EP. 116: EVOLUTION, HUMAN NATURE, AND OUR PURPOSE IN LIFE

Jun 11

WITH SAMUEL WILKINSON MD

A psychiatrist shares how he reconciles evolution with his spirituality and what an evolutionary understanding of our human nature can teach us about purpose and meaning in life.

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Episode Summary

Conventionally, we are taught that evolution implies there is no ultimate purpose to our existence, that life lacks inherent meaning — we are the product of countless intricate molecular and genetic accidents. And to many, evolution leaves little room for, and perhaps even contradicts, the existence of a deity.

However, our guest on this episode, Samuel Wilkinson, MD, a professor of psychiatry at Yale University, thinks there is another way to look at evolution. Drawing from an array of disciplines ranging from evolutionary biology to cognitive science, Dr. Wilkinson provides a framework for evolution suggesting not only that there is an overarching purpose to our existence, but what that purpose is. He presents this framework in his 2024 book, Purpose: What Evolution and Human Nature Imply about the Meaning of Our Existence.

Over the course of our conversation, Dr. Wilkinson shares how an existential crisis during medical school led him down the path of exploring the ways evolution can be reconciled with fundamental questions and answers about life's meaning; how navigating the dual potential of human nature — pulling us between selfishness and altruism, aggression and cooperation — is key to understanding our purpose; why evolution does not exclude the possibility of existence of a god or gods; the importance of relationships in living fulfilling lives; the role of free will in the choice between good and evil; and more.

Samuel Wilkinson, MD is Associate Professor of Psychiatry at the Yale School of Medicine, where he also serves as Associate Director of the Yale Depression Research Program. Dr. Wilkinson received his B.S. in mechanical engineering, summa cum laude, from Brigham Young University and later his medical degree from Johns Hopkins School of Medicine. He completed his residency at Yale, where he joined the faculty following his post-graduate medical training.
His primary research has focused on depression and suicide prevention and has been funded by the National Institute of Mental Health, the National Institute of Drug Abuse, the Brain and Behavior Research Foundation, and the American Foundation for Suicide Prevention.
His research and articles have been featured in the New York Times, the Washington Post, and the Wall Street Journal. He has been the recipient of many awards, including Top Advancements & Breakthroughs from the Brain and Behavior Research Foundation (2017 and 2020), Top Ten Psychiatry Papers by the New England Journal of Medicine Journal Watch, the Early Career Scholar Award from the American Psychiatric Association, the Samuel Novey Writing Prize in Psychological Medicine (Johns Hopkins), the Seymour Lustman Award (Yale University), and the rank of Eagle Scout.
In this episode, you will hear about:
• 3:37 - How a drive to understand human nature drove Dr. Wilkinson to leave his engineering studies and pursue a career as a psychiatrist.
• 4:44 - The scope of Dr. Wilkinson’s work at Yale
• 7:13 - What studying depression has taught Dr. Wilkinson about human nature
• 9:00 - How Dr. Wilkinson views the connection between evolution and God
• 24:00 - How the central argument of Dr. Wilkinson’s book differs from intelligent design
• 26:41 - Dr. Wilkinson’s view of selfishness in human nature
• 37:49 - The deeper meaning that Dr. Wilkinson sees within the biological patterns of evolution
• 39:04 - The validity of moral relativism
• 43:42 - “The Rider and the Elephant” as a metaphor for human nature
• 45:43 - Dr. Wilkinson’s thoughts on free will
• 55:15 - How marriage can provide a cornerstone to building “a good life”
• 58:10 - The way in which Dr. Wilkinson’s faith fits into his personal view of human nature
• 1:04:42 - How Dr. Wilkinson brings these principles into his clinical practice
Henry Bair: [00:00:01] Hi, I'm Henry Bair.
Tyler Johnson: [00:00:02] And I'm Tyler Johnson.
Henry Bair: [00:00:04] And you're listening to The Doctor's Art, a podcast that explores meaning in medicine. Throughout our medical training and career, we have pondered what makes medicine meaningful. Can a stronger understanding of this meaning create better doctors? How can we build healthcare institutions that nurture the doctor patient connection? What can we learn about the human condition from accompanying our patients in times of suffering?
Tyler Johnson: [00:00:27] In seeking answers to these questions, we meet with deep thinkers working across healthcare, from doctors and nurses to patients and healthcare executives those who have collected a career's worth of hard earned wisdom probing the moral heart that beats at the core of medicine, we will hear stories that are by turns heartbreaking, amusing, inspiring, challenging and enlightening. We welcome anyone curious about why doctors do what they do. Join us as we think out loud about what illness and healing can teach us about some of life's biggest questions.
Henry Bair: [00:01:02] Conventionally, we are taught that evolution implies there is no ultimate purpose to our existence, that life lacks inherent meaning. We are the product of countless intricate molecular and genetic accidents. What's more, to many. Evolution leaves little room for, and perhaps even contradicts the existence of a deity. However, our guests on this episode, Doctor Samuel Wilkinson, a professor of psychiatry at Yale University, thinks there's another way to look at evolution. Drawing from an array of disciplines ranging from evolutionary biology to cognitive science. Doctor Wilkinson provides a framework for evolution, suggesting not only that there is an overarching purpose to our existence, but what that purpose is. He presents this framework in his 2024 book, Purpose What Evolution and Human Nature Imply about the Meaning of Our Existence. Over the course of our conversation, Doctor Wilkinson shares how an existential crisis during medical school led him down the path of exploring the ways evolution can be reconciled with fundamental questions and answers about life's meaning, how navigating the dual potential of human nature pulling us between selfishness and altruism, aggression and cooperation is key to understanding our purpose. Why evolution does not exclude the possibility of existence of a god or gods. The importance of relationships in living fulfilling lives, the role of free will in the choice between good and evil and more.
Henry Bair: [00:02:32] Sam, thank you for taking the time to join us and welcome to the show. We are looking forward to discussion, as intellectually rich as it is consequential in its implications.
Dr. Samuel Wilkinson: [00:02:43] Thanks for having me here. I'm excited to talk.
Tyler Johnson: [00:02:45] Well, if I had sat down, as they say, at the beginning of 2024 and written out my bingo card, I don't think that Yale psychiatrist writes a book, reconciling Faith and evolution and Explaining the Meaning of life. Probably would have been on my 2024 bingo card. So, you know, your book is, I think, a fascinating contribution to this discussion. And it's also funny because Henry and I are always sort of on the lookout for things that might be a good fit for the program. And, you know, sometimes we find something and we think, oh, you know, that's a little like that's five degrees off. But that might we could maybe have an interesting conversation about this. But then there are a few times when we see something and we think, oh my gosh, that is like right in the exact core center. And I think that's how we both felt seeing your book come out. So we're really excited to talk to you about that today.
