February 12, 2001
Making stem cell citizens
Michael Johns is executive vice president for health services
Rebecca has given us, with her usual eloquence and insight, a view of
how the word reconciliationcame to represent the Universitys
inquiry into its own nature and aspirations as we enter the new millennium.
And she has asked whether what we have learned and experienced throughout
this symposium has meaning for us as a University.
I think the answer is yes, and, as she and every other speaker has suggested,
there are many ways to look for and develop that meaning.
I want to respond to Rebecca first by talking a little about how I view
the issue of reconciliation.
For me, the word reconciliation evokes a sense of one of the sacraments,
a meaning left over from when I was a kid going to Catholic school and
[my] time spent as a seminarian in Detroit. At that time we practiced
the sacrament of penanceof seeing and confessing what you had done
wrong and making it right. A personal version, perhaps, of Hannah Arendts
setting anew, setting aright.
Then, by the time I left the seminary for medicine (my interest in biology
having exceeded my interest in celibacy) the sacrament of penance had
been renamed the sacrament of reconciliation, to emphasize less the need
for punishment and emphasize more the need to set things arightto
restore, to use the Webster dictionarys first meaning of reconciliation.
More recently, I think the word reconciliation has taken on a new significance
and meaning, especially in the light of the reconciliation efforts in
South Africa. For many people reconciliation now connotes public confession
and penance for wrongdoing by a perpetrator, coupled with public forgiveness
of the perpetrator by a victim.
This effort to reconcile two opposing paradigms, to bring two polarities
togetherespecially when one of those polarities is considered to
have committed very bad acts, maybe even evil onesis a very profound
and, Im sure, quite painful exercise.
I believe this may be why many people who have spoken to me of this symposium since it was announced, even those who did so with excitement, have asked: What have we been doing wrong?
What are we meant to confess?
I think thats the wrong question. I believe this symposium brings
us together around a slightly different meaning of the idea of reconciliation.
It has less to do with penance, with the sense of mea culpa,
than with the sense of defining and finding commonalties and paths forward.
To quote from Websters Third International, there is another definition
of reconciliation that involves making consistent or congruous,
as in reconciliation of ideals with practical reality.
Personally I prefer harmony. Perhaps we even need a new word
To me, the central question for us is: How can and should the University
be a place where individuals can learn about and formulate ideas and ideals
in preparation for their application to and reconciliation with reality?
To put it another way, how can we enhance our university as a place where
we teach and learn ways to define and pose relevant questions and constructive
solutions to lifes many issues and challenges?
From my own training and experience and from my reflection on the educational
and learning process over many years, I have long maintained that the
role of medical education, for instance, is to produce what I like to
call the stem cell physician.
For those of you who arent or werent biology majors, a stem
cell is a basic, embryonic, unspecialized cell that, as an organism develops,
is capable of developing into one of any number of more specialized cells
with specialized functions.
Such a stem cell has the capacity to differentiate from a single cell
into an entire organsuch as a liver, or a heart or a lung.
So, taking the stem cell as an analogy, to me the best medical school
education is one that can produce the stem cell doctor, an individual
who is well rounded and well grounded; a person who can leave his or her
medical school training with the ability to take any path forward.
To my mind, such an education must involve not just the biological sciences
but also the history of medicine, ethics, law and medicine, public health,
policy and politics, and related courses on the role of the physician
in society. After all, how can you be an ethical physician if you dont
understand how society views you or your role in society? This also applies
to nursing and public health as much as to medicine.
That means that the students we admit to medical school (or any of our
schools) must not be just science jocks, but also well rounded and well
grounded in the liberal arts, having had the opportunity to contemplate
their place as scitizens of the world.
Further, picking up on Arthur Kellermanns comments from yesterday
and those of Bill Foege today, these students must understand that there
is no conflict between public health and acute and chronic care medicine.
They are all part of a continuum of caring for the health, wellness and
sickness of the public. And that means all of the public.
I believe it is time to revisit our health professions and redefine their
roles at their interfaces. So, for our university as a whole, I believe
our goal is no less than to produce the stem cell citizen of the planet
earth: a student who feels and has a passion and an awe-filled curiosity
about the peoples and the world we live in, with an exposure to a range
of issues from the origins of humankind to what humanness
They should have the opportunity to learn from Greek tragedy and from
the tragedy of the AIDS epidemic. They should investigate the intricate
horrors of dictatorships and the intricate complexities of our genome
As Duderstadt says in his wise treatise, The University of the
21st Century, the university should be a place where one learns
to live as much as a place one lives to learn. The undergraduate experience
should embrace the totality of the university missions of teaching (learning),
research, and service.
The student should depart our great university having tasted all three
of these vital offerings. Otherwise he or she may never know how great
a meal can be found at the table of higher learning.
And it points out so many pathways for further enhancing our missions:
in the ways we teach, the ways we interact across schools and disciplines,
even in the ways we need to adapt the new tools and technologies of learning
in the 21st century and the ways our own students can teach us to use
them with greater facility and effectiveness.
In the Woodruff Health Sciences Center, we certainly deal daily with
extraordinarily challenging issues requiring reconciliation, whether in
our patient care and service, in our research or in our teaching.
Although I used the traditional word, teaching, I think learning
captures our mission more than teaching. The students, our community and
faculty teach, but perhaps even more importantly, they learn from each
In Maywhen we host our Health Sciences Center Reconciliation Symposium
which we have titled Health Professional: Healer or Line Worker?we
will be dealing with the challenge of reconciling the role of the health
professional and educator within the new, market-driven health care environment.
I urge all of you to attend what promises to be a very penetrating, faculty-led
forum to delve deeply into personal and professional struggles to reconcile
very complex, cross-cutting demands and responsibilities faced by academic
health professionals, scientists and teachers.
So to close my response and reflection here, I want to agree with Rebecca
and all the presenters, and reiterate that the university is at its best
where it embraces the mission of reconciliationor, better yet, harmonizationwhere
it institutionalizes the relentless quest for knowledge and understanding.
It is in that relentless quest for knowledge and understanding that I think we find the best hope for developing stem cell citizens of the world, capable of finding new and constructive solutions to problems and challenges in their work, in their communities and in their lives.