12.1 - Neuroscience & the Soul with Dr. Sofia Carozza

In this episode of the Hippocratic Society podcast, Dr. Sofia Carozza discusses the intersection of neuroscience and the concept of the soul, exploring how modern science and medicine perceive the human person. The conversation delves into the historical context of these views, the implications of reductionism in neuroscience, and the importance of recognizing the soul in clinical practice. Both Dr. Carozza and Dr. Rhee share personal experiences that highlight the necessity of a holistic approach to patient care, emphasizing the integration of philosophical insights into medical practice. The discussion also touches on the impact of AI on our understanding of the soul and concludes with practical resolutions for fostering a deeper recognition of the soul in both personal and professional contexts.

51 minutes • Published Feb 23, 2026 • Download • Transcript

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[Intro music]

Hi, and welcome to the Hippocratic Society Podcast. This podcast is a project of the Hippocratic Society.

In the podcast, we aim to reflect on deeper questions in medicine, all with the aim of rediscovering the ideals that brought us to medicine in the first place in order to better serve our patients and colleagues.

Thank you for joining us and we look forward to engaging with you through this podcast.

Hi and welcome back to the Hippocratic Society Podcast.

We are joined today by Dr. Sofia Carozza.

Sofia Carozza is currently a medical student at the University of Chicago, but she did her doctoral studies at the University of Cambridge in England as a Marshall Scholar, where she used computational modeling to explore the neurodevelopmental effects of early life adversity.

Her current focus is on the role of social relationships in brain health research she was completing immediately before medical school. And more broadly, her work engages in the philosophy of science,

philosophical anthropology, anthropology,

and the dialogue between science and religion.

And as I understand it, Sofia also runs her own podcast. So thank you so much, Sofia, and anything else you'd like to share about your story or experience or perspective that you're bringing here today.

Thanks, Michael. It's a real joy to join you. I am new to the world of clinical medicine, and some of the most meaningful conversations I've had have been in the context of the Hippocratic Society,

and it's a real honor to be able to share in that conversation today also with the members of your community who listen to the podcast.

As you mentioned, I'm a medical student. I'm at the University of Chicago now. I did my bachelor's at Notre Dame, where I had the great gift of studying both neuroscience and theology and some philosophy courses as well.

So that's kind of the framework for the anthropological explorations that that I engage in. And it's been a profound gift to see how the years that I spent as a researcher in neuroscience shaped my gaze now on patients and left me with, I think, a deeper, perhaps more critical or nuanced view of the human person than I would have had had I not taken that path on my way to medical school.

So I'm excited to dig into some of these topics today with you both.

Yeah, that's perfect.

We very much looking forward to hearing that perspective. And also I can imagine you add a lot to your class. Coming from a neuroscience background and already having a PhD, I'm sure you're a fun person.

I'm an odd bird.

Well, wonderful. Yeah. So the topic today,

as hinted at, is neuroscience and the soul. So in the Hippocratic Society, we talk obviously a lot about medicine,

and we also talk about the soul and virtue theory in the Thomistic, Aristotelian understanding of that.

And so today we want to look at that more closely at the intersection of those two.

And so why don't we start off with how does modern science and medicine, from your. Both of your perspectives, Dr. Rhee and Dr. Carozza,

how do these two fields, just science and medicine in general, view the soul? What is our current understanding, or is there even a general understanding within each field?

Mm.

This is a mammoth, a mammoth topic, and one that has significantly changed over time. So I'm afraid that some generalizations are necessary if we're to approach it in the context of this conversation.

I think I'd start by saying that the origin of the Western scientific project lies in a view of the human person very similar to that which you use at the Hippocratic Society.

This view of the person as a composite of forms and matter, right? This matter, the intelligible physical structure of our bodies,

but also form that there's this organization, there's this principle by which this matter is a human body and not the body of some other organism.

The origins, again, of the Western scientific project also lie in Christian universities. And so there would have been an arrangement also of the sciences and a unity with philosophical and theological inquiry that we've lost in some regard, at least to some extent, in the modern university.

And so the scientific project,

the inquiry to the human person, would have been seen as a partial,

not an exhaustive explanation of the person. And so there would have been abundant room for the integration of these modes of inquiry into the nature of the soul.

So just kind of as a preliminary comment, I think over time we've shifted within science to a reductionist view of the soul by which we think of the soul as merely some kind of phantasm, an illusion,

perhaps at best something that emerges out of the physical substrate of the brain but is completely reducible to physical interactions between neurons. In other words, I mean, there are scientists up and down the last 150 years who say that we.