Dr. Samuel Wilkinson: [00:03:36] Sounds great.
Tyler Johnson: [00:03:37] But before we get to the book, let's just go way back. So as I mentioned earlier, you are a psychiatrist at Yale, and we'd love to have you start, as we usually do, just explaining. What was it that brought you into a career in medicine?
Dr. Samuel Wilkinson: [00:03:50] So I came about it in a little bit of a roundabout way. I studied mechanical engineering as an undergraduate, and I was planning to do graduate work in biomedical engineering or bioengineering. One of those and one of my professors, he basically said, you know, you should just think about becoming a doctor. You practice medicine, you can do research. You'll have a lot of opportunities open to you. You could also just do the research through a PhD. But he made me start to think about this. And as I thought about it more, I spent some time shadowing local physicians, and it made a lot of sense. And so I had a little bit of a shift. I wasn't planning on going into medicine when I started college, but I shifted about halfway through. And things have, at least in my perspective so far, have have worked out.
Tyler Johnson: [00:04:44] That's great. So two questions that go together with that. First is how did you then end up going into psychiatry. And what is it exactly that you do now. Like what is your area of expertise? What do you do at Yale?
Dr. Samuel Wilkinson: [00:04:55] Yeah. Well, why don't I start with the second question, then I'll come back to the first, if that's all right. So I'm on the faculty at Yale, and I, I mostly spend my time doing research and it's clinical research. So helping to conduct clinical trials, I also have a line of work in large database analyzes. And and the main questions I'm trying to answer is how can we treat patients better? My focus is in depression, specifically what we call treatment resistant depression, and also in suicide prevention, as both of you know, as many of your listeners will likely know, this is a big area and one in which there's still a lot of progress to be made day to day. I spend my time helping to run clinical trials. The other question you asked is how did I shift into psychiatry? Especially coming from an engineering background? This has to do with my book. So when I was a medical student, my first year med student, I was really thinking about otolaryngology or ENT ear, nose, throat, and I had started doing a little bit of research and shadowing with some of the ENT docs as a first year med student, and I really started to wrestle not with ENT, but just with kind of larger questions about, you know, what is the purpose of existence and is there a purpose of existence, or are we just really, you know, tens of thousands of molecular accidents and is there, you know, a purpose for me? And I had this wrestle.
Dr. Samuel Wilkinson: [00:06:21] I grew up religious, and it seemed like what I was learning about science, you know, this kind of quintessential science versus faith conflict, this perceived conflict was very large in my in my mind. And, and eventually I, I kind of came to this conclusion in a way that's difficult to describe, that things seem to fit together. And from that point on, I wanted to specialize in whatever it was that would lead me closest to studying human nature. And so I picked in part for that reason, I picked psychiatry. I also had a lot of great mentors. One of the the senior doctors who had been the chair for many, many years at Hopkins. He just had this, this charisma about him, and he made this topic seem so interesting and it is interesting, but he really helped draw me to this field.
Henry Bair: [00:07:13] So you mentioned wanting to study something that helps you better understand or perceive human nature. Can you share with us? What does studying depression help you see about human nature?
Dr. Samuel Wilkinson: [00:07:27] That's a good question. We could spend the next hour talking about just what is depression, you know? Depression comes in a lot of forms. And so much of of depression these days has to do with. The kind of some social pressures and social trends that have happened. And one of the ways that it's helped me is to really hone in on the finding that the biggest antidepressant and there's some nuance to this, but the biggest antidepressant we have are our personal relationships. It's the best antidote to the downs of life and the single most reliable up. I kind of realized that early as a medical student, I didn't quite understand all of the data and the nuances to it. This isn't to say that there are not forms of depression where people are doing great in their lives and so forth, or there aren't, you know, people can't have depression when their relationships are generally good. But of all the things that we have in our arsenal, we don't typically think of, you know, I'm going to pull out my prescription pad and write, you know, focus on your relationships more. But that is the data that when people have good and warm and uplifting relationships, that's probably the best factor to help stave off depression, to help people get through it when they're in the midst of it. So this finding was really eye opening to me. And I was I felt I was fortunate to recognize it early in my life and as well as my training.
Tyler Johnson: [00:09:00] So we do want to spend a good deal of time talking about the stuff in your book, only because your book is this kind of tour de force going through many of the most deeply felt philosophical questions of history. But to sort of set us up, I want to also just mention for listeners, I think, you know, one of the things that we hope to be able to do in the podcast, and one of the strengths of having a podcast that's now been running for a good long time is that we can put guests, even if indirectly, into conversation with each other. And so you might if you're listening to this episode, you might also go back and listen to the episode that we did with Francis Collins back near the beginning of the show, and then also the episode with Alan Lightman that we did. But I want to start to sort of frame the discussion about the content of your book with a quote that I think I also quoted on the Alan Lightman episode, but that I think is really helpful and instructive in terms of framing.
Tyler Johnson: [00:09:53] And so this is a quote from Bertrand Russell. Bertrand Russell was a sort of a predecessor of the New Atheists, except that he came about 80 to 100 years before they did, was he was in his prime around 1900. And he was a forceful, at least agnostic, probably atheist, who wrote some of, I think, the most eloquent and important stuff ever written in defense of those ideas. And so I want to read a famous passage from his. This is from an essay he wrote called A Free Man's Worship, and he says that man is the product of causes which had no provision of the end. They were achieving that his origin, his growth, his hopes and fears, his loves and his beliefs are but the outcome of accidental collocations of atoms that no fire, no heroism, no intensity of thought and feeling can preserve an individual life beyond the grave. That all the labors of the ages, all the devotion, all the inspiration, all the noonday brightness of human genius are destined to extinction in the vast death of the solar system, and that the whole temple of man's achievement must inevitably be buried beneath the debris of a universe in ruins. All these things, if not quite beyond dispute, are yet so nearly certain that no philosophy which rejects them can hope to stand only within the scaffolding of these truths. Only on the firm foundation of unyielding despair can the soul's habitation henceforth be safely built. So that puts a pretty fine point on it, I think. Yeah.
Dr. Samuel Wilkinson: [00:11:33] No, it reminds me of a of a of another quote that I have in the book that it says in the inevitable march of evolution, life is of profound unimportance, a mere eddy in the primeval slime. Right? And I laugh at that now. But when I was kind of in the crux of this, my existential wrestle, that was really disturbing. And for some people who may be listening to it, it may still be disturbing. So I don't mean to laugh and say this is not important, but I just profoundly disagree with with the conclusions and the logic that that lead to that, that conclusion.
