How to Attend: From Nursing to Teaching

(This is the fourth installment of the “Classical Bellyflop Series” in which Will investigates the relevance of Ancient Greek words in our lives today. You can find links to the other installments at the bottom of this article.)

I.

Before the Coronavirus descended on the human race, my wife and I endured a three-week hospital stay with our 4-month-old who required open-heart surgery. Since the baby’s birth in November, we’ve been in and out of the hospital a lot. In an attempt to treat this medical odyssey as a learning opportunity, I decided to turn my attention toward the work of nurses. I quickly realized that, in the hospital, nurses are, by far, the people who make the most physical contact with the patient. Doctors and Nurse Practitioners take vitals and make minor contact, but nurses are undoubtedly the most hands-on. Physical contact in the hospital environment is a peculiar form of intimacy that shows, among other things, a kind of care that is frequently overpowered by the technology and data that drive so many medical decisions. My observation about this intimacy has been burned into my brain even more now that physical contact is so limited and the stakes of touch in the hospital environment are quite high. When we left the hospital, one thing was clear to me. Nurses deserve our applause and emotional support in the present moment and into the distant future.

In the middle of our hospital stay, right after our son’s surgery, I came down with the flu and had to quarantine myself so as not to risk passing anything on to the baby. I was pretty much down and out for five days. In an effort to engage my curiosity as a kind of medication, I turned to Ancient Greek and started exploring the figure of the nurse. What I discovered was a surprising connection between the activities of nursing and teaching, on the one hand, and a renewed understanding of the verb “attend,” on the other hand. Underlying this foray into Ancient Greek is the pulsation of care, which, as I’ve written elsewhere, is a sustaining practice that was cultivated by many different people in Ancient Greece, from slaves to citizens and from nurses to philosophers. I’ll map my discoveries here and then end with some thoughts about, first, how nursing dovetails with teaching, and, second, how teachers might attend to students with more care during these tempestuous times. 

II.

There are two main words for the figure of the nurse in Ancient Greece: τιθήνη (tithene) and θεραπευτής (therapeutes). The first has a strong philosophical connection; it appears in one of Plato’s more enigmatic pronouncements from the Timaeus. There, he defines Space or Matter (translations vary) as the “receptacle and nurse of all becoming.” Scholars have debated the meaning of this phrase for millennia, though many contemporary thinkers seem to rely on a figure closer to Plato’s time, Plotinus, as the go-to interpretation. In his Ennead, Plotinus works through the difference between matter and the act of becoming so as to establish a logical and chronological order of these elements. Matter’s status as “nurse” suggests to him that it pre-exists the act of becoming and is therefore also prior to the act of change. This ordering helped ancient philosophers develop theories about the structure of the seen and unseen universe. If you’re curious about the philosophical interpretation of Plato’s phrase, I recommend starting with Plotinus.

My interest in Plato’s phrase, however, is less abstract and less metaphorical. The image conjured here of a nurse receiving all things as they come into the world—an action denoted by the powerful philosophical verb becoming—points directly to the midwife and the act of birth. The first hands placed on the newly birthed person in Plato’s time belonged to a person who was not a member of the family and who was, more than likely, an occupant of a social position that ranked below that of “citizen.” The event of birth led to one of those moments of suspension in which social positions and power hierarchies dissolved beneath the urgency of existence and the maintenance of health. Plato’s philosophical image may only be tethered loosely to the actual figure of the nurse/midwife, but the connection is there nonetheless. As such, there is a place of importance in the great theatre of the universe reserved for the figure of the nurse whose presence is vital.

So the first word—τιθήνη—is a nurse or a wetnurse or a midwife. The second word—θεραπευτής—is usually translated as “one who attends on the sick,” though it has numerous applications in the classical texts. In terms of strict definition, the word means “one who attends [on anything whatsoever].” Over time, however, usage of the word developed down two distinct avenues. One was medical, as we see in Plato’s Republic where the word is synonymous with (translated as) “doctor,” “one who cares for the sick,” and in Galen, where it appears as “one who treats the disease.” The other avenue was religious, and there the attendant was understood as a worshipper. A sect of philosophers from Alexandria eventually adopted the word as their name: the Therapeutae, those who attended on the important matters of wisdom. In the present, the “therapy” linked to this particular word for nurse brings our attention to the medical field. The philosophical valence is all but entirely lost. But the historical records remind us of the wider scope of meaning once attributed to “therapy.”

This second word, then, is intriguing and relatively straightforward. The nurse is one who attends on “the sick,” but the “sickness” deserving of attention may be either physical (targeted by medical nurses and other therapists) or spiritual (targeted by philosophers). At a certain point in time, the nurse ceased to be the only figure who deployed the therapy of care and was joined by the philosopher who, at least to some minds, was engaged in the healing of souls. Christian philosophers would eventually adapt this kind of welfare to their particular religious tradition at which point the classical philosophy of care was transformed into something else.