We don't need to invoke anything other than. Than matter than the brain in order to explain thoughts and behaviors. And so there's no need to have recourse to this idea of a soul.

And contemporary neuroscientists might try to avoid this debate, but you really can't be neutral. You have to adopt and operate within a framework and understanding of who the human person is.

And Therefore some kind of conception of the soul. And so I think reflexively, a lot of neuroscientists do adopt a reductionist view of the human person. We can talk about that if that's interesting.

And I think that in medicine things are slightly different. In fact, this is one of the things that drew me to medicine and away from my career in neuroscience.

In medicine,

perhaps there is, let me start with kind of the error that I see in medicine that complements the one in science. In medicine, I think there can be a dualist approach to the human person, right?

This idea that there's a ghost in the machine. There is this spiritual substance that is separate from and distinct from a kind of thing that's like the body, but just spiritual and somehow it interacts with the body.

And I think that in our Western post enlightenment culture,

the soul can be seen as this rational,

autonomous self interested mind or spirit that is somehow animating the body, but is ultimately the truth of the person.

So that's kind of how I'd frame how I see the soul being conceived of, at least implicitly in the water we swim in and the air we breathe. In science and in medicine.

The reason that I say I'm more hopeful about medicine is that we can get into this later. But the person resists this reduction, this dualism, and asserts herself as a unity.

And I mean that, you know, anytime you encounter a person and really observe her and really care for her, as is necessary in clinical encounters,

you will see evidence of the irreducible unity of the human person.

Evidence of, to go back to where I began, more of a hylomorphic Aristotelian view of the person as a fundamental unity rather than something reducible either to this dualist view of these two substances or to something that's purely reducible to biology.

Yeah, I think that's really great, Sofia. And one of the things that I think about a lot as a neurologist is this idea of how neurologists also think about the brain.

That we tend to love localization.

And so any deficit should be localized to the brain,

any act should be localized to the brain.

But I think that that's the part that we don't often talk about a lot, is that I think there's like an implicit assumption that as long as we understand the structures of the brain more and more, at some point we'll discover everything that's linked to some neural network.

And this, I think is an interesting assumption to reflect on. Because if that does not actually reflect the human person,

then we would also be doing science with a faulty foundational or fundamental assumption. Right.

And I see that sometimes in people doing work kind of in this intersection of neuroscience and perhaps more philosophical concepts like free will or meaning,

or maybe even like spirituality,

where there's kind of an assumption that we'll be able to find a neural network for it.

And whether that's like a correct assumption or not, I think it's also like an important question that we should ask ourselves. And also how we think about the person and the implicit assumptions that we're making as clinicians, too, in the treatment of the person, and also what the consequences of those are in terms of how we make decisions for patients,

how we guide patients in their decision making,

and especially, I think the consequences are largest at an end of life care.

Yes, those are critical points. And just to press a bit on exactly what you said about science,

implicit in what you're saying is that neuroscience and neurology are subsidiary disciplines that rely on definitions and concepts and ideas and truths that actually have been revealed and explored through these rich traditions of inquiry that are outside the empirical sciences and especially philosophy.

And exactly as you said about free will, I think about the early experiments in neuroscience that were conducted on, quote, unquote, free will, if you're familiar with them, Benjamin Libet, his work in the 1960s, and in the tradition that kind of emerged following his experimentation,

he operationalized what was interpreted as a study of free will,

as a study of acting on the urge to flex your finger at a moment when you kind of arbitrarily decide on it. Right.

Which to anyone who's not just studied philosophy, but maybe reflected on their own consciousness and their own structure of their own being,

is, on the face of it, a bit of an implausible way of operationalizing this idea of free will.

It's more something like acting on the urge to suppress a cough. I don't think my free will is necessarily at play there. I think it's rather something that's. That's rational, that's reflective, that's deliberative, that unfolds over time.

And so if you perhaps we can identify a neural correlate for this finger flexion and affect the readiness potential. It's been identified, it's been characterized.

And yet,

even if you can use that to predict my finger flexion, I don't think this provides evidence at all against the existence of free will. And so this example, I think, is profoundly illuminating.

It shows that exactly as you said,

an impoverished view of the person, an Impoverished view of the soul. Reductive philosophical ideas, when they inform our science, impoverish our science, they make it actually quite boring and uninformative.

And so there is an urgency for recovering a richer philosophical anthropology for our science and the quality of our science.

And then of course, to take this second step that you concluded with. When it comes to using that science and the care of concrete human lives,

the urgency is,

you know, increased a hundredfold.