Tyler Johnson: [00:12:06] But to your point, and this is something that we talked about a little bit with Francis Collins, I think that there is an argument to be made that society is in the throes of that existential wrestle that you mentioned. Right. And you make a lot of this in your book that, you know, the argument can be made that pre-darwin there was a mostly shared societal understanding and assumption that God had to be responsible for the diversity and existence of life, because how else could life have come to be right? But then evolution at first seemed to suggest that maybe there was more to it than that. And then I think over, you know, the last century and a half has sort of gained steam with a number of other sort of philosophical layers put on top of it to suggest that, so that now many people like Bertrand Russell does here and like the New Atheists did around the turn of the last century, make it out that that in the face of evolution, the idea of any sort of divine presence behind anything or any larger meaning to our lives is not only not necessary, but is just dumb, right? Like no serious person would think those things. And so your book comes as a very forceful rebuke to that. So I think it would be helpful to start out with, can you outline why is it classically that evolution has been portrayed as, in effect, debunking the existence of God? And why do you think that that's a misunderstanding? How do you read evolution as actually, if anything, maybe doing the opposite?
Dr. Samuel Wilkinson: [00:13:43] Yeah, I can certainly speak from my own experience. I think part of this has to do with the philosophical approach to deity that might be called the God of the gaps, and certainly pre-darwin. A lot of people said, well, we can't explain this, so it must be God, right? My God is in the gaps of our understanding. I think that's a not a great way to if you are a believer to to couch and and to rest your belief in those spaces because inevitably science, you know, closes those gaps as we, you know, understand how things work and how things came into being. So so that's part of it, I think part of it, without realizing it, a lot of people who are believers have this sense that, you know, science can't explain everything. So whatever is not explained, that must be where, where God is. And I don't really subscribe to that. There are some other parts to evolution. One is it could be called the randomness doctrine. Okay. There's a very influential physician writer who phrased this. Well. He actually for a time served as the dean of the Yale School of Medicine. And he said, I cannot make my peace with the randomness doctrine. I cannot abide the notion of purposelessness and blind chance in nature. And yet I do not know what to put in its place for the quieting of my mind. So I think, for me at least, there was a sense that if life was an accident, then that kind of goes against any sense of universal purpose. Maybe we can have kind of purpose that we make or form for ourselves. But if it is true that life is a total accident, then it would seem that that those people who say, really, there's no purpose or point to our existence, they're ultimately right. And so that was one thing that which, by the way, I think is a is a misunderstanding of the site, at least where the science is now that things were totally random.
Tyler Johnson: [00:15:42] And can you just to expand on that? But why do you think that? Because I think, right. Everybody who takes a molecular biology class in college, particularly if you want to think about this because you were raised religious or you're just have a philosophical bent or whatever, it seems like a pretty straight shot, right? In molecular biology, you learn that transcription and translation are a very high fidelity process, but they're not perfect. And when there is an imperfection, at least by all appearances, the imperfection is random. Most of the time, that random thing results in a cell that just dies. Right. So this is sorry to be clear. So this is when a cell is copying its own DNA or is using its DNA to make proteins, which eventually give rise to basically everything we see in the biological world, does it almost perfectly, but not quite. And when there's a mistake, then it certainly seems to happen randomly. And then those random mistakes usually result in cells that just die off, but occasionally they result in cells that change the way that the organism does something right.
Tyler Johnson: [00:16:47] It has a different color of beak or a different coat of hair, or it has some, you know, it's better able to regulate its temperature or whatever the thing is. And so then if that random molecular accident leads to an organism that is randomly better at doing something that helps it to sustain its life, then it maintains a growth advantage or a reproductive advantage. There are more of those. And then over time, then those things come to predominate. And and eventually you have the branches of the genetic tree split and split and split and split and split. And then that's how you go from single celled organisms to everything from reptiles to amoebas to humans to whatever. So all of which is to say that it seems like your college level molecular biology class is a straight shot explanation for why randomness lies at the heart of everything, right? Because everything is based in these molecular accidents. So, you know, and I know that many people read or learn about that, and it seems pretty much irrefutable. So how is it, in fact, refutable.
Dr. Samuel Wilkinson: [00:17:46] Well, a lot of this work has been done by a biologist named Simon Conway Morris. And I'm not arguing here that the mutations were not random, but it's, it's it's very possible. And I think it's I think it's the case where when you step back, you see there's a larger pattern going on. So maybe an analogy would be helpful. As an engineering undergraduate, I learned about a process called injection molding. This is a manufacturing process that is used to make many common everyday items like toothbrush handles, legos, plastic bottles and what you do with injection molding is you start with a solid material plastic, and you heat it up until it melts. And when it's in its liquid form, you inject it or push it into a hollow mold of a predetermined shape. And when the liquid fills the void and then it cools, you take off the mold. And in this it retains the structure of the mold. Right. And imagine if you could somehow look up close microscopically at the molecules bouncing around. It would look like randomness. But when you take a step back, there is a clear pattern. And there what physicists would call boundary constraints that constrain the whole process. And that seems to be what has happened with evolution. And again, this is the work of mostly of Simon Conway Morris, who has identified patterns over and over and over again in the biological world. This is called convergence or convergent evolution. I can run through many, many examples. When you think of, say, birds, bats and butterflies, they all have wings and the capacity for flight, but we are told that they each independently develop the capacity for flight.
Dr. Samuel Wilkinson: [00:19:33] Maybe one of the most remarkable examples is eyes. The human eye is referred to as a camera type eye, and it is, for all intents and purposes, exactly the same structure as the eye of a squid. But our last common ancestor did not have this structure. We each independently evolved this really remarkable structure. It turns out that eyes have developed independently about 40 different times. Okay. And you know, I could go on and on. I list several examples if you'd like to look them up. But even people who, you know, have no sort of kind of religious inclination will acknowledge this. So Richard Dawkins has kind of proved this point. He asked a friend of his, he said, hey, can you think of any, quote, good ideas that have evolved only once? His friend could only think of a handful. So there seemed to be these patterns where, you know, natural selection. It only has so many kind of things to choose from, and there may be only so many ways to create eyes, and nature may have stumbled upon them all. You can imagine a mold in the shape of a giant tree, right. And these genetic mutations are kind of randomly filling out the cavity of this tree. But there is a structure and and it's not just like a one random thing after another. There are these recurring patterns.
