My Philosophy

What follows is a personal statement written in the Fall of 2010 as part of my application for specialty training in Hospice and Palliative Medicine. I share it here because it continues to name my values and beliefs.

Personal Statement: Minke WinklerPrins, M. D.                               Fall, 2010

Philosophy I believe that Hospice and Palliative Medicine (HPM) offers a perfect marriage of my medical skills and philosophy, a spiritual calling, and the need to be useful and of service.

 It seems I’ve always been drawn to medicine. As a child I played in the waiting room of my father’s small medical office in the remote fishing village of Hermitage, Newfoundland. As an adolescent, I worked in his Internal Medicine practice, putting patients in rooms, taking histories, assisting with procedures, and doing lab work, EKG’s and chest x-rays. Because of the experiences in my father’s practice, I felt ready to commit to a medical track right out of high school and was accepted into the integrated six-year premedical/medical program then offered at the University of Michigan. Primary care proved a natural choice from the earliest days, and even in medical school and residency, I found myself drawn to the bedside of the dying. Then, once in medical practice, my more satisfying experiences often involved those ‘meaning of life’ conversations that inevitably show up with the dying. I found there a grounded authenticity in the presence and communications with the dying which occurred almost nowhere else.

And now? I am distressed with how terribly broken our health care delivery system is, especially at end of life. There are so many ways to provide care badly, and there are so many, many reasons (social, emotional, spiritual, economic) to strive to do it well. That our society is death denying also makes us woefully unprepared for this inevitable stage of our lives. Bringing death back into the social conversation has great potential to heal not only those individuals directly involved, but also to help heal and transform our society toward a greater maturity. At the core, my concerns and values involve issues of non-violence and social justice. Technologically focused medical care can be impersonal, alienating, physically damaging, unsustainably expensive, and resultant in a soul-denying violence. The patient-centered philosophy of HPM, “matching medical care with patient goals,” is a happy redirection of medical care which meshes well with my personal values. I believe that access to basic medical care is a human right and social justice issue, and I find the roots of the hospice movement philosophically aligned with this understanding.

My life’s spiritual path initially took me from my Calvinistic/Presbyterian roots to a complete rejection of all things religious, apparently in reaction to the perceived illogic and anti-intellectual nature of religious dogma, as well as to the deep hypocrisy and injustices carried out in its name. However, parenthood, life, grief, and loss eventually brought me to a different kind of relationship with life’s mysteries and, ultimately, to a deeper understanding of faith, grace, surrender, and a place where the divine shows up almost everywhere. All of life is sacred; the beginnings and endings especially so. We live in a largely secular society, which often allows little space for ritual, depth, spirit, and soul. Over the past few years, I have participated in the Sacred Art of Living education and have come to recognize that being with the dying is entering into sacred space. Everyone’s story is different, and honoring an individual’s unique circumstance at life’s closure is at the core of HPM philosophy. HPM fellowship training should prepare me to better integrate the medical needs with the social/emotional/spiritual concerns of the dying.

 At this next stage of my life, I recognize a need to be of service. I live with an awareness of the injustice and suffering in the world and am drawn to help. I have been fortunate, have now raised my sons, enjoy excellent health, and am ready to take on this new role.

 I believe that my medical, social, faith, and educational roots in our community could provide a unique advantage in helping facilitate future growth and integration of HPM services on the central coast.

Fellowship training and board certification in Hospice and Palliative Medicine should not only prepare me for this work, but also provide a grounding, legitimacy, and testament to the need for such expertise in modern medical care.