197 , ethics of face Waste Land and , caring 2003 Lippincott Williams & Wilkins, Inc. asked in the c Nurs Admin Q Vol. 27, No. 3, pp. 197–202
2 : “Where is the life we have lost Key words: Watson , It seems the task of nursing and health and When working with others during times of As T.S. Eliot Other Poems in living? Where is the wisdomknowledge? we Where have is lost in the knowledge welost have in information?” healing is relatedshared to humanity. the In very viewingdeeper nature nursing level, of at we our been this realize too small that for the our naturethe of needs jobs our of work have those and whomtoo we serve, small as for well as theand evolution collective humanity. of our individual despair, vulnerability, and unknowns, wechallenged are to learn again,own meaning to of reexamine life our and death. As we do so, what brings uspose. together for Thus a this commonto article pur- gather and up message newmay are knowledge, do not although that, they butgather rather nursing they together for are a intended moremon basic purpose: to com- perhaps to seekstein what called Wittgen- “reminders”—reminders ofwe what already know at someriential deep level, human, but expe- continually passday-to-day over living. in our 1(p117) —Rumi transpersonal caring theory , Love , Logstrup , Levinas This manuscript offers a newby view contemporary of European old philosophies, and andtraditions. timeless caring values: theory, It as the well integrates essential as ethic some ancientTranspersonal of Caring poetry of love, Theory. and informed the The wisdom metaphysics, philosophicalof metaphors, views and face,” the of meanings associated “infinity Levinas withdeeply of and “ethics ethical the Logstrup foundation human with foronly soul,” the Watson’s and our timeless shared “holding practice humanity, another’s but of the life love profession in and of our caring, nursing hands” itself. as are a tied means to to a sustain, not Jean Watson, PhD, RN, HNC, FAAN Let us fall in loveAnd again scatter gold dust allLet over us the become world. a newAnd Spring feel the breezes driftLet in us the dress heaven’s the scent. earthAnd in like green, the sap ofLet a the young grace tree from withinLet sustain us us. carve gems outAnd of let our them stony light hearts ourThe path glance of of Love. love isAnd crystal we clear are blessed by its light. We as nurses are invited, if not required, to unite at this cross roadsthis in new nursing century history, at ofquestioning of time nursing’s survival and to reconsider confusion and From the University of ColoradoCenter, Denver. Health Sciences Parts of thisat article the areAmsterdam, International The based Netherlands, Reflective June upon 2002. Practice a presentation Conference, Corresponding author: JeanFAAN, Distinguished Professor Watson, of Nursing, PhD, UniversityColorado of RN, Health HNC, Sciences Center,Box 4200 C-288, E. Denver, 9thuchsc.edu). CO Avenue, 80262 (e-mail: Jean.Watson@ Ethics of Face and Hand—An Invitation to Return toand the Soul Heart of NursingDeep and Humanity our Love and Caring AS207-01 June 24, 2003 18:18 Char Count= 0

Downloaded from https://journals.lww.com/naqjournal by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3FRWkQAwAvKWhqVyRx1Msdxmu+S323fT7nQ9GNrwFvFA= on 09/28/2018 Downloaded from https://journals.lww.com/naqjournal by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3FRWkQAwAvKWhqVyRx1Msdxmu+S323fT7nQ9GNrwFvFA= on 09/28/2018 AS207-01 June 24, 2003 18:18 Char Count= 0

