Starting the Bolk’s Companion Project, Look Toward the Future
Interview with Guus van der Bie MD
by Kore Luske MD
Guus van der Bie MD is one of the co-founders of the Companion group. Together with Christina van Tellingen MD, he initiated describing topics taught in medical school from a Goethean phenomenological perspective.
Guus is the author of the first Companion in the series Bolk’s Companions: Embryology, Early Development from a Phenomenological Perspective, published in 2001, 23 years ago. We talk about the inspiration of the first hour, about where this Companion currently stands, and about the future.
How did you come to write Companions?
I had been working with Machteld (partner) for some time on creating a double-entry medical study method and had ideas about themes I could apply it to, but it had never developed into an actual publication. At the same time, we met Christina who also had a lot of teaching experience. It helps tremendously to teach about a subject you are exploring. I was an anatomist-embryologist and was very much at home in embryology. I had led workshops at Utrecht University Medical School and also taught in the dissecting room. So it was logical for me to tackle embryology as a first subject. Christina took biochemistry as her first topic. We stimulated each other a lot.
Can you explain what you mean by a double-entry medical study method?
Students of the Young Doctors’ Course, a series of lectures given in 1924 by Rudolf Steiner PhD to medical students, were struggling. They found it hard to link what professors told them at the university with the spiritual scientific perspective that Rudolf Steiner told them about. At that time, Rudolf Steiner's advice was to take a notebook, write down on one side what they learned at university and on the other side the socio-spiritual scientific view. As far as I know that was never picked up.
In the 1990’s, when I joined the Circle of Teachers who were trying to bring a broadened perspective to medicine, which Christina was also a member of, exactly this theme was taken up. Our conclusion was at the time that students were not able to maintain their natural phenomenological abilities while weathering the tornado of university molecular-biological thinking. It was simply not possible for them, they could no longer do it. And we concluded, that we should try to introduce double-entry studying in regular medical training, at least show the phenomenological perspective of the study subjects that were presented in medical school. Because that had never been written about before.
So I tried with Christina to describe the missing link between regular knowledge and spiritual science, the phenomenological perspective. We did leave spiritual science aside for the time being, we first wanted to save the phenomenological ability of students, teaching them about the things everyone can observe who has their eyes and ears open and then show how their study subjects relate to its context, the whole human being and/or nature around us.
Would you do it differently now?
The Companion “Embryology” has become a very concise booklet, a synopsis. There is also a warning at the front of the booklet: make sure you know regular embryology when you read this. These days much less embryology is taught. I would provide more information now in the Companion itself. Twenty-three years ago it was still possible to write as we did.
You have written several more Companions, how do you look back on the series?
When I look at the downloads, the purchased copies, I think it has served its purpose. And is still serving its purpose or maybe especially now serving its purpose. They are used all around the world. However, they actually should be revised for today's students who are completely trained in molecular-biological thinking. In medical training there is little anatomy and embryology these days. Physiology and genetics is now mainly taught using molecular-biological aspects. We should make an methodological update for these students.
We have a problem there, though, since it is difficult to apply phenomenology to molecular-biology. In embryology and physiology, for example, that is easier. Even in immunology it was not that difficult, I studied very hard for two years, visited all kinds of conferences, bought study books, etc. Until I had learned so much about immunology that I no longer heard new things and then I wrote the Companion Immunology from a phenomenological Perspective. Which is also very concise.
So you feel you would have to adapt the Companions to molecular-biological thinking?
I think my knowledge of the material is not sufficient in that respect. I was a student of Otto Wolf MD as far as phenomenology is concerned, I had studied sodium, potassium, nitrogen, oxygen, fats, proteins, and carbohydrates with him and so on. We learned to place these substances in their context, zoom in to what was known about them and zoom out again.
So this is what we are particularly good at. One can then show that potassium supports vitality and that sodium serves the way the psyche—our conscious awareness--works in the body.
There are many modern molecular-structural formulas, also think of the modern oncological immunological treatments, for instance. To be able to approach them phenomenologically, we would actually need a thorough training.
Are you actually saying that your knowledge is not thorough enough? Or do you mean to say that with molecular-biology one goes too far into detail to be able to see it as part of a whole?
I would want to orient myself more thoroughly in molecular-biology to be able to say something about that. I recently wrote an article about embryology for the Merkurstab (German medical journal). In it, I also wrote a section about epigenetics, which I had studied in detail. In this article, however, I do not go into the details, I discussed the epigenetic phenomenon as a genome-determining force. This is possible since it is clear that in just a few days the existing epigenome is almost completely wiped out and the embryo then creates its own epigenome. I did not mention specific methyl groups or the role of hydrogen, except to show that there is more to it and that I know about it. I have chosen not to explain it in depth.
I sometimes wonder how important it is to zoom in that much? We were talking about the fact that there are squirrels, for example, that look very similar to other squirrels, but are genetically completely different from them. They originated on a different continent, via a different route.
We know that genetics cannot determine shape. It can only assist in the compounding of substance. We don't understand the function of Hox genes in this respect either: how can a complex of multiple genes in drosophila (the fruit fly) regulate the development of its wings and the same genes in mice control the development of a foreleg? (Sean) Caroll from the evo-devo movement writes about it: the organism arranges that for itself. To me it seems that with such an argument scientists allow themselves to come to a particularly abrupt stop where they should actually have continued. In doing so they miss the real point.
And as for the Companions, would you like to continue with the Companions as we have been or is there a different question? Should we, for example, take another step, beyond phenomenology?
Then you would have to do much of the series again and expand it with spiritual science. That would mean, for example, that I rework a Companion like Embryology, which would then also become quite a bit bigger. We could still show how to phenomenologize regular knowledge and then demonstrate how that connects to spiritual scientific content. But then you will also have to present some spiritual scientific content. That would be an exciting step.