Heart and bowels

You were for many years a member of the Board of the Foundation for Medical Sciences and Services that was responsible for the project that later became Mater Dei Hospital, but you have rarely spoken about its realisation. Now that you have had the opportunity to experience it first hand, are you inclined to say something more about it?

The medicine that did my ailing heart most good at least at the time when I was in the Intensive Therapy Unit was a comment by a nurse: “I enjoyed studying your book Peopled Silence when I was at Junior College, but a colleague of mine told me that your lectures on Kierkegaard’s discussion of the Book of Job in Repetition was much more interesting.”

I cannot imagine a nurse in the years before 1987 talking in that way. Only too often I have felt that much work I had done when Rector of the University had ended in shambles, but here I was experiencing personally what marvellous results had come out of the establishment of the Institute of Health Care, which has now become a fully-fledged faculty, and in particular out of the academic status given to nursing and paramedical studies.

No less than those in the ITU, those in the Cardiac Critical Care Unit not only showed a technical competence at their work that was of the same standard of excellence as that universally acknowledged in medical experts. The nurses also showed that deep humanistic culture that is the essential objective, although far from invariably attained, of a ­university education.

Admittedly, the level of performance of the rest of the staff who had not been to the University was undistinguishable from those who had been. So, I attributed it to ripple effect, or the team-spirit percolating from the top.

Another source of happiness in the otherwise limbo-like environment of any hospital even when care is provided beautifully was realising that the young doctors in attendance, more of them ladies than gentlemen, were following postgraduate training courses.

In this connection, I was, however, a little surprised to notice a carry-over from colonial times. Responsibility for the postgraduate training was not shared in at all by the University, but only by the professional associations and government bureaucrats.

This is just because of the peculiarity that in the UK, postgraduate qualifications in the medical field were granted in the form of membership or fellowship of the colleges, which were just the professional associations of the various specialities.

Surely, this is carrying copy-catting British whimsicality to a degree that is ludicrous in a culturally adult country.

On June 6 you had discussed medicines policy. Did your personal experience induce you to change your mind on any of the points that you had then made?

Not at all. I was infinitely ­grateful that the government spent upon me during nearly a month’s sojourn in some of the costliest wards of the ­hospital more than the taxes I paid.

But there were at least two kinds of pills that were recommended but not provided by the hospital. One was very expensive and related to my cardiac condition, but the other was quite cheap and related to my constipation. I still felt that I was inequitably privileged that I could myself purchase them, while others could not.

In my June column, my first complaint was that it was ­difficult to understand what policy was being followed and by whom it was being established. I cannot say I have a clear idea now. On the contrary, my impression is still that management is not optimal because there are too many cooks from various ministries who stick their ladles into the pot.

My own previous experience at the head of complex institutions leads me to guess that the best solutions would be found if full responsibility were left in the very capable and sensitive hands of the Minister for Health.

Did your experience of illness which might easily have been fatal instil in you any philosophical reflections?

The problem that worried the doctors was my heart, but my own major discomfort was the malfunctioning of my bowels. I began to consider in a new light the basic philosophical question: What is it to be a human being? – now that my deepest aspiration over several weeks was to experience bowel movements, rather than conceive any new ideas or experience subtle emotions.

I could not help recalling that in the Bible the different activities of the soul are associated with various organs of the body, and that alth­ough the heart is considered the seat of the will, it is the bowels or intes­tines, rahamim in Hebrew, that are considered the seat of the emotions, and therefore of the divine mercy.

When Joseph recognises his brother Benjamin, or when the real mother of the baby reacts to Solomon’s suggestion of splitting the baby, the Bible says that they “felt their bowels move”. So too Jesus when He saw the hungry and confused crowds. The Greek word for movement of the bowels (splang­chna) is usually translated as “moved to pity” or “from the very depth of his being”.

It was only in these weeks that I realised that the curious Biblical imagery actually had a cogent physiological foundation.

Fr Peter Serracino Inglott was talking to Miriam Vincenti.