The practice of medicine is often described as an art as opposed to a science. I could not agree more.
Clearly it is based upon sound scientific principles and is based on the latest scientific discoveries and perspectives.
The challenge to the practicing physician is how to integrate these findings into the day to day managemnt of real patients.
The patient who sits before me in the examination room with a series of complaints becomes the focus of all the knowledge and awareness of the latest scientific findings as applied to that particular individual.
A patient will rarely be impressed by my ability to quote from studies and articles regarding their disease IF I am unable to ease their suffering. Wisdom is not an abstract notion in this setting. It is simply the ability to make this patient, this one particular human being, better.
The practicing physician knows only too well the difficulty of such an undertaking.
Real people don't always follow the text books or the latest studies. They don't respond to what "must" be the correct therapy. They don't want to undergo anymore tests. They are impatient to feel better. "What are YOU going to do about this ?" is their implicit (or explicit) response.
The much talked about "evidence-based medicine' in which the results of scientific studies should be the basis of therapy, don't always work either.
Individuals are complex, intricate and confounding amalgams of the physical, emotional and spirtual selves. They seek help, relief from suffering from someone who cares about their problems. The physician who seems unconcerned, distracted, annoyed will hardly win their trust nor will he/she be successful in healing.
An unhappy patient makes an unhappy doctor.
Perhaps other sources for the patient's failure to improve need to be explored. Perhaps there is tremendous emotional / financial / personal stress underlying the patient's complaints. Perhaps this psychosomatic components manifest their unhappiness in terms of physical symptoms.
The patients are not deliberately denying their stresses when it becomes clear that they exist, it is merely a desire not to admit to emotional weakness of any kind. And even when stresses are acknowledged, there is often a denial that the patients physical complaints are in anyway related to it.
There is now the internet explorers who have already diagnosed and treated themselves as well.