Henry Bair: [00:20:56] Well, you've been saying reminds me of complexity theory. In fact, we had a conversation about 15 episodes or so ago with Doctor Neil Feis, a pathologist at NYU who has dedicated a significant portion of his life to studying emergent phenomena and complexity theory. It's a lot to try to summarize briefly, but the gist of what complexity theory tries to explain is how random interactions between relatively simple components in a system can self-organize, adapt, and evolve over time to create ordered structures that appear to have been designed deliberately. The prototypical example is how interactions between individual ants at a collective level create efficient foraging paths and sophisticated nest construction. But perhaps a more relevant example is how interactions among billions of neurons, each communicating through simple electrical impulses, give rise to consciousness and thought. The individual cells do not have awareness. They are talking to each other. And yet, as a collective, the human mind emerges. That's what complexity theory seeks to model and explain. You also cited Richard Dawkins several times in your book. And for those who don't know, Richard Dawkins is one of the most prominent atheists out there. But he writes often about how evolution does create complex, beautiful things like the human eye out of random mutations. So that makes me wonder if you are able to reconcile the unit level random processes of evolution and other complex systems with their apparent well designed outcomes, then what is the role of a higher power?
Dr. Samuel Wilkinson: [00:22:38] Yeah, and just to be totally clear and intellectually honest, the notion that evolution was not random does not prove there's a God or anything like that. But I do think it, at least for me, it brings these two worldviews a little closer together. It's more satisfying for me to think of a higher power, who used higher order principles to constrain and guide the process, to go in certain directions and not others. Then to imagine a higher power that is just kind of left it up to chance. You mentioned you had this episode with Francis Collins. I think he writes, you know, well, God is outside in space and time and and so he kind of knew the end from the beginning. That works for him. I have a hard time, I guess, internalizing that. So where is God in this? I don't know exactly. You know, my conception of deity is not someone who kind of waves a magic wand and things poof pop into existence, but one who uses principles and obeys laws. And God's beauty and power comes from a full kind of mastery of these laws. I'm not necessarily looking for the part where, you know, God put his hand in the soup and stirred the molecules. I don't think you're going to find a little tag on the end of a DNA that says, I, God did this right. My conception of deity is is one that is a being, an intellect that uses higher order principles. The thing is, we just don't have a full understanding of all the the laws of nature and the universe.
Tyler Johnson: [00:24:00] So let me ask one question that I think is an important distinction to make here. So, you know, after most of the 20th century, where arguably at least within most of the latter half of the 20th century, I think the idea could be pretty strongly argued that the premise that we set up at the beginning, that the randomness of molecular biology leading to evolution, had led most self-proclaimed scientists to be very comfortable with not ascribing any role to God anywhere in the process. I think that at least that was the popular notion. And then one response to that from believing folks, was a school of thought promoted by Michael Behe and others like him, which was the intelligent design movement. And again, we're trying to reduce a lot of complex ideas into sort of simplistic soundbites here. But in effect, the idea there was that there were certain things in nature that they claimed you could demonstrate statistically were irreducibly complex. And so one of their actually most famous examples is the eye. And basically what they said was the eye, the camera style eye, as you were mentioning earlier, is so complicated and so elegant that they claim to have statistical models, which I can't make any comment on one way or the other. But anyway, that purportedly demonstrated that it was literally impossible for random evolution to yield that kind of a result, that those notions have been questioned. And I think that they're at least as far as a statistical, quote unquote, proof of God's existence. I think that their analysis is not given much credence anymore. But all of this is to say, can you talk us through what is the similarity between or differences between what the. The intelligent design folks have argued. And what you're arguing about evolution in your book.
Dr. Samuel Wilkinson: [00:25:44] I think one of the key differences is that. Their approach to my understanding is still a sort of God of the gaps. Right? It's we can't explain this by evolution, ergo it must be God, right? It's just statistically impossible. And what I'm saying is, well, we may be able to explain it. And also it's not random. And when we get into human nature, it seems like you can draw inferences as to what the purpose of our existence is. So I still see them as having an approach. And by the way, I think many of them are very intelligent and very brilliant and understand some of these processes to a level that I don't. But I still think it's a God of the gaps approach. And I'm trying to say, look, yeah, you can explain this, but that doesn't mean that there isn't a higher order pattern that we can infer from it.
Henry Bair: [00:26:41] To move on to the next thing you tackle in your book. When you read the writings of the most prominent voices of atheistic evolution, such as Richard Dawkins and Daniel Dennett, you'll quickly come across the important role of selfishness. The selfish Gene, to be exact, is what drives evolution. It's the fundamental unit of natural selection rather than the individual organism or the species. Genes that are good at replicating themselves, that act in self-interested ways to preserve themselves, will spread through populations over generations, regardless of the impact on the individual organism. To these thinkers, the selfishness of genes is the higher order principle in evolution. In your book, you try to reconcile the selfishness with your view of human nature and its ability to be unselfish. Can you talk more about how you tackle that apparent conflict?
Dr. Samuel Wilkinson: [00:27:37] Yeah. And going back to when I started this project, this was one of the things that was at the heart of my wrestle. I thought, well, if evolution is true and we're the products of it, then at our core we are ultimately selfish. And I didn't you know, that's kind of a bitter pill to swallow. It's a depressing view of human nature. This reminds me of this quote by a woman who supposedly said this around the time that Darwin first published The Origin of Species, who said, you know, dear, let us hope that it is not true. But if it's true, let us hope it doesn't become widely known. Right? Um, and you're right that Richard Dawkins, in probably his most famous book, The Selfish Gene, in the most of the book, by the way, is not necessarily about selfishness, but it's about the mechanisms of evolution. But he does stake out a claim in the early pages who says, look, if you're trying to build a good society where people help one another, you're not going to get any help from biology because we are born selfish, right? And it turns out that it's a lot more complex, even a relatively superficial observation, not only of human behavior, but of animal behavior. There's lots of examples where people, as well as animals, behave in ways that are altruistic, which is the opposite of of selfish. There's a there's a whole literature in evolutionary biology and evolutionary psychology as to why would it be that organisms, people included, would behave in ways that are unselfish? And there's a logic to it.
Dr. Samuel Wilkinson: [00:29:03] One of the things that you refer to, Henry, is this notion of what biologists call the levels of selection. So when I say the phrase survival of the fittest, which has some problems to it, and biologists these days mostly don't, don't use that. But it is it is instructive in that when I say it, most people intuitively understand survival of the fittest. We turn that into a question. Survival of survival of the fittest. What is it? The fittest gene, the fittest cell, the fittest individual? Or what about even the fittest family or group? And especially with those last few levels, there are profound implications as to the social traits that tend to emerge. By the way, I'm I kind of believe that all of these levels have had some relevance depending on different contexts and time periods and such. When you think about social traits, let's say in respect to humans, these last levels, I think are the most important. So you think of an individual level. Of selection and you think of a family level of selection, which is called kin selection, or even a group level of selection. And you come up with different in many ways, opposing social traits. So let me let me share a story, if that's all right.