III.

As I dug through the texts, I became interested in a few cases of the philosopher’s brand of nursing. The first came from Plutarch’s Moralia, in a section titled “That a Philosopher Ought to Converse Especially with Men in Power,” where I found the adjective—θεραπευτικός—used to describe “an attendant”: “No, on the contrary, the man who is ambitious for himself and afraid of every whisper is just the one who avoids and fears being called a persistent and servile attendant on those in power. For what does a man say who is an attendant upon philosophy and stands in need of it?” Here, Plutarch paints the philosophical attendant as a courageous person who shuns ambition and personal interest. With no other reason to attend on the powerful than to help heal them or guide them, the philosopher reveals his (or maybe “her,” though in the classical world this was less likely) own health, since only a person who has been cured through philosophy can turn and cure others.  

 In contrast to Plutarch, Pseudo-Lucian, writing of the figure of the Cynic, deploys the verb form of the word: to nurse (θεραπεύω). He writes, “But I dance no attendance at the doors of the so-called fortunate, but consider their golden crowns and their purple robes mere pride, and I laugh at the fellows who wear them.” Unlike Plutarch who, like Plato, would mobilize the philosopher to educate and transform the powerful into just and noble leaders, Pseudo-Lucian’s cynic philosopher avoids them altogether. The powerful are beyond hope, and, as such, true therapy only belongs to those who can see through the smokescreen of political and social circumstance. 

Between the two poles—Plutarch, on one side, and the Cynic, on the other—Epictetus considers the same topic through the question “How ought we to bare ourselves toward tyrants.” He spins out an entire paragraph that plays with “therapy” as its keyword in order to arrive at the proper function of the philosopher. The translator of that text explains: “The whole passage turns on the various meanings of θεραπεύω, which include serve, attend to, give medical care to, pay attention to, pay court to, flatter, etc.” Epictetus suggests that each verbal mode of “therapy” has its usage but, ultimately, the philosopher has to avoid the sycophantic so as to maintain a clear view of the Truth.

These three different examples demonstrate an emphasis placed not on the figure of “the nurse” but, rather, on the activity of “nursing.” How one attends on others becomes the focus of philosophers and other healers. The activity of the nurse takes us to both of the keywords above: τιθήνη and θεραπευτής. But we also encounter another word, one that is quite familiar to me but somewhat surprising to find in this search: παιδαγωγία (pedagogia). Its more common variant, παιδαγωγός, one who undertakes παιδαγωγία, shows up in a variety of places.

For example: There is an entire character in Sophocles’ Electra named “Old Slave” in English, but that term is translated from Pedagogue in the Ancient Greek. (As I’ve written here, the practice of pedagogy leads straight into the world of slavery.) Pedagagos appears again in Euripides’ Medea, but there it is translated as “Tutor.” Tutor is also the preferred translation in Menander’s Aspis. The translator of Plato’s Lysis clarifies the link between “Old Slave” and “tutor” for us: “The παιδαγωγός was a trusted slave who was appointed to attend on a boy out of school hours and to have a general control over his conduct and industry.” Plutarch, who seems to show up a lot in my forays, pursues the matter of how we ought to study poetry and shines some light on this role of “tutor” as explained by Plato’s translator: “Now in all cases it is useful also to seek after the cause of each thing that is said. Cato, for example, used, even as a child, to do whatever the attendant in charge of him ordered, yet he also demanded to know the ground and reason for the order. And so the poets are not to be obeyed as though they were our keepers or law-givers, unless their subject matter be reasonable.”

IV.

Ok, enough digging. What can we make of all this? First, the trail of “nurse” leads to connections  between the nurse who cares for the sick (harmonious with our current understanding), the therapist (semantically related but a bit foreign to our thoughts on nurses today), and the philosopher who cares for the sick of soul (likely totally bizarre for most people). On this road, the nurse and the philosopher eventually meet another figure, that of the pedagogue, who serves a similar function as the other two, namely to guide.

It is possible, then, to begin a conversation today about the need for teachers to practice care for their students in the same way a nurse cares for the sick. But, before we get there, the figure of the pedagogue throws us a curveball because, at least in terms of Ancient Greek history and its heritage, it is not a figure we would necessarily want to emulate today. A. V. Yannicopoulos, for example, explains that, “While  the teacher's function was to equip the boy with useful knowledge and skills, the tutor was to enforce decent conduct. [...] pedagogues, holding their sticks in their hands ready for action, used to sit between the pupils in order to prevent them teasing each other [i.e., under threat of violence].” And he adds, citing historical texts, “What is taught to the child by his teacher is supplemented by the pedagogue', states Libanius, '...he coaxes the child, shouts at him, produces the rod, shakes the lash, constructs the lessons  to be stored in his mind'” (176).