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we engage in a more authentic process to cul- loss that was and remains deeply profound, tivate and sustain caring healing practices for I find that I was ironically given the gift of self and others. Such care and practices elicit Spirit—the opportunity to fully experience and call upon profound wisdom and under- life and spirit in raw form, in the midst of standing, beyond knowledge, that touch and deep suffering.4,5 But the universal lesson draw upon the human heart and soul. from Buddha is that it does not matter how In this reminder of basic values that tran- long you (we) have forgotten, only how soon scend all circumstances and time and place, you (we) remember. It is as if we have to be we invoke the fullest and highest spiritual, stopped to allow our souls/our soulful pur- spirit-filled dimensions into our work, allow- pose to catch up with us. This insight may of- ing us to engage once again in compassionate fer a moment of enlightenment for nursing as service, motivated by love, both human and this crossroads of its survival, which may be cosmic. From this place we offer to ourselves, the gift from this passage. and those whom we meet on our path, our Perhaps it is only when we acknowledge compassionate response for fulfilling our cho- how much pain and suffering there is in our sen life’s work and calling. broken hearts and broken spirits, our broken Just as it is in our personal lives that dur- world—within and without—that we can re- ing crises of illness, tragedy, loss, or impend- turn to that which is timeless that can com- ing death that we ponder spiritual questions fort, sustain, and inspire/inspirit us. It is here that go beyond the physical material world, it in this broken, wounded place that we can is here in our professional life, in its conven- quiet the outer pace, bow down, and surren- tional, dispirited physical, technical, life form, der to the loving presence of the universe and deathbed of sorts, that we are given new free- all its infinity. dom, new space to reconsider a deeper level So within this framework of caring and of nursing. This may be the moment to recon- love, we now have a new call to bring us sider what has always been the foundation of back to that which resides deep within us, caring and healing, but must now be recon- and intersects with the focus of this time and sidered again, for new/old reasons. Could the place to uncover the latent love in our caring professional deathbed of sorts that we face in work as well as connect us with contempo- the conventional, medical, and nursing world rary philosophies that invite love and caring be an opportunity for us as professionals to through our ethics of being-becoming. For ex- consider how we may live our lives if we had ample, the philosophy of Emmanuel Levinas6 “only a year to live.”What and how would we and his notion of the “Ethics of Face” help us approach our last year to heal and be healed connect with this ancient and contemporary with so much unfinished business accumu- truth. Likewise, I acknowledge the work of lated during this past century? How could we Knud Logstrup,7 a Danish philosopher who offer up our heart when we may be disheart- mirrors views similar to Levinas, but from the ened or in fear? metaphor of “Hand,” in that he reminds us As Kierkegaard3 might say, how do we en- that: counter our sickness unto death, in this in- holding another person’s life in one’s hand, en- between existence—where spirit and matter dows this metaphor with a certain emotional have been torn off, split asunder, from our power ...that we have the power to determine identity, our existence, our very being? Re- visiting such foundational issues of infinity of humanity in relation to our caring may be the difference between life and death of a We now have a new call to bring us profession. back to that which resides deep Having during the past few years come within us. through a period of personal trauma and AS207-01 June 24, 2003 18:18 Char Count= 0

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the direction of something in another person’s in the end, it is only love that matters.Itisin life ...we’re to a large extent inescapably depen- entering into and participating with the great dent upon one another ...we are mutually and in a mysteries of the sacred circle of life and death 7(p28) most immediate sense in one another’s power. that we engage in healing. By attending to, honoring, entering into, Perhaps it is love that underpins and con- connecting with our deep humanity, we find nects us through our metaphors of facing and the ethic and artistry of being, loving, and car- holding another in our hands, reminding us ing. We are not machines as we have been of another dimension as to how to sustain our taught, but spirit made whole. humanity at a deeper level at this point in hu- From Rumi in the 13th century to Levinas man history. (1906–1995)6 and Logstrup (1905–1981)7 in Josephine Hart of the London Times wrote the twentieth century, we find the ancient a compelling article on September 19, 2001, truths of our work. We share the wisdom about the events of 9/11. Her article frames of these mystic poet-philosophers who cap- these issues more profoundly: tured the “Infinity and mystery of the Human We learnt a new moral alphabet this week. soul, mirrored through the ethics of face”(Lev- The letters which form the word love seemed em- inas’s view); the fact that “we hold another’s powered with more resonance, as though for all life in our hands” (Logstrup’s view) and that our lives we had not been spelling it correctly. “the glance,” the mystical experience when We learnt that the dying understood that they eyes meet is ancient Rumi’s reminder of how would not be forgotten and that the manner of we mirror the human soul, through the eyes, their leaving would determine their family’s ability the look, the glance. to survive their death. We learnt that, with death In Rumi’s words: “I see my beauty in you. crashing towards them and with no means of es- I become a mirror that cannot close its eyes cape, men and women absolved their families of to your longing ...These thousands of worlds the edge of grief that leads to madness. They did not scream in range “Why me?” nor babble in ter- that arise from nowhere, how does your face ... ror at what awaited them. They spoke a last “Ilove contain them?”And “ out of eternity I turn 9(p12) you,” then turned towards their ghastly fate with my face to you, and into eternity ....” unbelievable grace. They taught us another way to How can we dare to be so bold as to live and to die.8(p9) bring caring and loving and infinity of souls into our lives and work and world again? With the crisis of meaning in our lives and Because, without returning to this ancient work during this era in human history, we may place of cosmic power, energy, and beauty, paraphrase W.H. Auden to remember that in we are inclined toward what Levinas referred the end, love is all that really matters: The Na- to as a “totalizing of self and other”6—that tive American Indians remind us that everyday is, a congealing of our humanity, separating we should do an act of power and an act of us from any connection with spirit, with in- beauty. By reconsidering the role and power finity, with the great divine—with no hope of love, light, and beauty in our life, we bring for healing and wholeness. A totalizing oc- back reminders of what is truly valuable, serv- curs when there is no relational engagement, ing ourselves with timeless reminders that in no soul connection; thus no cosmic human returning to our own inner light, and inner field to engage our shared humanity. This to- love, we offer an act of power and beauty to talizing of self and other, this turning away our self and those whom we serve. from the mystery of our shared humanity and Perhaps the purpose of this manuscript and divine connection, can be an act of cruelty my writing of it, is more specifically to remind to self and others; an inhumane act toward myself and others of one other basic thing: human civilization itself, perpetuating more that it is our humanity that both wounds us inhumane acts, violence, and destruction of and heals us, and those whom we serve; and human spirit in our work and world. AS207-01 June 24, 2003 18:18 Char Count= 0