Dr. Samuel Wilkinson: [00:30:18] This is a story that I get from a colleague of mine, Yale sociologist Nicholas Christakis, in 1864, which, coincidentally, is the same year that the phrase survival of the fittest is coined in 1864, in what's called the Auckland Islands, this is an archipelago 300 miles south of mainland New Zealand. There were two ships that shipwrecked on the on that same island on opposite ends.They never learned of one another's presence. The first ship was led by a man named Musgrave, Thomas Musgrave, and after about 18 months and much ingenuity and resourcefulness, all of the crew from Musgrave Ship survived. The other ship was led by a man named George Dalgarno, and unfortunately most of the crew from his ship died. So what was the key difference? Well, the first ship led by Musgrave formed a remarkably cohesive and cooperative group, and this was epitomized really in the first minutes of the shipwreck when the captain himself, Musgrave, he carried an injured man on his back as he swam to the safety of the shore. The other group, they adopted a sort of every man for himself approach, and this was seen in the first few days of the shipwreck, when they left a wounded man behind to die as they searched further inward for food and other resources. So. You can imagine similar scenarios playing out in our distant evolutionary past, where it was cooperation and altruism that was favored. Let's say a group level, right. And there are two biologists that I really respect a lot. E.o. Wilson and David Sloan Wilson. And they they have this phrase that I think sums this up perfectly. They say, look, selfishness beats altruism within groups, but altruistic groups beat selfish groups and everything else is commentary. So does that help you us understand how, when we're thinking about which level of selection is most prominent, is going to determine kind of which social traits emerge?
Henry Bair: [00:32:29] Yeah. Is this what you refer to as like the dual potential of human nature?
Dr. Samuel Wilkinson: [00:32:34] Exactly, yes. And just an academic caveat, because there may be some hardcore biologists listening. Group selection is a bit controversial. I think it has happened in some contexts. But what is not controversial is kin selection, which you can conceptualize as small group composed of people who are closely related a family. Right. But that that principle holds right, that selfishness beats altruism within a family, but altruistic families beat selfish families and so forth, and it seems like, you know, so when you when we ask the question, are humans ultimately selfish or altruistic? I think to me the answer is yes. We have the capacity to be both of these things. And it doesn't take long to look back through the history book of humanity to come up with terrible examples of where we have behaved in very selfish and even violent ways. But there are also moral heroes, people who, for a variety of reasons, have chosen another path that chosen the path or their circumstances have nudged them into a path where they treat others with an immense respect and kindness and altruism. So I think this helps us, at least for me, escape kind of the quagmire that philosophers and social scientists have been wrestling with for a long time is that we have both of these capacities within us. We all have strengths and weaknesses. We all, we all, to some degree have capacities to be selfish or to be unselfish. And that I think, as best I can tell, you can tie back directly to this issue of, well, in some circumstances one level would have been more prominent, in another circumstance, another level of selection would have been more prominent.
Tyler Johnson: [00:34:20] So your book is written in such a way that it it is sort of like successive layers of scaffolding that build on top of each other. Right. And so I just want to pause here for a second to sort of review where we've been the classical atheistic view of this whole matter, if we were to sum up, would be that random mutations at the molecular biological level lead to a series of at first subtle and then more dramatic changes which result in evolution that is entirely random, and furthermore, on the organism level, that to the degree that there is any organizing principle at all, it is the principle of selfishness. It is nature red in tooth and claw, every man, woman or organism for him or herself. And so whether we want to use the term survival of the fittest or not, that's sort of a fair encapsulation of kind of the way that the whole thing operates. And you are suggesting so far two fundamental disagreements with that encapsulation. The first one is that while you acknowledge the apparent randomness of mutation on the molecular biological level, you also believe that there are not proofs per se, but hints or indications, or there is sort of the suspicion at a larger organizing principle that, as you put it, is sort of like the mold in injection molding that allows evolution to proceed in certain ways, but not in an infinite variety of ways that you would expect if it were truly only ever random and turtles all the way down, so to speak.
Tyler Johnson: [00:35:59] That's number one. And number two is that you believe that while you acknowledge that there are certainly strong traces of selfishness all along the development of evolution from, you know, single cells to us, you also believe that there is equally strong evidence that in every place where you can say, well, look at this selfish trait that's emerging over here, you can point and say, well, yeah, but look at this altruistic trait that is evolving over here. And that in some cases, as you put it, especially if you talk about small groups or families or kin groups or whatever you want to call them, and maybe even larger groups. So that remains controversial, that in some cases, the altruistic traits actually best, the selfish traits depending on complicated group dynamics and other things. But the point is to say that there is evolutionary basis for both the development of selfishness and the development of altruism. And then as you get to in the book, you can see that across multiple traits. So whether you're talking about love versus lust or cooperation versus competition or selfishness versus altruism, in all of those cases and probably others that we have incited, there is evolutionary, biological and sociological evidence that there are, in effect, competing inclinations inside of everyone, and that both, paradoxically, both of those competing inclinations may have an evolutionary basis. Does that seem about right? Yes.
Dr. Samuel Wilkinson: [00:37:22] And I'm not making up evolutionary stuff. I mean, the atheists will, you know, if they know biology, they will acknowledge, oh, yes, we do have things leading us to be unselfish as well. I'm just saying that when you take this and put it into a larger framework, there implies a meaning and a purpose to, to our existence. So I'm not adding anything new. I'm just bringing things together that I don't think anyone else has brought together in a single framework.
Henry Bair: [00:37:49] So can you share with us where this leads us? What is the meaning the grand reveal?
Tyler Johnson: [00:37:54] So what is the meaning of life? Yeah.
Dr. Samuel Wilkinson: [00:37:58] Bear with me because I know this is grandiose and I apologize for for sounding that way, but I do believe this.
Tyler Johnson: [00:38:04] We've been waiting so long to get a guest on the podcast who could tell us. So we're really glad you're here. Go right.
Dr. Samuel Wilkinson: [00:38:09] Ahead. So this is what I call the dual potential of human nature, right? We are all pulled in different directions in many ways. The ones that we've identified have a particular moral implication to them. And when you combine this aspect of our nature with the observation and the perceived experience that we have, that we have this ability to choose, right, this free will, to me, it seems like life is a test, right? There's this cliche motif of a person walking down the street in a cartoon, and there's a little angel on one shoulder whispering into the ear and a little devil on the other shoulder. Right. This I think that there is some truth to that. You know, that depiction of how life is. We we all face these choices, many of which don't really have moral implications, but some of which do. And I think that is part of the purpose for our existence.