But even on the level of our science, it matters that we take these philosophical views of the human person seriously, spell out our assumptions, and ensure that we're working with the concepts that we truly hold to be robust and true.

Yeah, I love that point. I think it's a very natural transition to my next question, which is, as you were talking, philosophy informs the neuroscience and the neurology and, and you're working with these robust concepts.

But is there anything that neuroscience and neurology alone can discover or find out about the soul? And what is that? I mean, presumably medicine and doctors, I mean,

knowing them, I know a lot of them have wonderful views and ideas and wisdom about humanity and what it means to be a human.

And I imagine the same is true to some extent of neuro, of neuroscience.

But yeah, what is it that they can say in themselves about the soul or about the human being?

That's a great question, and I'm glad that you ask it, because I think in my frustration with reductive approaches in neuroscience,

my temptation is perennially to throw the baby out with the bathwater and say, like, who needs neuroscience?

But instead.

No, precisely because if we take this hylomorphic view of the human person seriously,

actually studying the brain is an incredibly powerful, unique and informative way of approaching the human person. Because of this unity,

I might start by saying that I think neuroscience, what can it tell us about the soul? It actually provides evidence in favor of that hylomorphic view. If you take neuroscientific evidence seriously,

you have good reason to doubt or take issue with both the reductive materialist and the substance dualist view of the human person.

I think, for example, of a friend's PhD thesis. She was working on reasoning, logical and deductive and mathematical reasoning and trying to identify the neural networks that are recruited by human persons involved in these kinds of tasks.

And she found that they involve a sort of logic network of an a set of brain regions that's distinct from the set of brain regions that's necessary for the use of language.

And furthermore, she was studying folks with aphasia, those who have difficulty producing or understanding language, often due to a stroke.

And she found that they're still able to perform these abstract logical reasoning tasks. And in fact, even persons with congenital brain disorders that entail the loss of huge chunks of their cortex still show highly ordered and structured, structured cognitive abilities.

And so, and in, in a different arrangement, but the same kind of logic network of the brain.

So this, these sets of findings, I think first problematize very directly a physicalist view of the human brain, because there is this kind of downward causation from the organism as a whole that is organizing neural activity and enabling this higher cognitive capacity of abstract reasoning that's clearly not reducible.

You can't work your way backwards from the brain and say, oh, that's what this person is doing,

right? It's instantiated in a variety of different neural substrates.

It is again integrated and ordered. At a higher level, you have to look at the whole person in order to make sense of the brain,

which is the opposite of what you would expect from a physicalist view of the person.

But it also problematizes substance dualism because there are these incredibly tight correlations. I mean, up and down neuroscience, you look at any domain, very tight correlations between the organization of neural structure and the organization of our mental powers.

And you know, as you just mentioned, John, in you see this with the localization of injury, that if you intervene on this physical substrate, you cause ischemia on some part of the brain, you can alter or abolish these mental powers.

And this is hard to square with a strong substance dualist view of the person.

So one first thing that I would say that we can learn,

you know, that neuroscience can tell us something about the human person.

It's actually consistent with the view of the human person as this integrated living being who has mental capacities that are not reducible to her physical substrate, but are somehow mysteriously realized in and through this embodied human form.

And we could talk further about, you know, specific characteristics of that human nature that emerge from neuroscience findings. But I think at a very high level, just to talk about the basics of philosophical anthropology, I think the hylomorphic view is one strongly supported by a reasonable interpretation of neuroscientific evidence.

Thank you. I really love that it's just a continuation of this hylomorphism, that it really is true. Neuroscience can tell us that the hylomorphism is true and it's completely consistent across that.

I'd love to hear from your experience in,

I guess, the discoveries of neuroscience, but also now that you're in medical school and have shadowed people. And John, as well, your experience in the clinic,

how these sort of things come up practically or present, or stories maybe, where.

I mean, I studied neuroscience in undergrad, so I love the stories of people with, you know, neurological illnesses or congenital defects who have incredible,

you know, something you couldn't even think of, like missing half a brain, they can do the same thing. Or Phineas Gage is the classic example. Or.

Hm. Where they took out the hippocampus.

So, yeah, I guess how does that present in the research and then in the clinic as well,

where you see something and it's just like, yes, this is. There clearly is a soul, and this is clearly something that is affecting it. And it's clearly hylomorphic because it's related to the body, sort of.

As you were mentioning before,

I think,

John, actually of one experience that I had with you in clinic one day,

we saw a variety of patients with different complaints that almost all seemed to be psychosomatic, Right. That there was something going on in their spirit, in their relationships, in their mind,

that was manifesting in the body as a physical complaint.

