Meeting in St. James Park

Let me tell you a story, which changed the way in which I look at how we construct knowledge and understand complex learning situations. As a story, it has also served as a model for the ways in which I have approached my own research in this thesis, since it represents Family Physicians' interesting ways of reasoning.

I met Dr. G. in Winter 2002, at St. James Park, London.  Dr. G. is a 42-year-old Israeli Family Physician, who acquired his expertise during the eighties, after he emigrated from Russia. Our first acquaintanceship was during 2001 when we both worked in Leumit Health Fund. He took part in "journal club" learning meetings, while I was in charge of the Training and Human Resource Development department.

Dr. G. decided to search for his professional future as a Family Physician in the UK, and emigrated prior to our meeting; he was taking an English course to prepare for his professional registration. Still enthusiastic about living in London, the big city, and the opportunities that he so long dreamt of, he suggested meeting outside, at St. James Park. We were walking through the garden paths and he told me, in his unique manner, and in a very strong Russian accent, his life annals and exciting stories*.  Since he hadn’t yet got his longed-for work permit in the UK, I asked him about his expectations of living here and in particular with respect to the job he intended to get as a practitioner.  Dr. G. replied that, his acquired skills, his professional background, and his rich experience in care giving, would serve him similarly in England and even would enable him overcome cultural differences in mentality.

"Look", he said, "the medical way of thinking is similar, to a great extent, among all Family Physicians, no matter whether they are working in Israel or in England".

"What do you mean"? , I asked.  "Look", he answered, "we have all studied the same doctrines, been assisted by the same books, and we read the same journals and periodicals in Medicine".

"Aren't you anxious about encountering medical aspects that you haven’t met before?", I asked naively, worried and bewildered.

Dr. G. stopped walking, looked at me and then directing his eyes towards an imaginary distant point in front of him, "Yes", he answered, "there will always be something hidden from my eyes". "Well", I pushed further, expecting that my approach would "break him" as he might be confronted by a realistic test. 

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* The meeting was tape-recorded after Dr. G. gave his oral consent. It is presented as raw material scarcely fitted to my theory. It took me some time to understand the full relevance of this meeting, stimulating me to further explore the ways experts think. 

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"I am going to tell you an allegory that might clarify what I mean", he responded. "Do you see the bench in front of us, on which an elderly man is sitting, with a hat on his head?".  "Yes", I replied.  "O.K.", he kept on, "In the background, four big trees are flourishing with white colored blooms, and on their left side is a pink colored tree". "Indeed", I curiously answered back. "Those deeply rooted trees, whose name I can't remember right now, were brought by Queen Elizabeth from China. They have lovely blooms. Can you see them?". "Really wonderful", I wondered how this story related to my question. "A bit behind these trees, we cannot see it though, there is a fountain and in its center is a statue, surrounded by a flower bed. I know it is there. I also assume that if we walk towards the fountain, we might see Big Ben".   "Really?" getting excited. "Maybe we wouldn’t be able to see it, but if you direct your imagination towards your right, you might see the Houses of Parliament. I am sure you will find it worth visiting. A very special building although a very touristy site " he sounded quite apologetic. "You are right", I answered, "but how does it connect to my question?". "O.K.", Dr. G. continued: "Doctors do not know everything, nor is everything apparent to them. Yet, they are always proceeding, step-by-step, from the position they know and feel well acquainted with. As long as they continue examining and assessing, they meet completely new knowledge, some parts of which they might have encountered in their past, and some other parts might only be inferred, supported by salient issues, which are revealed, though from a different angle. This is how we meet the world step-by-step".

We carried on our conversation, but the metaphor of the trees from China, which we saw in St. James Park, was very vivid and kept me thinking for a long time. How conscious was Dr. G. of his allegory of the deep-rooted trees? And how did it relate to his expectations for becoming well implanted in the UK? Yet, our discussion raised many other questions, for example, as to how the un-seen fountain or Houses of Parliament analogically serve for stimulation of further searches for knowledge? Are inferences valuable in the construction of knowledge? What if the fountain and the statue only themselves became subjects of the imagination in which Dr. G. carried a complete imaginative world?  Dr. G.'s analogy and his rich and multileveled story by which he opted to explain the medical ways of reasoning, became one of the main subjects of interest for my exploration. His spatial descriptions in a pictorial fashion became core subjects for me to investigate; they have served as models for the ways in which Family Physicians use analogies and metaphors, in order to explore the world around them; they have highlighted the special ways in which stories became important tools to organize meanings.       

 

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