Tyler Johnson: [00:39:04] So this is not the main direction that I want to go. But I do feel compelled to ask. One of the things that is really interesting to me about, I guess I would say postmodernity. So I think that while it is true that for 150 years, let's say there have been, you know, maybe evolutionary biologists who might have put forward something like what I quoted from Bertrand Russell, that everything is meaningless and purposeless and that and that, you know, there is no moral valence. I think that at least most of the broader public like, would have intuitively resonated with the picture you painted a minute ago of like the, you know, so to speak, the devil on one shoulder and the angel on the other shoulder or whatever, you know, sort of pulling them to do different things. But one of the things that's so interesting to me over the last however many years is the popularization of people who are now questioning even the underlying assumptions here. Here are some examples of what I mean. So, for example, we have spoken to people on the podcast who I think if you really could get them to kind of, you know, excavate all the way down through multiple levels, in effect, have argued that, for example, the word virtue has no normative value, that it's purely descriptive. So in other words, virtue or value or whatever is whatever matters to me.
Tyler Johnson: [00:40:32] But there is no ultimate description, right? So love is actually not better than lust. And altruism is not actually better than selfishness. You do you, so to speak. Right. Like that's a very 2024 encapsulation of a philosophy to life is just sort of whatever, you know, feels good. Do that right. By the same token, there has been a lot of talk in the press over the last six months, especially, but even over the last 2 or 3 years, about the rise of a sort of free wheeling polyamory culture, right, where and people who are writing about that are trying to make the point. They're not trying to say, oh, well, I made this mistake by going outside of my marriage. They're trying to say, no, no, no, we should just redefine marriage so that two people who are in a couple say, raising children, can just the two members of the couple can have sex with whomever they want, as long as, you know, everybody's aware of it and what have you. And so that's just to say that it seems like there are those who are arguing that narcissism, for example, should actually be if there is any sort of reigning moral framework, that narcissism rather than altruism, would be the sort of postmodern suggestion for how we govern our lives. And so I'm curious, what do you make of that? Or how would you respond to those trends?
Dr. Samuel Wilkinson: [00:41:47] Yeah, I think what you're hitting at is moral relativism. Sure. That there's not necessarily moral absolutes. I mostly would disagree with that. But I mean, I get that from a philosophical or a religious kind of authority. And people might say, well, you know, your authority is not valid. I have a different authority. I think what makes sense to me when I look at, in broad strokes, the philosophies, the religions across the world, this is a first order approximation. It is not fit necessarily every instance or example, but. When you think about the ways that most religions will try to teach people to live. It lines up very nice with the types of behaviors, the social traits that would emerge at a higher level of selection, kin selection or group selection. Right. It's it's do unto others. It's an other focused approach. And so I think, you know, if if you don't believe in anything in terms of religious or philosophical moral underpinnings, if you kind of, as a first order approximation, say what is good and what is bad, you know, the things at the at the higher level, those types of traits that emerge. I think that's a good first order approximation. What to me, you know, we have traditionally thought of as good and and not good now. There's a difference between self-interest and selfishness to split hairs. You know, self-interest is doing things for yourself. Selfishness is doing things for yourself that harm other people. Self-interest is not, you know, we have to have self-interest to survive. And, you know, society couldn't really run without it. But when it veers over into, I'm doing something for myself at the expense of someone else's welfare, then even people who don't have any sort of religious authority or grounding would say, yeah, that that crosses a line into something that that is not good.
Henry Bair: [00:43:42] So to boil it all down, is it fair to say that in your view, recognizing the dual potential of human nature, of our capacity for cooperation and aggression, for love and lust, and then exercising that free will to choose the things that will bring us closer to other people. Is that the purpose of life?
Dr. Samuel Wilkinson: [00:44:02] I think that's a big part of it. There's a lot of nuance to this. Choice is it's not just a simple binary, right? I mean, because you say, well, how do I choose between selfish and, uh, being selfish and altruistic? There's a really good metaphor that the writer and psychologist Jonathan Haidt has about human nature. He calls it the rider and the elephant. A human rider is on top of and riding an elephant. Okay. And he says, this is like our psyche. You know, we have a deliberate part of ourselves that is, you know, consciously making decisions to steer the elephant this way or that. And then we have the emotional or reflexive part of ourselves that is the elephant. And as long as the elephant doesn't have like strong desires of its own, the rider can steer it in one direction or another. But if the elephant really wants to do something, you know, a little puny human on top of it is not really going to be able to direct it one way or the other. Right? So part of this, I think if you follow my logic and say, okay, I, I acknowledge life is a test. There's, you know, you know, weaknesses and strengths within each of us. How do I accentuate my strengths and overcome my weaknesses? Part of this is leading yourself, your your elephant, to continue the metaphor to go in certain directions and not others, right? If you are writing an alcoholic elephant that wanders into a bar, it's going to be really hard to control before the elephant wanders into a bar you want to steer away from from here. So part of what I think is a really important goal of social science is what sorts of contexts lead people to be on their best behavior, okay, because there are certain contexts that are going to elicit it more than others.
Henry Bair: [00:45:43] Just to add another layer of complexity to our discussion, something we've taken for granted over our conversation so far is the existence of free will, of our ability to choose between good and evil. I think for most people, the existence of free will is intuitive, but there are fairly serious thinkers who have articulated eloquent reasons why free will does not exist, or at least that we have a lot less free will than we think we do. Sam Harris, another noted atheist and public intellectual, has argued that free will is an illusion and uses a thought experiment to illustrate our inability to predict our next thought. In this experiment, he invites individuals to sit quietly and observe their own minds, waiting to see what their next thought will be. He states that during this exercise, people will realize that they cannot predict what thoughts will emerge next. Thoughts simply arise in consciousness without prior intention or control. This unpredictability highlights that we do not choose our own thoughts. They are driven by underlying processes outside our conscious awareness. So if we have no control over our own thoughts, which are fundamental to our decision making and actions, then the concept of free will is fundamentally flawed. Another skeptic of free will, someone you cited in your book and whom we'll be interviewing soon, actually, is Robert Sapolsky, the Neuroendocrinologist at Stanford. He recently wrote a quite hefty book called determined, which builds a rather intellectually rigorous case against free will. His main argument is that all human thoughts, intentions, and behaviors are the result of a complex interplay of preceding causes, including our genetic predispositions, hormonal influences, early life experiences, environmental factors, our social interactions, and much more. Each decision you make comes from a neural circuitry that has been shaped by so many things you had no control over. He discusses how brain lesions, hormonal changes, and neurological disorders can drastically alter a person's behavior, personality, and decision making. All of which is to say that we have a lot less free will and less control over our actions than we think. What do you make of these arguments?