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So rather than asking how can we dare to more expanded way of thinking about the bring love and caring together into our lives power, beauty, and energy of love, a car- and work? We can ask: How can we bear not ing moment10,11 becomes an energetic vibra- to? tional field of cosmic love that radiates reci- Levinas reminds us the Infinity of the hu- procity and mutuality, which transcends time, man soul, mirrors the mystery of humanity space, and physicality confirming and sustain- back upon itself to us, through our shared ing our humanity and our connection with the human connections, through “the face,” “the Levinas’ Infinity of the entire universe.4,12 glance,”the facing our own and others’ shared The connections between caring, loving, souls as routes to this infinity and mysterious and infinity become the process of facing our circularity of life. humanity as mystery, thus mirroring humanity To engage, to dwell in this new space of of self and other back on itself. Such a human- caring, living our mystery of being and dying, to-human act of caring within a given moment reveals the very situation in which we exist. becomes a basic foundation for facing our hu- This new space becomes our basic foundation manity, uniting us and the cosmic energy of for being and sustaining our humanity. This love, as one. In Rumi’s words: “I am here, this cosmic perspective, which invites spirit, mys- moment, inside the beauty, the gift God has tery, and soul back into our lives and work, given ...this gold and circular sign ....”9(p10) raises our courage to ethically engage in life Logstrup frames these issues and ethics of and all its depths of being. Somehow, know- our artistry of being human, not only through ing that we can endure the pain, with the the “look,”the “face,”the gesture, the glance, joy; the hurts and humiliations with the for- the voice, but also the Hands. He puts it this giveness and praise; the suffering with en- way: durance, dignity, grace, and poise, is tied to our infinite capacity to love and be loved, to By our value/attitude to the other person we help become love. to determine the scope and hue of his/her world; To paraphrase Emily Dickinson: The mind we make it larger or smaller, bright or drab, rich or dull, threatening or secure. We help to shape his is wider than the sky, cause it can hold it and world not by theories and views but by our very be- Thee beside, can be transposed to: The heart ing and attitude toward him. Herein lies the unartic- is as wide as the sky, because it can hold pain ulated and one might say anonymous demand that and joy side by side. we take care of life which trust has placed in our Though we can find this deep ethic of be- hands.7(p19) ing, in Rumi, Levinas, and Logstrup and other poets and sages through the ages, we are in- These views remind us that one’s human vited now to be present to our own and oth- presence never leaves one unaffected. Ex- ers’ deeply human soul conditions and con- pressed compassion and caring is not only nections that embrace all the vicissitudes of the word that is spoken or the eye that sees, living and dying. As Rumi again reminds us: leading to action. The gaze itself is an ex- To die before we die—to find that delicate pression; the word is also a gesture framed balance between self-discipline (dying of ego) in a voice, an intonation. In the intuitive ex- and cosmic surrender. pression, what is said can be welcoming, receiving, affirming, but it also can be a care- less phase, a looking away—nonfacing of an- CARING MOMENT AS RADIATING other’s humanity and human condition ...a FIELD OF COSMIC LOVE “totalizing of another,” setting and limiting, objectifying other ...rather than an honoring I recently heard it said that when a nurse of the “Infinity and mystery of the human enters into a patient’s room, a magnetic field condition and humanity”....afacing and of expectation is created. In this deeper, connecting with the human soul and the AS207-01 June 24, 2003 18:18 Char Count= 0