And I think,

you know, I think too, of a patient that I saw with psychogenic seizures, right? So seizures that do not seem to be due to aberrant neural firing in the hippocampus that has this spreading depolarization throughout the brain, but rather psychogenic, starting in an affliction of the mind and I would say also of the soul,

Right.

This level of explanation that's higher and integrates more of the person,

this doesn't. I mean, there's a way of looking at these complaints is like, oh,

they're not real, Right. And some people will say that,

that it's not real because it doesn't originate as a problem in one's physical constitution.

But that's actually not what I think you get from these patient encounters at all. Instead, what you see is the person is one.

I cannot treat her as a sack of organ systems and try to localize her problems to one of them, intervene on it mechanically and expect that to restore this person to health, I need to address.

I need to gaze on, receive, accompany and then address the whole of this living organism that I'm beholding.

And how simple it was when I think of one of the patients you approached with a profound disposition of listening and acceptance and validation of concerns that she had been bringing to other clinicians and maybe seemed to have been dismissed by them for precisely because it seemed somewhat psychogenic and how that changed the clinical encounter with her that it was no longer combative and no longer seemed to be such a stumbling block for her acceptance of the

course of chemotherapy that she was being asked to pursue.

So I'm sure you have many more stories, whether it's of encounters like this or others, but I think these sorts of problems, which actually constitute, in my very limited clinical experience,

a substantial proportion of the things that I've seen in the hospital provide great evidence for the truth, but also the practical relevance of a hylomorphic view of the person.

Yeah, I think that actually I remember that day and also those particular patients and the one that you're talking about, Sofia. And it just brings to mind,

in some sense, the seminal article in the New England Journal of Medicine by Eric Cassel,

who was talking about this idea and also criticizing the dualist approach in medicine.

The main example that he brought up was chronic pain.

And because somehow in medicine,

we only believe something is real if we could somehow measure it or see it.

And if it's not measurable or seeable. Seeable, including under a microscope, but kind of seeable. Right.

That somehow it's not real.

And how that this has caused both a lot of suffering and to patients who may have more chronic conditions that are not measurable or seeable,

but may be an affliction of suffering of the person as a whole.

And when we do relegate the work of medicine, then only to things that we see or measure,

then in some sense we are not actually providing healing to the patient because,

well, one, we are telling them that somehow it's like in.

In their mind.

I mean, in their head, in the sense that it doesn't really exist. But even that expression is kind of funny because why is it bad that it's in their mind?

Of course it's in their mind, because

that is like part of their whole person. Right.

And that if the fundamental cause itself is not addressed,

then we could also provide more harm to the patient in some sense by doing all these additional tests or doing all these additional things that may lead to even more, in some sense,

distress and suffering on their part.

And then being told that because these tests are negative, somehow this problem is not real.

And I think that the reason why Dr. Cassell was like kind of criticizing this doulas approach was that he felt that that was not then ultimately the healing that the patient needs, but also reflecting on the duty and role of the physician in trying to also understand the fundamental causes of things or where causes of things originate from,

and trying to address the source of things,

I think, in some sense, with a sub, sub, sub specialization of medicine. And, you know, in some sense, I am also an example of that.

But the subspecialization of medicine has also made it so that it's harder and harder to see patients in that holistic view.

And therefore,

in some sense, when we might not, like, understand something about a patient, we say, like, oh, that's not in my expertise.

And that also causes a lot of distress for patients to person after person.

But I think one other thing that I've just kind of developed as a clinician is this recognition that I have seen things that I cannot explain pathophysiologically,

but clinically, it must be related to the thing that happens to the patient, because it happened right after.

And so, I mean, that's just clinical judgment, right? And so,

sure, like, the side effect of this chemotherapy,

it doesn't list this particular side effect that this patient is reporting.

But, like, in reality, the patient can have, like, any side effect for any treatment that they get, right? Because in reality, that's also, like, possible.

So I think there's also a tendency in medicine to look at things just from a point of view of, like, statistics without sometimes also even understanding,

like, where those statistics come from or how they're developed. I mean, just the list of side effects themselves are just only based on the clinical trial that approved the drug by the fda.

Right. So just because it's not on there doesn't mean that it's not a side effect. And so I think this overall deeper capacity for reflection to go to the foundations of things, to not just think about things in terms of statistics or numbers,

or do I see it, or do I understand the pathophysiology logical pathway, but rather seeing, like, what is the healing that this person in front of me needs,

and how do I kind of know that or come to know that and address that in particular.

