For the last 12 years, I have been involved with a group of colleagues in the world of medicine who are engaged in an ongoing, yearly, reflective retreat based on work by Parker Palmer, author of On the Brink of Everything: Grace, Gravity, and Getting Old. The retreat was started in the mid-1990s by ornithologist turned educator, facilitator, and coach Penny Williamson, and soon after joined by Hanna Sherman, an MD and early promoter of relationship-centered leadership.

 

Mixing poetry, literature, group interactions, and self-reflection, the encounter lasted 18 months, with meetings once each season and then six months later. At the end of our last scheduled get-together, the group implored Penny and Hanna to keep it going. It has lasted 11 years.

Designed to address issues of integrity, authenticity, and heart amid the often-overwhelming demands of the medical profession, it affords participants the ability, in their existing leadership roles in the medical community, to bring their true, honest selves to the fore in those positions they hold and, as Hanna stresses, “To avoid the all too pervasive moral injury that we may find ourselves suffering.”

The retreat, with its group interactions and readings, achieves its deepest purpose in an exercise called The Clearness Committee. This is a practice started more than 350 years ago by the Quaker Community and, because of its unique benefits, it has prevailed in that community and communities in education, ministry, social activism, and others ever since.

When someone in the group has a problem deeply troubling them that they cannot resolve themselves, they will reach out to get help from the community and request a committee be formed. The person making the request is designated as the “Focus Person.”

The committee, made up of three to seven members, is called, within the guidelines of “double confidentiality.” This means that no one in the group can broach the subject raised after that committee ends unless prompted by the focus person.
Equally important to enabling its goals is the idea and promise (initiated by Parker Palmer) that the committee members will hold the focus person in their hands like one holding a fallen baby bird, and, when the committee ends, they will allow that bird to fly free.

The committee begins with the focus person facing the group. Everyone sits and enters a place of quiet reflection and centering silence. When the focus person feels ready, they talk about their issue. This happens for 15 minutes while the other members observe and take notes as needed.

The members then begin to ask open-ended questions. These are questions they don’t have an answer to but that have come to mind through the focus person’s impassioned and concerned words, their gestures, and their affect as they speak. Being forced to refrain from asking questions that offer a solution, or that might try to elicit a specific answer, these questions are instead based on chords struck or thoughts that come into the questioners’ minds. This way of asking is what creates the magic of the committee. As it winds up, the group may use “mirroring,” reflecting back the facial expressions of the focus person, or their body language expressed, amid the questions and answers.

The transformation in the group dynamic and the energy, chemistry, heartfelt insights, and deep reflection it allows to flourish are unlike anything I’ve been involved with. And, as Parker and others describe it, the committee is “a method that protects individual identity while drawing on the wisdom of other people.”

The ensuing conversation invariably unearths deep associations and reveals to the focus person insight into the situation and subsequent resolution or understanding of how to approach the issue in the most honest, fearless way.

As Penny says “We each have our inner teacher, inner wisdom to resolve the issues and questions that come up for us, and yet we need others to help us find that wisdom by one method alone: asking open honest questions that help us hear our inner teacher, find our clarity.”

The process has greatly influenced my interactions with patients, colleagues, and especially the physician assistants and nurse practitioners I have supervised. And interestingly, the whole idea of being clear, and having clarity is so much a part of medicine. Anyone who has been involved in patient resuscitation knows the question, “Is everyone clear?” that’s shouted out as the paddles on a lifeless patient’s chest are about to deliver a high voltage shock, warning everyone to move away as that shock is transmitted. I have a story in my book, “Is Everyone Clear,” that goes deeply into one such event in the emergency room. But obviously “clearness” goes a lot deeper than that. Being clear and focused when seeing patients and their families, and in our interactions with our colleagues, being clear with our intentions is a challenging and lifelong endeavor, and the committee has given much fuller meaning to that.

Even though there is a Quaker Meeting House at the bottom of my road upstate, I’d not known much about the Quakers, other than that Richard Nixon was one. Over the last 12 years, I have developed great respect for their practices and beliefs, especially the committee. And, while I still harbor a deep suspicion of how much any person can change, about how much any process can lead to insight, I am astonished at how much I have changed, in my own evolving self-confidence, self-love, and humility. That may be the most important change of all.

I feel comforted by the knowledge that our group will continue to meet, stay open, probing, and contemplative with each other into the future, and that we’ll always have a committee where we can hold one another like a baby bird.