THE ART OF MEDICINE & The Conundrum for Scientists

My personal journey which led me to become a physician was rather atypical.  In fact rather than follow the traditional pre-med path, I completed  my undergraduate years at Franklin and Marshall College in Lancaster, Pa. with a BA in Religious Studies.  Of course I did have to play “catch up” in order to fullfill the basic sciences, plus calculus (ugh).

I did not emerge from the womb with an inborn desire to become a doctor. I had no doctors in my family and the concept of being a doctor for some sort of prestige or money was far from my consciousness.  Although I was always curious about the world worked (including biological processes) it was the threat of being drafted into the war in Viet Nam which led me to quickly choose a career move into medicine.  Fortunately I was a compulsive enough student to make it through the process and find my way into Albert Einstein College of Medicine.

Fortunately it is a path I have never regretted. 

 Most of my fellow students were hard-core science people—chemistry, biology, physics.  Because of its rather progressive nature I did encounter several other humanities majors at Einstein.  We all were concerned that we might struggle with the process.  We didn’t. 

In fact if I have learned anything during my 33 years of clinical practice in medicine it is the following—medicine is much more an art than a science.  This is not to disparage the necessity to be scientifically literate when it comes to progress and advances in medicine.  It remains the core and basis of everything we do.  But what I am referring to is the healing relationship that occurs between  patient and doctor. 

I find that it is my ability of “read” what is truly disturbing my patients–the complexity of their emotional, spiritual  and physical condition and how these factors interact—that allows me to escort them along the path to healing.  I must engage that particular individual as just that–a unique human being who brings to the examination room their specific mix of mind, body and spiritual issues.  The ability to discern their particular condition and work with them to alleviate their suffering is difficult and at times frustrating for us both.  But I offer my plegde to do everything in my power to accomplish that end. 

What I have come to understand is that this is not a scientific endeavor at all.  There is no mathematical formula or algorithm to accomplish this.  Patients are indivdiuals who often do not respond to treatments the way they “should”.  They have their own particular biases towards certain therapies which I must acknowledge.  They have side effects that they should not have, yet do.  They may even surprise us both at their improvement.  We are both disappointed when healing doesn’t happen.

I fear that some of my more scientifically oriented colleagues become frustrated when this occurs.  They became doctors to do science.  They had no clue how nebulous and unscientific their dealings with their patients actually is. Perhaps the English major who explores the  emotional, intellectual and physical complexity of the characters from literature might be better equipped to interpret what is going on with their patients. But of course this English major would have to know science very well.

 Perhaps it is no coincidence that the deductive reasoning of Sherlock Holmes and the scientific knowledge of Dr Watson offer a useful paradigm for the practice of clinical medicine.

At any rate I continue to call upon all my resources when dealing with any individual human being. 

It is certainly a challenge but one I embrace.

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