Yes,

if I can add, I think complementary to exactly the mystery and the subversive truth that you're outlining is also the fact that so much of healing and recovery for those patients who do recover from their conditions is not something that's measurable and the factors that contribute to it are not purely physical.

So also, if we look at this positive angle of what is it that is going to help the patient and what is going to catalyze this patient's health.

We might have RCTs for the different medications that we can prescribe, but so much of it is a function of things that you need to look at the organism as a whole living being, if you're going to account for it.

I think of one patient I saw in vascular neurology clinic who came in after a triple bypass heart surgery. He had been discharged from the hospital,

he had died on the table and been resuscitated.

And he had every risk factor for stroke, vascular problems that you could possibly imagine, right? You know, lifetime smoker,

diet, all, everything, everything was there.

But he came in for his first appointment with the neurology clinic to try to, you know, mitigate his risk of another stroke.

Oh. Cause he had also had a stroke on the table. That was the other thing that happened.

And when the physician that I was working with started taking the history,

he refuted ev basically every risk factor that had been the case.

So he said that he quit smoking cold turkey. He was no longer living alone, he'd changed his diet, he was exercising daily,

and he had been in the hospital like two weeks prior. Right. This was not. He didn't have a lot of time to make this change. And he had been previously on smoking cessation programs.

So it's not like it. There hadn't been attempts in the past. And the physician was dumbfounded, understandably, and looked at the man and said,

why? And how, like, how what happened?

And this man, a somewhat taciturn construction worker, just looked back, it looked back at him and said, doc,

I want to live.

And that struck me. So, like,

you can't do an RCT on the desire to live, right? As like, effectiveness of an anti smoking intervention, like inject the person with a desire to live.

Now you could say, okay, well, motivational interviewing, doesn't that kind of get to it? Yeah, yeah, yeah, but,

but that doesn't actually measure the human being's desire to live. And that, that can not in every case, right. Because our freedom is, is very constrained by our habits and our upbringing and all these things.

But in these moments of grace,

that desire can be the most powerful catalyst for recovery and healing that a person could, could ever imagine.

I was recently rereading Abraham Joshua Heschel's address to. I think it was the ama, something like that. Like some group of doctors in the 1960s.

It's called the Patient as a Person, and I would heartily recommend it to all your readers. But in it he talks about how, yeah, you know, diet, physical exercise,

understanding the composition of blood and urine, like these things are all important, but so too is a patient's capacity to praise,

a patient's capacity to revere someone's self discipline Someone's capacity and desire for self transcendence, like all of these things are elements of the process of recovery for both the patient and the physician.

For both the patient and the physician. And that's very hard to square with a biologically reductionist approach to the human person. And so I think, again, it's an invitation to step back, to look at the whole person, to look at the whole picture and say,

this person is a unity. How can I respect that unity in my process, yes, of diagnosis, but also of accompanying the person to wholeness.

That's beautiful. And it just triggered just one beautiful thing that I just had. Small thing yesterday where a patient sent me a message.

And he had been struggling due to kind of progression with his brain tumor, needing to kind of leave his job,

but wanting to support his family. And so, like, just feeling really distressed emotionally and sent me a message saying, two days ago he had an epiphany that in the morning he reflected on how in some sense he's gotten extra time, like more time than he would have had,

and to live each moment with gratitude.

And just reading that message from him made me reflect on the fact that, like, wow, there's like, some deep healing there too.

And that's not also some just like,

yeah,

neural networks that healed or some like, kind of physical.

Right. This is like something deeper, an aspect of meaning making for him.

It also comes from.

In this process of making meaning, he's like, rediscovered a sense of his faith and transcendence,

and that's also feeding his sense of gratitude. And so a lot of things coming together and just reminds me of, like, wow, that is more profound healing than I've given him as a doctor in many ways.

And just. Yeah. That beautiful interaction yesterday.

Yes.

Wow.

Praise God.

Yeah, that's beautiful. And that I think this whole conversation, especially bringing into this clinical side of things, it makes me curious, from your perspective, both as a doctor and as a medical student,

the two of you, what is the like. As it. As a physician,

what is the approach for approaching the soul? Because,

you know, hypothetically, the physician is reaching for healing, which is not just the body. If we are holomorphic beings, it's not. You can't really separate them.

So what in practice has your approach been for approaching a patient's soul? Even if that's not sort of explicitly spirituality, Whether that's. I mean, I know there's chaplains and you can always refer to a chaplaincy and ask the.

The chaplain to come visit and give spiritual care to the patient. And then Also from the perspective of the medical student, what is it like in medical school and clinical rotations and among your classmates?

