What is to be done?
While we have a choice how to respond on an individual level to a situation like the above, an ethic of hospitality also demands consideration as to why the current design of our health care system may obstruct fuller expressions of hospitality in the first place. We might rightly ask why the design of acute care spaces conjures unfamiliarity in the first place. We might ask to which degree health care systems may carry negative connotations for those accessing them, thinking specifically of the long history of colonialism and structural violence that has impacted Indigenous peoples living in what is now Canada. We might ask how the affordances of the medical language that clinicians employ – so useful in effecting biomedical treatment – may be limited by the impenetrability of that language to many families. We might ask whether a more robust primary health care system may have meant an earlier assessment of this infant, preventing him or her from falling behind on secretion clearance and breastfeeding. These are necessary questions that the demands of busy clinical duties might prevent us from addressing, that current curricular content and design might not adequately position us to even ask, and that a system that demands exhaustive expressions of altruism from its individual practitioners to shore up its shortcomings may obstruct.
It is undeniable that the onset of acute illness is a time of unavoidable precarity. While there may be little we can do to offset this aspect, infusing clinical care with an ethic of hospitality may open up needed space to better understand how professional medicine can provide care that goes beyond only addressing the biomedical aspects of illness. Specifically, it provides us with an orientation and a language that may speak to the silences that shroud patient experience of the unhomelike state of illness and the journey into the kingdom of the sick, the additional disorientations that may accompany a family’s navigation through the landscapes of the acute care setting, and the vulnerabilities and anxieties that accompany patient engagement with health care systems writ large.