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infinity of the mystery therein. The opposite • Our consciousness, our intentionality, of this, a turning away from facing our hu- our presence, makes a difference, for bet- manity, can actually be an act of cruelty. So, ter or for worse; in these deep ethical philosophical views of • Calmness and mindfulness in a caring Levinas and Logstrup, which unite with car- moment beget calmness and mindful- ing theory, we acknowledge that through our ness; very being, through our human presence to- • Caring and love beget caring and love; ward facing self and other, we hold others • Caring and compassionate acts of love in our hands, for better or for worse, either beget healing for self and others; opening horizons to infinity, or totalizing our • Transpersonal caring becomes transfor- own and others’ humanity. mative, liberating us to live and practice In this view of ethics and the metaphysics love and caring in our ordinary lives in and metaphors of love, face, and hands,Lev- nonordinary ways. inas posited ethics as being beyond ontol- To enter into this new space of love, car- ogy: he placed ethics as the first principle ing, hands, and heart that sustain infinity of of philosophy. It is acknowledging the eth- our humanity we can consider the following ical responsibility for the other, understood practices: as vulnerability and proximity. In this view, • Suspending of role and status: honoring love is originary. Love watches over other each person, their talents, gifts, and con- demands, such as justice.13 The subject as tributions as essential to the whole; other is an incomprehensible, infinite other- • Speaking and listening without judg- ness. The human face is not a concept, it ment, working from heart-centered is not a figure which message can be cap- space; working toward shared meaning, tured by knowledge. It is the face in its ex- common values; posedness, its nudity, as an opening toward • Listening with compassion and an open the infinite that makes the one responsible for heart, without interrupting: listening the other. to another’s story is a healing gift of This view is beyond philosophy; it is not self; an ontology, it is not a normative theory, • Leaning to be still, to center self while it is a metaphysics: it explains how being- welcoming silence for reflection, con- for-the-other precedes being-with-the-other. templation, and clarity; This approach critiques Heideggerian ontol- • Recognizing that a transpersonal caring- ogy by positioning ethics as preceding ontol- loving practice transcends ego self and ogy. Within this metaphysics, we dwell in orig- connects us human-to-human, spirit-to- inary love, cosmic, and divine.13 spirit, where our life and work are di- Finally, what is traced in Levinas’ Ethic of vided no more; Face, in Rumi, mystic-ecstatic love and mys- • Honoring the reality that we are part tery, and Logstrup’s holding another in one’s of each other’s journey: we are all on hand is central to all professions involved in our own journey toward healing as part human care; it comes before and informs clin- of the infinity of the human condition: ical judgments and can serve as an epistemo- when we work to heal ourselves, we con- logical foundation for any clinical care.13 tribute to healing of the whole. To frame these profound truths as foun- In conclusion, the crisis in modern dational to our humanity, we can relate for medicine and health in this new millennium new reasons to some theoretical notions of seems to lie in the lack of a meaningful transpersonal caring:11,14 perspective on the very nature of our hu- • Each thought and each choice we make manity. It seems that somewhere along the carries spirit energy into our lives and way modern medicine has forgotten that it is those of others; grounded and sustained by and through the AS207-01 June 24, 2003 18:18 Char Count= 0

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very nature of our being and becoming more belonging-being and sustaining our human- human. ity, is the same as sustaining our dignity, our We have forgotten that we are nurtured and divinity—reminding us of the sacred world of sustained by love, by grace, by the beauty, the infinity of existence; thus humanity is ul- and depth of life. We are reminded that our timately floating in, trusting in, the spirit, en- wounded humanity, including our vulnerabil- ergy, and grace of cosmic love. ity, suffering, and joy, the light and shadows of This ethic of love and caring, become first our teeming humanity, we enter into and con- principles for facing and sustaining the infin- tribute to connecting with the infinity of the ity of our profession. If we follow this ethical human soul, life itself, and all the vicissitudes demand nursing has a critical role in moving that encompass and surround our humanity. humanity toward the omega point, ever closer Addressing the role of our being and to God and the mysterious sacred circle of liv- becoming more human, through the phe- ing, trusting, loving, being, and dying. nomenon, the metaphysics, and ethic of love I conclude with a Teilhard de Chardin and caring allows us to more fully “face our quote: humanity.”These considerations are critical to engage in healing practices for ourselves and Love in all its subtileties is nothing more, and noth- for those whom we serve. ing less, than the more or less direct trace marked This process of connecting with Logstrup’s on the heart ....This is the ray of light which will and Levinas’s ethic of first principle6 of help us to see more clearly ....15(p265)

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