?

Dr. Doolittle: That's a great question. I think that the art of medicine includes the inner and outer life. It is appropriate for a physician to have some equanimity around human suffering and at the same time be present at the bedside. The landscape of medicine is so complex because there is an expectation for the physician to be all things to all people at all times. I think there is some spiritual dissonance in the role of the physician.

As someone who works with physicians and trains medical students, I find that physicians have a very deep inner life and ponder questions regarding suffering in a special way. Every physician knows what it’s like to fail. Every physician knows what it's like to feel ignorant about what is happening. Every physician has had an encounter with a patient that did not go well. So the practice of medicine is always humbling because the stakes are so high. I find that the people going to medical school and training in residency, at least at my institution, are some of the most gifted, thoughtful, compassionate, devoted people I have ever met. They are outstanding models of technical expertise and evidenced based, high standards of medical care. And in the same breath, they are so gifted in the language of emotions and the psychosocial aspects of medicine.

I know that it is a trope to say that the physicians are the technicians and the pastors are the relational people, or that they address the emotions. I think it's actually much more complex and nuanced than that simple dichotomy. Every physician I work with has wrestles with these questions of doubt, failure, illness, and suffering.

The challenge is to dwell in that space in a way that's thoughtful, healing, supportive, that takes real work. Just as we go to the gym to make our bodies better or a school to expand our mind, we need ways to exercise our spirit that are authentic and real. Sometimes that place is a religious institution or a church. As a Christian pastor, I recognize that sometimes churches are limited in the ways they can reach out to people in intense suffering at the bedside. Yet, as we’ve continued through this smoldering pandemic, I’ve been deeply moved by what happens in religious communities.

I can only speak about my church community. We were remote for many months, and when we came together it was as if we drank from a fresh spring. And I realized anew that what we do in worship is to address so much of the angst and loneliness that much of our society is experiencing. We come together and sing in what is perhaps the most artistic and intellectual thing that people do. It is a very communal act. We pray together. We grieve together. We celebrate together. At my church, coffee hour lasts just as long as the church worship service.

And I think the worship service and the coffee hour part just are a simple continuation of our experience of the spirit working in our lives. Though we are a small church, I am appreciative of the fact that we commune with joy and friendship.

I wish that those in the medical community would also experience the wholly restorative and rejuvenating gift of religious community. But I think that in the medical world that kind of spiritual, communal experience is lacking, at least according to the data.

ED: You stated that part of what makes physicians unique is that they take on so many different roles in their vocation. They must have the necessary technical competence to relieve pain, but they must be deeply and lovingly present in a patient’s suffering. As a physician, do you experience a great degree of burnout in taking on these roles? And how do you deal with this burnout?

Dr. Doolittle: We know a great deal about the prevalence and cause of burnout among physicians, nurses, nurse practitioners, physician associates, and everybody in health care. We are struggling to make it better because when a physician is burned out, it affects the patient. Burnout is associated with increased errors and poorer medical outcomes. But when physicians are engaged, patients get better care.

The treatment for burnout is multi systemic. Some of the challenges are within the inner life of the physician. Physicians need to learn to cultivate a rich inner life and to make the practice of reconciliation, love, gratitude, and grieving a part of our spiritual architecture. Much of the challenge to reduce burnout is systemic. Burnout tends to come from a mismatch of responsibility and influence. The challenge of healing and fixing a problem is placed upon the physician, but the physician doesn't have the resources to fix the problem. Sometimes there are challenges with documentation or insurance requirements. Or maybe a patient can’t be discharged from the hospital because there is nowhere for that patient to go. What is the physician to do short of building a new home for the patient. This dissonance between responsibility and support is where burnout comes from.

We know that health care providers who feel well supported by their administration are less burned out and feel better about their jobs. We’ve extensively studied physician satisfaction here at Yale. When physicians have a sense of connection with their colleagues and with friends outside of work, they are more satisfied with their job. When physicians have the autonomy to control their schedule or regulate policies within their practice, they are happier with their jobs and happier with their sense of vocation. So there's a lot of work to do because oftentimes there are very powerful, top down forces that make the practice of medicine challenging. And these forces are even bigger than just the institution: government insurance, cultural expectations, and other causes.

Now at the same time, the vocation to serve as a healer and physician in this world is a tremendous gift and great privilege. I would not want to do anything else. In the same breath, I love being a pastor because I feel like being a pastor gives me the space to care about people, society, and community in a way that's driven by the beautiful values of love, universal acceptance, and care.

ED: Finally, what advice would you give to pre-medical students and people contemplating a medical career who are very drawn to the prospect of caring for others and tackling the big questions of human suffering?

Dr. Doolittle: I think that pursuing one's joy and curiosity is an important way to discover one's vocation. Many times people will give the advice of following your passion. Well, what happens if you don't know what you're passionate about? You might not know what you are passionate about. So I don't really advocate following your passion. I advocate pursuing your curiosity and trying things out. I am a believer in what I call the Renaissance conversation. Once a month, I reach out to somebody different from myself and I have a conversation with that person. The first thing I counsel my residents to do is to have rich conversations with people different from themselves in order to pursue their curiosity and discover a sense of vocation. We cannot discover our passion alone. We need others to help us along the way. So I think the method is to be curious, follow your joy, and reach out to people with Renaissance conversations. Because who knows what the path is for you? And the only way you're going to find your path is to look for some signposts along the way.

The other piece that matters to me personally is cultivating an inner life. I do that by journaling every day. I call it my Renaissance journal. I journal every day, sometimes even just three pages a day. This was not my idea. It came from a woman named Julia Cameron who wrote a book called The Artist's Way. I have also cultivated a prayer life that means a lot to me. That prayer life includes everything from the Jesuit Examen prayer to mindfulness, to the daily office. It has some variety to it. I just find that prayer is absolutely essential to my sense of balance and joy in doing all that I do. Cultivating an inner life for our spirit is exactly like going to the gym for our bodies. So that’s my advice.

Illustration by Meya Gao '26


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