The Renewal of Generosity:
Illness, Medicine, and How to Live contemplates the phenomenon of
generosity as it is realized in the stories of physicians and patients. For Arthur Frank, generosity is grounded in
the willingness of people to give themselves over to dialogical processes of
communication wherein participants best realize themselves through relational
engagement: generous, dialogical communication leads to a renewal and
realization of human being. Health
care systems today tend to impede communicative generosity, however, and the
result is a de-humanization and de-moralization of both physicians and
patients. As a remedy, Frank proposes,
first, that we re-figure our conceptualization of the physician-patient
relationship—from the economic or business metaphor of “provider” and “client,”
we should turn to the metaphorical conceptualization of “host” and “guest,”
which clearly has implications for manner of treatment and communication that
occurs in the relationship. In addition,
Frank turns to and thinks with stories of physicians and stories of the ill to
reflect on the ways that generosity is realized. Drawing on the wisdom of the striking
philosophical triumvirate of Marcus Aurelius (Stoicism), Mikhail Bakhtin
(Dialogism), and Emmanuel Levinas to amplify the reflections
emerging from the physician and patient stories, Frank ultimately proposes
“exercises” for training to generate a vivifying generosity within the medical
profession, which can in turn lead to a re-humanization and re-moralization for
physicians, improved care for patients, and enhanced flourishing for all.