How can a medical student approach medical education with this view of the soul being so important? And how is that sort of being taught, at least in your experience?

Yeah, maybe I could start there and then, and I feel like Sofia will,

like kind of the way that I'm framing this because of the particular word that I'm going to use. But in the sense that,

you know, as doctors, we tend to think of ourselves as perhaps treating predominantly the body.

I think that that's how physicians think about what they're doing. Like, that's why even medicine is organized into like gastroenterology or cardiology. Like this is the organ that I treat in the body.

And now it has some benefits, like in the sense that you could have like a sub specialist who knows about this particular heart condition and knows so much about it that it could be very helpful to the rare patient who has this particular condition.

Right.

But because of the over focused on an organ based approach,

I think the, maybe the, the only specialty that kind of break this in some sense is like psychiatry and palliative care is that even in a patient encounter, we approach the patient as a body.

The way that we examine the patient, the way that we interact with the patient. I think that this is kind of clearly seen in most, I think, inpatient interactions where like the team comes in,

they kind of like sometimes don't even talk to the patient. They might just talk to the family member. There's almost like a sense in which the patient is just there as a clump of organs or just the body being there.

And so I think the way that we fight that is that we have to retrain ourselves to recognizing that we are treating a person and not a body.

And that is I think, where the key aspect comes in which is like, how do we encounter the person?

Right. And what does it mean to encounter another human being or another person?

And that, I mean, in some sense complex question, but in some sense in practice, not that complex,

which is you sit and you look and you are attentive to the heart of the person in front of you. Right. And I don't mean the heart as this cardiovascular organ,

but the heart as the seat of desires, wishes, hopes, worries, sufferings. Right.

I think only when we encounter the person in this deep sense can we also understand holistically,

not just what is happening to them physically, but all of the other things that are happening to them as a whole, as a whole person.

And so I think that frame shift is constant battle. I have found in medicine,

even as a somewhat recently graduated trainee myself who's gone through this medical education system for a long time. And we can have many more discussions that probably cannot fit into this podcast on how some of the culture of medicine also malforms us.

And that's why we have to also, in some sense, like,

reform ourselves to that which is kind of true and good to our vocation as clinicians.

And I think that there's a lot of, like, even now,

reforming that malformation that I've had. There's also been a lot of good. So I don't want to just say, like, oh, medicine, medical education is, like, terrible. Like, let's, you know, say everything's bad.

I don't think that that's true either.

But I think that there's a lot of, like, bad habits that also I've picked up through my training.

And trying to unlearn and relearn those in different ways has been a process that I've also found very fulfilling and meaningful as a new attending.

Thank you for that reflection, which gives me hope for my own,

my own future in medicine.

I've been grappling with this very question,

Michael, this week in an intense way. I spent one afternoon in the ICU and was involved in the care of a patient who was sedated and intubated with multiple failing organs.

And I was told by someone else involved in this patient's care that there wasn't a life there anymore, it was just a body,

and that the life, in fact, was not worth living.

Even if the patient did leave the ICU because of the profound damage that would have been done to this person's brain and the fact that this person was already, before coming into the icu, living in a wheelchair.

It was a profoundly dehumanizing way of describing and approaching this person that left me full of grief and anger on this person's behalf.

And full of grief, too, for the person who expressed these judgments to me, these false judgments about the value of this person's life,

because that person's medical training,

in a sense, has malformed this person.

I don't think that anyone goes into medicine with that view of someone who is profoundly sick.

No.

But the risk of our medical training is that we become so proficient in these, again, technocratic manipulations of the body and so used to seeing the person as primarily a function of autonomous choice of what to do with the body,

that when those mental capacities are gone and that Body is failing. There's no person left anymore.

Many of us will develop dementia before we die. That's one of the side effects of this incredible increase in longevity that we're experiencing in modernity.

We will be the patient in the bed who is seen as no longer human because we've lost the capacity for autonomous self control and expression of our wishes.

So I think when it comes to seeing the soul in the patient, seeing the patient's soul,

there is the risk of malformation and the developing of blindness.

And it's a risk that we need to be vigilant about.

But to go back to something we were talking about earlier, I'm very encouraged by the fact that the patient resists this reduction.

Like you're gonna, if you, if you ignore the soul, you're gonna trip on it and lie on your face. Like you can't actually splinter apart the person in this way.

And if you try to see her as just a collection of organ systems, each the rightful territory of a different specialist, you're gonna be less effective in your medical care.

And there are gonna be so many signs of that.