Wary of this violent historical precedent, perhaps we can phrase the issue as a question for all teachers: Do you care for your students like the nurse and philosopher, or do you watch over them like the slave who guides well-to-do children to school and enforces morality through violence? Assuming that teachers would rush to emulate the former and shun the latter, we then have to ask what it would mean to “attend” to our students like the nurse and philosophical therapist.

That question leads to a confrontation with the word “attend,” which has been part of this inquiry from the beginning. When we look that word up in the Ancient Greek dictionary, we find a number of synonyms. One—Attend on (as a servant on a child)—is pedagogue. Another—to attend medically—is the variant of therapy that we’ve talked a bit about. But we also find a new word: ἐφέπω (ephepo, a verb). A look at the definitions paints an aggressive picture:

• Molest, or follow a woman

• Ply, or practice a pursuit

• obey, attend to

And while we’d all like to run away from this verb as fast as possible, does it not set up a confrontation with the dialectic of power that teachers face in the classroom? As we stand there at the front of the room, we embody the position of The One Who Determines Grades. As such, all the scaffolding of lessons and collaborative or dialogic learning we facilitate can’t shake the fact that, at the end of the day, we make the grades, and, therefore, that students are going to recognize the need to bend to our will. This type of violence is far from the stick wielded by the ancient pedagogues, but it is a form of violence nonetheless, epistemic violence that relies upon the unspoken yet well-maintained gap between teacher and student. 

The first step toward deconstructing this power play, I argue, is to ask the following: in what ways ought we, teachers, attend to/on our students? At the surface level of analysis, I think we all agree that we must avoid the violent role of overseer or stalker who, in the name of obeying existing ideologies, follows a student through a course of study like a stalker would follow a woman. Likewise, it seems obvious that an ethical pedagogue will steer clear of the ancient role of “tutor” that sought to correct the conduct of the pupil through force or verbal harassment or anything of the sort. The only classical dimension of pedagogy that seems relevant is the thread that ties “teaching” to “attendance,” namely the kind of attendance that a nurse contributed to the sick. But here, the trap would be to liken students to the ill who are always necessarily coming to the classroom in need of repair or an antidote of some kind. The power dynamic there is unbalanced, too: teachers have the remedy of which students must partake. 

My recent long stay in the hospital becomes helpful here because it reveals particular qualities of nurses that point beyond this unhealthy power dynamic. First, whereas doctors seem more often to consult numbers and data gathered from the patients by nurses, nurses actually touch patients. This kind of touch is not without stakes since an improper or harmful touch leads quickly to pain or dis-ease or even death. As teachers, we, too, “touch” students, something visible in the phrase “contact hours” (which describes the number of in-class hours devoted to any given course of study, as opposed to the time out-of-class utilized by students for homework). This “touch” must, like the nurse’s, both assertive and non-coercive, aggressive yet not abusive. 

Second, nurses resemble a medical generalist, one who knows a bit about each of the areas of medicine. By contrast, doctors specialize. The general knowledge of nurses feels much more comprehensive and starts to feel like the philosopher’s knowledge of “general” or “universal” truths (putting aside, for now, the challenge of those terms). In the realm of teaching, I think we become deluded by thinking we teach only such-and-such a subject, or that our class only fulfills a humanities or a science requirement. Is it not true that we teach generally? That, regardless of the subject of the course, we are entering into a teacherly relationship with impressionable and often young people who are engaged in the overall practice of learning about the world? 

Third, it is easier to converse with a nurse than with a doctor, meaning that the close contact between patient and nurse (or patient’s parents and nurses) leads to conversations that reveal the connection between the medical world and the world beyond the hospital. This “dialogic” quality to the relationship is often lacking in the doctor-parent relationship. If, when teaching, we hide behind our doctorate or certificate and play the role of specialist whose time is quite valuable and whose research always beckons, then do we not whittle down the scope of the dialogic relationship that forms the bedrock of the teacher-student relationship? If we work hard to “keep real life at the door” so as to focus intently on a given classroom subject, are we not producing an illusory divide between school and life?

Through all of these points, I begin to understand “attending on” our students in a new way. Most broadly, there is a “care” that nurses bring to their work that philosophers and teachers would do well to emulate. In the post-pandemic world, this care is twinned with great risk since the nurse puts her or his or their presence into a dire situation. To perform the role of nurse is to risk one’s own life. While the stakes of that might seem very high, I think teachers might do well to at least imagine a teaching practice that measures up. What would it mean to teach as though life depended on it? Looking around at the shocking extent to which willful ignorance has spread across the globe, isn’t it already the case that education is linked to the well-being of humanity?   

Related Blog Posts:

Bellyflop Series: “Forget your story. Think about your plot.” ; “Repeat yet again” ; “Nomos”