Dr. Samuel Wilkinson: [00:48:12] Well, I think Robert Sapolsky is a brilliant writer and scientist, and I agree with him on a lot of things. I disagree with him on at least two really fundamental things, and one is this issue of free will. In listening to him and reading his books, particularly about free will, it seems like he is looking for a version of free will that if it existed, wouldn't really make sense. So he says, you know, show me an uncaused cause that had no influence from prior causes or experiences and so forth. And if that existed, that would not really be free will. That would be randomness. I have no qualms saying that, yes, our past experiences influence our decisions, our genetic makeup influence our decisions. If our past experiences did not inform our future experiences, they would essentially be no self, right? The self is is a consistent pattern and series of decisions over time. So inevitably when you talk about free will, you you have to define your terms, because some people mean a very different thing when they're talking about free will and whether it exists or not. So I have no qualms ceding that. Yes, a lot of our decisions are swayed or influenced one way or another by our past experiences. If that were not the case, really be no concept of self. What I push back against is one. That behavior is deterministic because I think there's there's a fair amount of evidence, even in relatively simple organisms, we cannot predict with, you know, the types of certainty that you would imagine from a title such as determined, the title of Sapolsky's new book.
Dr. Samuel Wilkinson: [00:49:54] So I guess what I would posit to him and to others who who deny free will is if you can write a logistic regression equation or some sort of regression equation that predicts behavior and has no error term, even for a simple decision, I will say, okay, you're on to something here. But even for the simplest of organisms, it seems to be a probabilistic thing. So I'm very comfortable saying that behavior is probabilistic, right? If behavior wasn't probabilistic, then policies and other things that we do to try to shape behavior wouldn't really make sense. But even with it being a probabilistic feature, you know, there's still, I think, plenty of room for an individual to go one way or the other. Now, another thing that free will deniers sometimes will point out is, well, they'll say, well, it's clear that our neurons are causing our thoughts, right? You know, if you get intoxicated, that's going to affect your behavior and your thinking. And so that's bottom up causation. So we have that causation going bottom up. So there can't be any top down causation. It just can't happen because that wouldn't make sense. Well I would say that's not the case.
Dr. Samuel Wilkinson: [00:51:10] There's clearly a lot of evidence from psychology to show that what you think influences your behavior. So, you know, you have two groups of college students and you tell them both to exercise. But on one group you say, I want you to think out the details of this and plan it out in your mind, that sort of thing. The one that thinks about it more is more likely to do it. So there I think there's abundant evidence that there is top down causation. I think sometimes it's hard for people to understand, well, how is it that there's both bottom up and top down causation? An analogy I like is maybe say American football, right. So during the play, the the players are acting as a team, okay. What a player does informs what what the team does comprises what the team does. That's kind of the bottom up causation. But when they they huddle, they come together. There and they make a decision as a team. Okay. So in other words, what I'm saying is that these these processes do not happen instantaneously. Right? There's bottom up causation. And maybe a couple milliseconds passes and then there's top down causation. To be honest, no one knows exactly how this happens because there's this huge gap of consciousness or what's called the mind brain barrier. We don't really understand how physical things like neurons and neurotransmitters seemingly emerge to intangible things like thoughts and emotions.
Dr. Samuel Wilkinson: [00:52:35] But it seems to happen when the American football team is in the huddle. They get together and they say, well, you know, it looks like this guy is going that way. We should run this play. And so there's a there's a period when they're acting, you know, there's top down causation and there's a period when they're in play, when there's kind of bottom up causation. What the individual players are doing are causing what the team does. So again, we get into the the nitty gritty here. It's a really fascinating topic. I think the data is is clear that both that behavior is not deterministic, even in very simple organisms. And in humans we have the ability to, because of language, to see that there is top down causation and what you think influences what you do. So to me, that's enough to say, look, yeah, I agree that in many instances we probably don't have as much free will as we think we do. But I think we do have some, you know, it goes back to this, the rider and the elephant, right? Once the elephant is like really wants to do something, your free will is, is not as much as, as it as it was when your elephant didn't have a strong desire to do something.
Tyler Johnson: [00:53:45] Well, in a sort of backwards way. I would actually argue that that you mentioned a sort of probabilistic notion of sort of soft determinism, which is just to say that we can acknowledge that there are all kinds of genetic and social and familial and psychological and whatever factors that are predisposing us to do one thing or the other. But I would posit that intuitively, that understanding actually undergirds our intuitive understanding of how we define heroism is the person who has all kinds of predisposing factors to do the selfish thing, and yet chooses the altruistic thing anyway, right? Like we intuitively know that that is deeply admirable for reasons that we often have a hard time even explaining. Okay, I know we've already gone over time, but I want to ask two questions that we just can't stop if we if I don't ask these two questions, one is a little bit broader, and then one is going to be a little bit personal to you, and you can decide how much you want to go into it. So the broader one is this. Our listeners have long ago grown tired of me referring to this interview that we did near the beginning of the podcast with Anna Lemke, who is a researcher on addiction. Right. So one of the things that she references is that we have become, in effect, addicted to everything. Right? So the book is Dopamine Nation. And basically what she says is that we are so we've structured society in such a way that we just we get dopamine hits. That's like all we do all day, every day. Many of us is just look around for dopamine, right? We're like rats going around and pushing the buttons to get the little pellet of food.
Tyler Johnson: [00:55:15] And so whether that comes from buzzes on our social media feeds or whether it comes from junk food that we eat or online pornography or whatever, the thing is, we're just buzzing for dopamine all the time. And so she then in our conversation, talked about how when she works with college students, the first thing that she has to do is to help them to decouple themselves from the need to have this sort of constant stream of dopamine infusing into themselves by pushing all of their various buttons. One of the things that we talked about with her in the podcast is we said, okay, so then let's say that you do that you have a young person and you also are a psychiatrist. She's a psychiatrist. Let's say. I know that you don't do a lot of this clinical work, but let's say you had a young person who came to you after having spoken with her, and they had managed to decouple themselves from all of those dopaminergic stimuli, right? All of their social media and whatever. And they had kind of cleared the deck of their life. And now they were ready and they said, okay, Doctor Wilkinson, I'm ready. I want to, starting at 22 years old, go forward and build a good life for myself. Now, you've talked in these kind of big, sort of big picture terms about altruism versus selfishness and whatever. But like on a practical day to day level, if I'm a person who wants to build for myself a good life, how do I do that?