And so I'm heartened by that. Reality resists the ideological reductions that we attempt to make of it. We try to carve it apart and fit it into our little boxes.

And reality says,

no, I will not let you.

And so this, this fills me with. With hope that even if I forget, I will continually be recalled by the patients that I see and by the many exceptional. You know, this was somewhat of an anomalous experience.

I work with many exceptional clinicians and medical trainees who also remind me of the fullness of the humanity of the patient in front of me and my own. This is the last thing that I'll say on this point.

But I think another thing that can help us in this regard, like see the patient in medicine, is to practice seeing our own.

Sorry. See the soul in the patient in the medical context is to practice seeing ourselves more fully.

Because there's the risk of the reduction of the clinician as well as someone who just provides this technical service. And you stop, you leave, you start leaving everything else. At home, you strive for work, life, balance, and at work you become this robot that prescribes medicines.

And then you go home and you spend your time doing what you really want.

But that's not satisfying to me. I want to live a full, integrated life where I am the same person and fully myself.

When I'm in the patient's room, when I'm studying for my renal physiology Examination.

And when I'm with my family, when I'm at church, when I'm sleeping, I want to be the same person.

And so I think attentiveness to ourselves and all of those dimensions of ourself that cannot be reduced to a number or quantified in the spreadsheet in epic, or assessed physically, attentiveness to those things, taking them seriously, cultivating them,

those virtues, those desires, that capacity for freedom, that spiritual longing,

friendships, all of these things like that can help hone our gaze and help us more readily recognize and attend to all of those same dimensions of the patients that we care for.

I have one question, Sofia, that I would love your thoughts on,

especially because it's an unavoidable question, I think, with all of the things happening right now in technology,

which is with the advancements of AI, so how can we not talk about AI? Because we talk about it all the time with these neural networks. I mean, we even call them neural networks, right?

In reference to how the brain works and what AI tells us and may teach us actually,

because of the things that it does, but it does also cannot do about the soul and perhaps are also misunderstandings of what the soul is,

maybe because of our increased interaction with AI.

Gosh, big question.

And I'd love your own thoughts on this.

I think a couple preliminary thoughts. One is that I could see you hinted at this at the very end. I could see a reduction in our understanding of what the soul is falling, following from our use of AI.

If we take AI,

as many people are,

to be an accurate and adequate imitation of human intelligence, which this is where I think the neuroscientists are actually pretty strong anthropologically. Maybe just because of their professional pride. They don't like being, you know, but they.

No, this is not human cognition.

This is not even an imitation of the brain. It's a very advanced computational tool that was inspired by early primitive models of some neurons interacting with each other. But it is not actually intelligence.

That's a misnomer.

And so I think there's an opportunity here if we could make that fact penetrate the public imagination.

There's an opportunity here actually to enrich our understanding of the human soul precisely by distinction. It's like, oh,

the human soul is not the same thing as an artificial neural network. So even if the artificial neural network can draft a summary of this 25 page document, that means that there must be something about me that makes me human.

That's not my capacity to draft a summary of a 25 page document, right? So precisely in this distinction, there's an opportunity to say, then what is it that makes me human?

What is distinctive about the human soul? It must be something that the AI can't do.

Perhaps it's, I would say, I think, essential to the soul is a capacity for spiritual things. And that is something that squarely the AI cannot do. Other, you know, philosophers of mine will invoke qualia or the subjective experience of something.

There are any number of features that. But that's an opportunity for enrichment, I think.

Now, perhaps this is not exactly what you were asking, but a second thought that came to mind is.

Is always keeping in mind our goal, the end of medicine, when we incorporate AI into these clinical encounters and interactions.

Again, it's a question of ordering. I'm not a technophobe. I don't think I use AI. But it's a question of ordering. And I think there are many great uses of it that can aid our receptivity to and awareness of the soul of the patient.

Like those wonderful AI tools that will write the note in the background as you're talking to the patient. Great. If I don't need to be typing into epic, but instead can look somebody in the face and ask them questions without worrying about how I'm going to document it, that's fantastic.

That would aid my capacity to see and receive her soul.

But then, too, I think that there are uses of AI that do the opposite. So it's a matter of ordering.

Yeah, I think those are great. And it somewhat ties back into the first topic that we were talking about,

which is the assumptions that we make as we roll out these types of things that we don't know much about yet. Right. New technologies.

And. And if we make an assumption that, for example,

using AI chatbots and developing relationships with them could be good for the grieving process, let's say,

or for an AI chatbot to simulate your dead loved one to help with grieving.

