The ethical life is not first about decision-making but about discernment. It is concerned with the long and often painful work of coming to understand oneself within a world of obligations, histories, and relationships (Williams 308). This understanding of ethics was an animating conviction behind the Columbia Character Cooperatives—a professional and moral formation initiative for which I served as Director and intellectual curator, but also co-led with internist Lydia Dugdale and hospitalist Beatriz Desanti de Oliveira at the Columbia Center for Clinical Medical Ethics from 2022 to 2025. The Cooperatives sought to create an extramural, parallel space to bolster curricular medical education for precisely this kind of work: to ask what kind of persons medicine was shaping and to explore whether it might be possible to form clinicians not merely capable of clinical mastery but with competencies in moral and existential attention. Our guiding image was not the sovereign provider but the discerning practitioner—someone who is willing to be interrupted by suffering, implicated in community, and claimed by care.
As a theologian and ethicist embedded within the clinical world, I came not as an expert with answers but as a witness and companion. I did not spin a web, like Jonathan Swift’s spider, drawing only from the thread within myself. Instead, I tried to live—and invite others to live—as the bee.
In The Battle of the Books, Swift offers two figures for the intellectual life. The spider, spinning from within, constructs elaborate but fragile webs of self-referential thought. The bee, by contrast, ventures outward, collecting from many flowers, not consuming but gathering, and in the end produces honey and wax—sweetness and light (Swift 108-11). This is no idle image. It is a vision of how truth is gathered: not spun from self-sufficiency, but borne from attention, humility, and synthesis.
The fourth-century Church Father Basil of Caesarea saw the same truth. Writing to young learners, he urged them to be like the bee—discerning, careful, and generous. “Just as bees do not visit every flower indiscriminately but gather what is useful,” he writes, “so too should we” (Address to Young Men 4.1). Basil’s was not only a pedagogical metaphor. It was an ethics—and understanding of the right way of being. The bee is not only wise—it is committed to life. It pollinates even as it nourishes. It is a figure of mutuality, of the possibility of shared flourishing.
So too, I thought, could be the Character Cooperatives.
The Cooperatives were not to be courses or clubs. They were to become spaces of intellectual and moral formation—small communities where medical students could risk the vulnerability of asking what kind of person they were becoming within the places where medicine is practiced. Together, we read texts ranging from philosophy and theology to poetry and prose not to master them but to be mastered—to be interrupted, undone, and reoriented. We asked what medicine requires of us, not only technically, but morally. What does it mean to listen to the patient who claims us? What does it mean to be shaped by traditions that have both healed and harmed? What virtues are latent in the crafts of physicianship and surgical care—and what vices?
These questions could not be asked abstractly. They required us to learn a kind of attention—what Iris Murdoch called the “just and loving gaze” (The Sovereignty of Good 33). The Cooperatives cultivated what I began to call hermeneutic competency: the capacity to interpret not only texts and symptoms but situations, histories, silences, and selves. This is not just a clinical skill. It is a moral and existential practice that allows the clinician (and the clinicians-to-be) to discover themselves already implicated in colonies of responsibility and possibility.
Our aim in the Cooperatives has never been perfection. Rather, our members have learned (I trust) to strive continuously through the mundane work of doctoring to form what Donald Winnicott once called the “good enough” caregiver—one who is reliable, responsive, unfinished, and still willing to be claimed (Winnicott 10). Our model, therefore, was not the sovereign hero but the humble servant. We, therefore, have worked carefully these past years to take seriously and to hear the call of the sick and infirm, who do not simply request care but command it—who summon physicians and surgeons to be with and for the patient in ways they did not choose, and might not yet know how to fulfill.
And so, I have often said that the Cooperatives are not about producing better doctors in the measurable sense so predictably familiar to these medical settings. They are about forming persons who can receive the life of medicine as a vocation—not simply as a career but as an answer to the call of those who are ill. Accordingly the Cooperatives have been about becoming persons attuned to suffering and capable of bearing the weight of another’s vulnerability. The Cooperatives have been concerned with becoming transfigured by the strange moral life of clinical work. That life is not neat. It is knotted, unfinished, and often incoherent. But in the knots, we can sometimes discover the moral task of the doctor and through the craft of medicine help others to recover health—even health within illness (Carel 77-108).
What has emerged over the years is not a program, or a product, or even a curriculum. It is something more organic and fugitive: a cultural apiary, of sorts. Students, fellows, and faculty alike have become inquirers, watchers, and rememberers. At their best, the Cooperatives have been hives—small, buzzing communities of shared labor and reflection. Our students and joining faculty, residents, or fellows have been bees, gathering nectar from philosophy, theology, literature, history, and experience. They have not consumed it whole; they have made something new of it. In their learning, they have begun to craft not just competence, but wisdom. Not just knowledge, but judgment. Not just treatment, but care.
They have, like Swift’s bee, begun the good labor to bring home honey and wax. Sweetness and light.
And although our particular nucleus hive was framed at Columbia, its spirit is portable. The task of forming clinicians in discernment and mutuality while supporting both intellectual and moral striving must not be unique to any one institution. Medical schools willing to ask not only what medicine does, but also what kind of person it requires, can take up this work. The practices of mutuality, moral imagination, and hermeneutic attention that we cultivated are not bound to a single colony. New hives can be framed and colonies nurtured wherever there is courage to ask and to enact what it means to be “good enough”—not only as a caregiver but also as a human being. The future of medicine may well depend on it; it most certainly will be transformed by it.
Works Cited
Basil of Caesarea. Address to Young Men on the Right Use of Greek Literature. Translated by Roy J. Deferrari, Loeb Classical Library, Harvard UP, 1934.
Carel, Havi. Illness: The Cry of the Flesh. 3rd edition. Routledge, 2019.
Murdoch, Iris. The Sovereignty of Good. Routledge, 1970.
Swift, Jonathan. The Battle of the Books. In The Major Works, edited by Angus Ross and David Woolley, Oxford UP, 2003, pp. 102–15.
Williams, Rowan. “On Making Moral Decisions.” Anglican Theological Review 81, no. 2, 1999, 295–309.
Winnicott, D. W. Playing and Reality. Routledge, 1971.
Image
Nameplate of the American beekeeping periodical Gleanings in Bee Culture, vol. 9, no. 12, 1 December 1881. Artist unknown. Wikimedia Commons.
