Finding the Heart in the Art and Conscience in the Science of Medicine

Finding the Heart in the Art and Conscience in the Science of Medicine ‘’Now,the practice of medicine is not what it was during our times. ‘’added our professor at the end of an hour-long lecture. This was perhaps the tenth time I heard such a comment being made by one of our senior professors. Are they reminiscing? Are they complaining? Are they worrying? Or is it all three? Naturally, since the advent of Modern Medicine in the 1900,change has been inevitable. Some welcomed it with open arms and some tried to chase it away, albeit unsuccessfully. The ‘command and control’ style of practicing medicine wherein patients consider doctors to be gods and their words unquestionable has long since been gone and (thankfully) cannot be wished back. However,there is one aspect which remained unchanged through the years ,until recently. It also happens to be the fundamental principle on which medicine is based.It has almost disappeared. I speak of that almost mystic quality called ‘trust’. When I meet my extended family and friends ,I am questioned about what I study.When I answer-‘’Medicine’’ I instantly receive two kinds of responses which are polar opposites. Some people are ecstatic and start rambling away stories about how their doctors saved their lives (even if it be suturing a cut finger) and how they admire all doctors. Some step back and look at me with suspicion.They share unfortunate incidents describing how doctors are no longer compassionate but just money-making machines. They state confidently that they wouldn’t get into a hospital even if it were a matter of life and death. Ofcourse,there have always been supporters and opponents of Modern Medicine. However,what I find alarming is the exponential increase in cynics and how we are responsible for it(if only partially). I would be a liar if I stated that all doctors are always right.I am not blind to instances where sheer negligence on part of the treating physicians have resulted in the death of women in state-run sterilization programmes or poor elderly people going blind after cataract surgeries. Even situations where a doctor’s callous attitude causes pain and sorrow to a patient are unacceptable. These occurrences further the distrust between doctors and patients. The burning question-What can we do about it? All of our medical specialties have seen a great spurt in knowledge. Even on a day to day basis ,enormous amount of findings are released from around the world.Keeping up with these new discoveries, our course curriculum, clinical rounds, lab work and projects while trying to build our clinical acumen is a herculean task by itself.Thus,as medical students ,we are hardly equipped to pause and reflect on our clinical experience and relationships. This has destroyed the essence of medicine.Our eagerness to master the latest technical skills or acquire the latest scientific knowledge has left us deeply impoverished as far as humanity in medicine is concerned. As such, illness, is an altered state of existence arising out of an ontologic assault on the humanity of the person, resulting in the “wounded humanity. The patient's wounded humanity, rather than being a secondary aspect of the clinical encounter, must become the cornerstone of the healing relationship.This is where the psychological and therapeutic value of face-to-face personal and compassionate encounters between physicians and their patients come in. Patients are more than just bodies, organs or tissues.Each patient we are privileged to help treat, lives a live quite similar to our own-replete with joy, hopes, dreams, sorrows and insecurities .They all have stories of the paths they’ve traveled in life and the paths they intend to take. Though seemingly insignificant, listening, really listening to a patient may help us heal the patient and not just treat the disease. The Medical Curriculum in my country (India ) equips us well with a wealth of information and technical skills.Yet,most people will agree that the quality of medical education and patient care are deteriorating. There have been proposals to incorporate Medical Humanities into the curriculum. Though the extent to which another class-room subject will be effective in helping us find our heart while at the patients’ bed-side is questionable, the intent is laudable. Until then thousands medical students who graduate as doctors each year will have to learn to find their heart in the Art and their Conscience in the Science of Practice of Medicine, on their own. It’s time to move beyond the pills and bills that widen the chasm between doctors and patients. It’s time to reconnect and re-build the trust with every patient we see.