These are fundamental, I think, assumptions of the human person that are coming into play in clinical research that we have to ask ourselves, is that a good assumption? Because if not, we could actively be harming the person.

But if there is a sense of potential harm,

it has to come from also philosophical or anthropological understandings of what is or is not good for the human person based on what the human person is. Right.

So I think that these are all the other. Yeah, just things that are tying together and even the scribing. I'm also not anti AI. In fact, my research is in large language models so people can Say that.

Yeah, I'm actually a fairly avid user in many ways, but have been thinking deeply about how, though we apply it in medicine.

And I've actually actively resisted the scribing because there's a sense in which I think the writing of the assessment and plan is an aspect of analysis and bringing together pieces of information and putting it into a whole.

That the process is important to me as a developing physician that I don't think should be outsourced,

though there are many things that.

There are many levels to that. Right. I mean, if it's just like a quick urgent care visit and it's like, about a cold and you're not doing some serious integration, then I think that that is better.

And you're seeing maybe hundreds of patients in the emergency room. So even there, I think there's a nuanced, perhaps, view of what is good in terms of integration, what is not.

And all of these, in some sense, have to come down to, at its core, our understanding of what is good from the human person, based on our understanding of the person,

him or herself.

That's a great point.

I love these reflections, and I have to say I'm very inspired, both for the work of the Hippocratic Society, because just hear you talking, it just reinvigorates me that it's very necessary, but also for medicine and how.

It sounds like this is the perfect time to actually go deeper in our understanding of the soul.

And like you were saying, Sofia, that AI can actually spur this reflection and maybe this conversation.

Anyway, I think we are just about running low on time, but I would love maybe one from each of you of a practical resolution maybe that we can bring in to our daily life and work.

And what does it mean to recognize the soul? How can we foster that in our practice, seeing that in others or seeing that in ourselves?

Yeah, I could start. And just in case we don't have the opportunity, Sofia is a good friend of ours, so we're so thankful that she's here.

We lost her because she was in Boston for a while now. We lost her to Chicago. But she is a dear friend, and we're so happy that she was able to join us and also continues to be a part of our community.

Yeah, I think my practical point has to do with what we were talking about before, with the encounter.

And it's a simple, small, practical thing that I practice,

but maybe helpful for clinicians,

which is whenever we do go see a patient,

just briefly asking ourselves,

am I encountering this person as a human person? Like, am I encountering this patient as a person.

And that question can be asked at the beginning, but it could also be asked in the middle as a kind of a mindful exercise. Right. Like is the way that I'm treating this person as another person.

And I think that this kind of constant self reflection and asking of oneself this can over time transform the way in which we do encounter not just a patient perhaps,

but perhaps in all of our relationships, a depth of encounter,

especially those that are closest to us, that we love. But it is also, I think,

a realistic thing to know that if we spend a large part of the day encountering patients as just bodies, that that will affect our relationships as well.

It's like impossible that it doesn't. Right. And so.

But conversely, if we spend our whole day encountering people as persons, right in this deep way,

trying to get to encountering their heart, who they are again, all of these things that are deep in people's hearts. And that is also how we will encounter people in our daily lives, especially those we love the most.

Thank you, John. That's,

yeah, profoundly inspiring and a helpful reminder for me at this stage of my training. And I think, Michael, I would offer the encouragement to read literature,

perhaps also nonfiction, sort of memoir style writing or very thoughtful insightful biographies, but literature. I just finished Edwin O'Connor's the Edge of Sadness and I read it while I was sick with the flu.

And so there really was something about, you know, the particular time and place that perhaps let it hit me the way that it did. But. But I find regularly with novels that they catalyze a transformation in the way that I view myself or a loved one or some reality outside of myself.

I think that we in medicine are very good about keeping up to date with the latest literature and medical students are great at consuming incredible amounts of factual information about the human body.

And I think that equally important is nourishing ourselves with rich accounts of the interior experiences, the life of the mind and the soul, the lives of the relationships of others,

seeing how lives unfold through experience over time.

These can heighten our sensitivity to those elements of the experience of the people around us and I think enrich what can often become kind of two dimensional caricatures that we replace the mental schema that we have of others can be quite impoverished and injecting some life into it by reading literature is a good idea.

I love that. And if I may, I think they're both very right brain practical resolutions, which I love.

Anyway, thank you very much, Sofia and John, for this very informative and inspiring podcast. Honestly, it was really wonderful having you, and I look forward to continuing this conversation in other ways.

All right, we'll see you all next time on the Hippocratic Society Podcast.

Thank you very much for joining and reflecting with us today.

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