Cohen, Ed. On Learning to Heal: Or, What Medicine Doesn’t Know (Durham and London: Duke University Press, 2023).
On Learning to Heal is scholar Ed Cohen’s lived history of Crohn’s Disease, which he was diagnosed with as a teenager. The narrative is generated by two distinctions that guide his emotional-intellectual reflections of this experience: between medicine and healing and knowing and learning. While all are critical to one’s well being, Cohen argues for an increased focus on learning and healing, which he explores through memoir, movement, and dynamic relationship to the world.
Cohen illustrates the concepts of learning and healing using twelfth-century composer, mystic, and botanist Hildegard von Bingen’s concept viriditas, or “greening”. Hildegard observed that plants and animals shared a similar tendency toward growth and thriving when they are unencumbered by illness and other obstructions to their health. With this in mind, rather than approaching the distinctions between knowing and learning and medicine and healing as binaries, perhaps we can approach them as dyads: the two halves of maintaining well being. According to Cohen, Hildegard, and other thinkers, medicine can be useful in maintaining the conditions within which plants and animals can continue their path toward full health, but cannot itself inspire this kind of maturation. Similarly, “knowing” can be useful in understanding ourselves and our ailments, but it cannot put us on the path of healing.
One could therefore say medicine and knowing are often necessary to thriving as a human, but not sufficient. Doctors provided the knowledge that saved Cohen’s life as a teenager and that continue to support him in adulthood. He describes the medical contribution as nosological (classificatory), a power that uncovered not only his illness, but generated new understandings of himself as a person with Crohn’s Disease. As he states in the subtitle of the book: “why medicine is not enough”: medicine is not the problem; the problem is that it is presented as the whole solution.
So what is healing? To understand, Cohen argues, we must first rein in the scope of the medical field. He offers histories of mechanical, physical, and biological determinism to demonstrate how medicine has built its prestige by contrasting itself with ignorance. However, ignorance is not a dead end but the beginning of tapping into our natural tendency toward thriving because it drives true learning and growth, processes that thrive in the unknown and often in the realms considered less valuable by our knowledge-obsessed world. We know who we are, we understand the ramifications of our illnesses and other ailments, but then what? How do we live a life of growth?
These tensions coalesce in Cohen’s body, the site of another critical binary disrupted by his autoimmune condition: the self and the not-self. Autoimmune disease, in which the body attacks its own immune system, requires one to face “the self” critically–as multifaceted. Cohen engages these tensions through movement in his dance class. He understands the individual as protean depending on its relationships–to disease, to learning, to other humans, and to space. As Cohen writes, human movement and dance often “privilege movements not cultivated by our society because they have no obvious utilitarian or functional value.” Pursuing his dance class allowed him to experience movement differently and meet a community that inspired his growth.
His dance mentor’s teaching sum up the connection between the embodied, the intellectual, and the relational, which are not “natural,” but rather reflect our society’s values. “To transform such culturally prescribed habits, she explains, “we need to create new cultural contexts that both affirm and support us in experimenting with different movement possibilities. By invoking and enhancing a field of significance that can support us as we explore such new potentials, these embodied value contexts help us appreciate capabilities that might otherwise remain unrealized. In other words, when we seek to transform ourselves, it helps to join with others to create collectives that can support us as we learn to body forth new ways of being” (137).
Cohen’s next step is putting ourselves in relationship with those people and activities that inspire healing and thriving: academic collaborations that inspire thinking through together, and finding those who will embrace ignorance alongside us. This book will be of interest to medical humanists, physicians, scholars of narrative medicine, and any thinker who has intellectually, physically, or emotionally intuited that the split between knowledge and ignorance calls for creative integration in order to move our fields forward and live well.