Dr. Samuel Wilkinson: [00:56:42] I think it goes back to relationships. And at 22 I would say don't put off forming a long term romantic relationships. And another way to say that is, is think about marriage. For a lot of us in the doctor world, some people tend to sequence these big milestones right finish med school, finish residency, get a job, then focus on your relationships. I'm not presumptuous enough to say that it needs to be this way for everyone, but I think there's something to be said for not sequencing them. Scholars who study marriage will sometimes refer to capstone marriages and cornerstone marriages, and a capstone marriage is when you put it in sequence, right? And a cornerstone marriage is when you kind of get married a little bit on the younger side. And your marriage is kind of the thing on which you build. And so, again, I'm not presumptuous enough to say that everyone needs to do it one way versus the other, but I think there there are some advantages to to not sequencing them. I'm not saying this is fair. This is just what the data show, that that marriage can just be a huge benefit to happiness and well-being.
Tyler Johnson: [00:58:01] So in the book, you are very clear that you're not going to get into theological details of anything other than tracing a very broad outline for where you see the contours of some kind of positive divine presence operating in evolution, and all the rest of what we've talked about. You're not going to get into any theological details that said a little bit in the book and more in other things that I've read that you've said and have written, it's clear that you personally are a person of faith. We talk a lot about faith and spirituality on the podcast, particularly as it relates to medicine, but also just as it relates to life. And one of the things that has struck me, as I have thought myself about these matters, is that one of the things that is striking about being a person of faith is that, you know, we can sit here all day and have an interesting philosophical discussion about what whatever we want. But probably at the end of the day, once we finish that, having that discussion, we're all going to put our headphones down and, you know, go to work and go back to or Henri or Henry as post call after a night shift.
Tyler Johnson: [00:59:07] So hopefully he'll go to sleep. Right. But like we're just going to go back to doing whatever we're going to do. Right. And like and like whatever we said on the podcast kind of doesn't really I mean, it sort of is interesting and whatever, but it may not matter that much to the operation of our daily lives, but with religion, with spirituality, that's not true. If I'm going to be a religious person and I decide to subscribe to a particular conception of God or a particular ethical view or whatever, the thing that's so striking about that is that that then is going to lay claim on my behavior. It's going to say that I should do certain things and shouldn't do other things. And sometimes the shoulds and the shouldn'ts are going to be hard. They are precisely going to be like the time that religion, as a moral influence in a person's life becomes most operative is precisely when the probabilistic description says, do the selfish thing and your religion is saying no, that's where you're supposed to do the altruistic thing or whatever. But what is striking to me as also a person of faith listening to you, is that when you having clearly thought about this a lot, describe your understanding of the role that God plays in all of this? What I hear are a lot of words like, imply and suggest and intuit.
Tyler Johnson: [01:00:26] Which is to say, you don't believe, as we talked about earlier, that that you have proven the existence of God or that you have proven the evolutionary basis of altruism. You don't you don't claim, at least as far as I've seen in the book, to prove anything except that, as you mentioned, you can bring them a little bit closer together what appeared to be warring factions, a little bit closer together, or bring disparate ideas a little bit closer together. So the thing that I want to ask and again, I recognize this as a personal question, but as a scientist and Doctor Who, when he thinks about these things so deeply, so to speak, the best that you come to is a sort of an intuition or a suggestion of God's presence. How do you then make the leap from there to living a life that is governed by the principles of your religion, and actually guiding your own behavior by those specific tenets?
Dr. Samuel Wilkinson: [01:01:31] That's a good question. Some of this is is fairly personal, and I won't get into all the personal details. A lot of them have to do with experiences that I've had, that have left me with a deep conviction that this is the way to go for me. In addition. I like who I am. When I am involved in this. I like the type of family that this helps me rear. I like the fact that my kids. I've got five kids. That they have a framework that helps them understand that this is what life is about, and how it teaches them a little bit of this meaning. I find a lot of benefit and strength in organized religion, and I say that intentionally because it seems like over the last decade or so, organized religion has a bit of a negative connotation. And there are reasons for that. And I think there are reasons. There are things that we can do to make organized religion better, but the data is pretty clear from mental health, you know, staving off depression, anxiety, helping people find meaning and joy in life. Religion in America is a very pro mental health institution, and most of that comes from gathering together with other people. And that doesn't really happen for people who are spiritual but not religious. There is benefit to that. There is benefit to just believing. It helps stave off stress and somewhat. But so much of the effects, the positive effects come from organizing with other people, getting to know your neighbor, going to church with someone who maybe voted for someone else. Can you can you imagine that? And recognizing that you know what they have strengths that I don't have, or they see things a little bit differently. So many people will look across the aisle and say, that person is all bad, it's all weakness. And that's just not true. Every human being is a mix of strengths and weaknesses, and going to church with people who don't necessarily share my same ideas, sometimes even deep seated ideas, I think. Really helps me to not fall into this trap of everyone who's not in my group is bad.
Henry Bair: [01:04:14] You talked already about encouragement for nurturing meaningful, deep relationships. Is there anything else that you would add to that? Um, you know, because it's interesting because we practice said, yeah, well, because we spent most of this conversation talking about evolution. I just like I was just thinking like, you know, this is this show is called for doctors art, not the evolutionary biologists art. Is there anything that you would add to to how you bring this work into your patient counseling?
Dr. Samuel Wilkinson: [01:04:42] I think remembering why you went into this is a really powerful thing. I keep a journal. I'm not the best at it. There's sometimes many months go by without an entry, but I feel very fortunate that I can look back in my journal, even when I was in an undergraduate or a medical student and read about my thinking, why did I want to become a doctor? Because I think a lot of people forget that over time, right? We we change a little bit. We lose sight of this is why I did this in the first place. Emr and other stresses that we have to deal with as as clinicians, they weigh on us. And I think it is really grounding to be able to go back and think. And if you did keep a journal, you're fortunate to have kept a journal to look back at some of your thinking. That, for me, really reminds me of why I wanted to do this, and it can be really refreshing.
Henry Bair: [01:05:40] Well, with that, we want to thank you for taking the time to join us in conversation and for sharing your thoughts with us. The implications of your ideas are incredibly far ranging, and we think this discussion will be quite valuable to our listeners. Thank you so much. Appreciate it. Thank you for joining our conversation on this week's episode of The Doctor's Art. You can find program notes and transcripts of all episodes at the Doctor's Art.com. If you enjoyed the episode, please subscribe, rate and review our show available for free on Spotify, Apple Podcasts or wherever you get your podcasts.
Tyler Johnson: [01:06:17] We also encourage you to share the podcast with any friends or colleagues who you think might enjoy the program. And if you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments.
Henry Bair: [01:06:31] I'm Henry Bair
Tyler Johnson: [01:06:32] and I'm Tyler Johnson. We hope you can join us next time. Until then, be well.