Assisi Italy

Giving and Receiving: A Biological Imperative

Dec 13, 2023

By Mick Krasner, MD

For it is in the giving that we receive.
– St. Francis of Assisi

I am writing this blog post while sitting at a small wooden table in a beautiful stone apartment on a small farm just a few miles outside of Assisi, Italy. What has brought me here is a mystery in some ways, although I can easily trace the sequence of events that have occurred, thus creating a narrative that is both understandable and truthful. Yet, on some level that narrative would be incomplete while also denying the true mystery of life unfolding with all its choices and non-choices.

I could say, perhaps more accurately, that my physiology, neurobiology, genetic endowment, epigenetic expressions, and even living at the leading edge of the evolution of our species that I am a member of has brought me here. Since the moment of birth, and perhaps even prior to that, there has been a constant interaction between actions, choices, nurturing, turning this way and that, not doing this thing or that, all driven by biological imperatives for moving toward what is life affirming and moving away from what is life alienating. And along the way, the reinforcers of these actions or inactions have supported my arrival from moment to moment to moment, to the here and the now, every literal and figurative step of the way.

One such reinforcer has been the imperative for giving actions. Seemingly altruistic on its surface, these actions are reinforced biologically because they are essential to the survival and success of our social species. Nature wants us to feel good about it and rewards us thusly. So I am certain that the path that has led me to a career in medicine, and the path that has led me to explore what it means to be awake as a person to one’s sensations, emotions, and cognitions, and the path that has literally led me to this farmhouse in Assisi after a week of filming medical students at two European institutions that foster these kinds of personal and professional development, and everything that has led up to all the decisions around those paths have been reinforced, supported, and encouraged by this biology. One could say, wherever we are, we have been carried there by our humanity and our human endowment, and in a large part by this drive for receiving through giving.

Francis of Assisi, born Giovanni di Pietro di Bernardone, was an Italian mystic and Catholic friar who founded the religious order of the Franciscans. Francis is associated with patronage of animals and environment, as well as the poor, hungry, and ill. What is remarkable is that Francis articulated in the 12th century CE what we now know about our biology, physiology, and future as a species. That it is intimately connected to giving, and through giving, receiving. Medicine as a profession and as a way of being brings us close into this aspect of our inclination to give to others. It allows us as professionals to support others and ourselves with right livelihood. And that is also why threats to our ability to enact our professional expression resulting from the complexities and dysfunction within the health care system are so difficult and challenging. They are literally threats to patient well-being, threats to our well-being, and threats to giving and through giving, receiving, and threats to the very future of our species.

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