Dale Guenter – Essential Curiosity. [PDF]

Dr. Dale Guenter is a family physician, teacher and researcher at McMaster University in Departments of Family Medicine, and the Master of Public Health program in Department of Health Research Methods, Evidence, and Impact. He is a co-founder of Shelter Health Network, which provides primary care services to people in Hamilton, Ontario who are precariously housed. 
After reading this piece you should be able to:
  1.  Appreciate the importance of humility, empathy, and expressive action in working with people who are “other” from yourself

They were dirty and haggard and, whether for effect or from the heart, their faces conveyed a torment that I have never seen elsewhere. Suddenly one woman appeared from nowhere right beside my window. Her hand was on the window, a few millimeters from being inside the car in the space that was mine. Her face so close I could have touched it easily were it not for the closed window that came between us. Here we were with a cardboard-thin piece of glass separating our two worlds, each arriving at that glass with a story that neither of us could know, each with ideas and emotions that neither could comprehend, the other making a clear request to me to hear her pain and to respond with some sustenance.

Something draws us to do the work that we do, and to reach out to specific people or their issues. If you are reading this book, out of interest or for a course, then it is likely that something has spurred you on. Maybe you have felt ‘called’, to devote energy, or to give of yourself. You have chosen to bridge across divides, to mediate, to advocate. You aspire to making the world a better place, maybe to fixing some part of it. This stems from compassion.

And do you know why you are doing this? What of your humanity do you bring to this work? And why does it matter?

I was born into relative privilege, the first child of a physician and nurse. I am a wealthy white male with above average intellect and no physical ailment or disability. I was raised in the Christian faith. My university years began during the confusing outburst of the AIDS epidemic. My youth was shadowed with a sense of non-belonging as I slowly recognized that my sexual orientation gave me minority status.

It is from this palette that my joy, suffering, action and reaction take some sort of shape. Together these traits create a force of gravity that has drawn me into a 30 year medical career involved in HIV care, social determinants of health, global health, poverty reduction, mental health and addictions medicine. I understand that I am here because there are stories and journeys I long to understand, maybe even to feel. From what sort of palette does the joy, suffering, action and reaction of ‘the other’ take shape, as simple or bizarre as that appears to me? As I increasingly understand and feel their place, I live more fully into my own as well. I am drawn to people like this because I know I will find a similarity of our hearts hidden in the vast difference and injustice of our respective social locations.

The most important lens we can bring to this work is curiosity, especially the type that is attentive to social and emotional dynamics, rather than the intellectual or ‘novelty’ varieties. (Baumgarten 2001; Dych 2011) The substrate for a robust curiosity is humility, and its enemy is overconfidence, or worse, arrogance. Curiosity and humility will fuel empathy, which is our longing to know what makes ‘the other’ tick. Empathy will eventually melt difference, and pull threads of similarity between us.

Curiosity is not an act, but a way of being. It is not a program, a fix or a deliverable, and yet its impact is pervasive. We can come to any of our projects with excellent intentions, evidence and methods. We may have collaborations and community input and be following international ethical guidelines. But with all of this, the delivery could still take place without curiosity. Genuine curiosity is generous, attentive to differences, and open to change. It has the power to heal, to strengthen, and to prevent burnout in those of us doing the good work (Mount 2007; Chou 2014).

The Quaker scholar Parker Palmer (1990) describes two kinds of action: that which is instrumental and that which is expressive. He describes instrumental action as being governed by logic of success or failure. It gives primacy to goals and external valuation. It devalues the gift of self-knowledge. Expressive action is that which grows out of a conviction, a leading, or a truth within us. The two are not mutually exclusive, and both are necessary. Palmer sees expressive action as something that often matures and emerges from action that is more instrumental. When our action is expressive, it fills us up, it gives back, and it is more likely to be appreciated as a gift by the other.

The Russian philosopher Mikhail Bakhtin articulated the distinction between monological and dialogical interaction. If our work is monological, our contribution will be delivered without inviting, hearing or integrating a response. Our actions speak into a situation with a notion of ourselves and other that remains fixed, closed and static. If our work is dialogical, then we are convinced that neither we, nor other, are final or fixed. Any truth that we each bring to an encounter (no matter how good we consider that truth to be) will become a new and evolved truth. Any course we have steered may need to be re-steered again. (Most program funding models will be too linear to accommodate a dialogical process of steering and re-steering.)

In the vignette that opens this chapter, as I looked briefly upon a destitute woman in a poverty-stricken street– a vast world millimeters from my own–my tears were marking some truth that I did not yet know but would need to discover. I was there to develop a grant proposal, yet it was almost impossible to connect the woman in front of me with the project I was writing up. I knew that my humanity was being called upon, and my sense of failure and inadequacy was a door to something else yet to be learned. Even without words, we had shared a brief dialogue. The curiosity of the moment had changed me, and hopefully could change something for people like her in the future.



  1. When is a time when you were open to being changed by the experience of someone that seems very different from your own?
  2. What is it about your own life experience that has made you open this book, or do this kind of work?



Bakhtin, M. (1973). Problems of Dostoevsky’s poetics (2nd edn.; R. W. Rotsel, Trans.). Ann Arbor, MI: Ardis. (Original work published 1929 as Problemy tvorchestva Dostoevskogo [Problems of Dostoevsky’s Art]).

Baumgarten E. Curiosity as a moral virtue. Int J Appl Philos 2001;15 (2):23–42.

Chou C, Kellom K, Shea J. Academic Medicine, Vol. 89, No. 9 / September 2014: 1252-8.

Dyche L, Epstein R. Curiosity and Medical Education. Medical Education 2011: 45: 663–668

Mount B, Boston P, Cohen S. Healing Connections: On Moving from Suffering to a Sense of Well-Being. J Pain Symptom Manage 2007;33:372e388.

Palmer P. The Active Life: A Spirituality of Work, Creativity and Caring. Harper and Row, San Francisco, 1990.