Good Work
September 2024

Medicine and the Good Life: Tackling the Big Questions of Flourishing at Johns Hopkins University

Wes Siscoe

Dr. Margaret Chisolm, Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University, was at a crossroads. She had just completed a decade of clinical addiction research, and she wasn’t sure what she wanted to do next.

“At that point, I was thinking I didn’t really want to do that kind of research anymore,” said Chisolm. “But I didn’t really know what I was going to do. I was a bit adrift in terms of what project I wanted to take on next.”

At that moment, an opportunity presented itself. Paul McHugh, a Distinguished Professor of Psychiatry at Johns Hopkins, came to one of her research presentations, and instead of asking a question about her work, he offered her a job – the opportunity to co-lead a new program on human flourishing.

“It really came out of nowhere,” said Chisolm. “I didn’t know much about models of human flourishing, but it was really perfect. He needed help in getting a program off the ground, and it was exactly what I was looking for in terms of thinking about having a deeper and more lasting impact on patients. It might sound silly, but for me it was an answer to prayer, and I think it was an answer to prayer for him as well.”

So starting in the fall of 2015, Chisolm helped found the Paul McHugh Program for Human Flourishing. With the goal of helping medical students explore “big questions,” like what it means to be human, to be a good physician, and to lead a life of flourishing, the program started out as a drop-in reading group. Classic works of literature opened up the conversation, allowing students to discuss topics that were too difficult to tackle head on.

“Students would just come,” said Chisholm. “We would serve them lunch, and we would read things like Francis Bacon’s “Of Truth,” “The Birth-Mark” by Nathaniel Hawthorne, “A Small, Good Thing,” by Raymond Carver, and the Hippocratic Oath. All of the readings would then spark a dialogue on the deeper, ethical aspects of healthcare that students didn’t have another place to discuss.”

While this was a good start, Chisolm also wanted to create more long-term relationships between students and faculty. So in 2018, the program adopted a cohort model, requiring students to apply in their first year at Johns Hopkins and stay involved for their four years of medical school. The semester kicked off with a community dinner, and faculty and peer mentoring were added to the program.

“We also include an annual multi-cohort event with all the students,” said Chisholm. “We do something together, whether that is going to the symphony or touring the art museum, and then we have dinner and conversation afterwards. What we’re really trying to do is build a deeply rooted community, one focused on what it means to be a physician and what it means to lead a good life for ourselves and our patients.”

People are starting to take notice. The program’s advisory board now features luminaries like the University of Chicago’s distinguished professor Candace Vogler, former chairman of the President’s Council on Bioethics Leon Kass, and Hall of Fame baseball player Cal Ripken Jr. Chisolm’s team has published academic work on medical student flourishing, using art to support flourishing, and piloting flourishing measures of mental health. And In 2021, Chisolm brought her work on flourishing to a wider audience, publishing From Survive to Thrive with Johns Hopkins University Press. A popular level work, From Survive to Thrive encourages readers to think of mental health in terms of flourishing rather than just the absence of illness. 

What is next for the program? Until now, the project has primarily targeted those in medical school, but in the coming year, Chisolm hopes to build the program’s ability to reach more undergraduate students as well.

“Right now I have a number of funding proposals out to offer more courses at the undergraduate level, exploring the big questions with students who are just starting to think of their future place in healthcare and other professions,” said Chisolm. “The prospect of working with undergraduates is exciting because medical students are so busy, and their schedules are so crammed, that it’s very hard for them to make space to consider the moral dimension of being a physician. So the opportunity to expand this work, and have conversations with students that have the space to fully consider these questions, is going to be our next big step forward.”