Adversity

Justine Owens and Dr. Margaret Plews-Ogan
Photo by Tom Cogill

Although she was a philosophy major in college, Dr. Margaret Plews-Ogan never intended to study wisdom; her patients sparked her interest in the topic. Plews-Ogan observed that having “a creative response to adversity” could be tremendously valuable for a patient. “I saw that some of my patients faced suffering and emerged as better people even in situations where medical science could do little for them,” she says. “They seemed to have gained a perspective on their experience that enriched their spirit rather than diminished it.”

Plews-Ogan found a similar situation among physicians. As an associate professor of clinical internal medicine and head of the Division of General Medicine, Geriatrics and Palliative Care, she often mentors young physicians. As director of the new U.Va. Institute for Quality and Patient Safety she has also been deeply involved in efforts to reduce medical error by educating physicians and nurses, and by applying techniques from systems engineering to medical processes. “Making a mistake is perhaps one of the most devastating things that can happen to a clinician,” she says. “Here too, I saw some physicians who faced this and became better doctors because of it, and others who struggled and responded defensively.”

As a caregiver and mentor, Plews-Ogan wanted to help patients and young doctors frame their difficult experiences in a positive way. She found, however, that there is no documented process for achieving a wise response to adversity. With a $1 million grant from the John Templeton Foundation, Plews-Ogan and co-investigator Justine Owens, along with their colleagues from U.Va. and other institutions, plan to find out how and why people act wisely in these situations. “We believe that there are steps in this process,” she says, “much like the steps in coping with grief that Elisabeth Kübler-Ross described in On Death and Dying.”

Utilizing an Appreciative Inquiry framework, Plews-Ogan and her colleagues plan to interview 100 patients who have experienced chronic pain and 100 physicians who have made a serious medical error. They hope to be able to map the path through adversity to wisdom and to more fully understand traits—particularly spirituality—possessed by those who make this journey successfully. Ultimately, they plan to produce a set of DVDs that will document their findings and help patients and physicians gain insight into their own experiences.

 As she sets out on this project, Plews-Ogan is clear about her underlying premise. “I don’t mean to suggest that suffering is the only way to gain wisdom and that those people who have found in suffering a source of growth have achieved wisdom with a capital W,” she says. Her purpose is as practical as it is philosophical. “I am interested in how people create a positive experience from adversity,” she continues, “so that I can help other people do the same thing.”