The Doctor As Human – Physician William H. Welch
said, Medical education is not completed at the medical school; it is
only begun. With the luxury of hindsight, I realize now that my diploma
for finishing medical school was actually a license to learn. Medical
school, my internship and my residency laid the foundation to begin the
next phase of my medical training, becoming more fully human. Even as
a young medical student, I always knew that I was a human first and a
doctor second and that my patients were human beings first and patients
second. So in my time, I have paid more than a few phone bills for patients
just so they could communicate their needs to my clinic staff. I have
mediated upsets and disagreements between spouses, parents, children and
siblings. And on numerous occasions, I have sat and just listened when
a patient had no friend or family to turn to. And although they rarely
notice or care, in these situations, I usually benefit and learn at least
as much as my patients. Twice each year, I invite all my patients and
their families to gather together at my office and exchange their views
and experiences with one another and with me. As a physician specializing
in oncology, I deliver chemotherapy but I can not possibly feel what a
cancer patient feels. No matter how empathetic I am or how much I want
to understand, I will never know how a female patient feels when she loses
a breast. At these semi-annual gatherings, I am simply a human, the catalyst
that brings them together for mutual support. And in the process, I always
learn something, too.
The Doctor As Healer – It took me awhile in the
day-to-day practice of medicine to realize that cure and heal are not
necessarily synonymous. It dawned on me rather slowly that often healing
happens independently of diagnosis or prognosis. Even as cancer ravages
someone’s physical body, I am often called to help them heal their
life and their relationships, most especially their relationship with
themselves and with the Divine. As a fledgling doctor, I was taught to
think only of healing the physical aspects of the body. As I grew in my
practice, however, I realized that I was missing the major complement
of the mind and that the patient’s mind also needed healing. Most
people think of a doctor as a healer of pain but that is only completely
true if I take into consideration their physical and mental pain. Only
then can I become a true healer.
The Doctor As Teacher – I have never thought of
myself as a “born teacher.” Growing up, I never aspired to
be a teacher nor ever thought of myself as one. Increasingly, however,
with the advent of ever-more complex and complicated technology and ever-more
potent drugs, much of what my patients – and their loved ones -
rely on me for is to be their teacher. The patients turn to me to help
identify and thoroughly evaluate their options to decide which one is
best for them and how to weather the side-effects of the powerful drugs
involved. The patients’ families look to me to learn how to take
care of their loved one who is suffering from this deadly disease and
how to remain resilient and strong for their loved one with death written
on their forehead.
The Doctor As Preacher – Henry Ward Beecher, one
of the nation’s most popular preachers in the mid-1800’s,
said, To array a man’s will against his sickness is the supreme
art of medicine. Here is where the spirituality in my title really takes
root and flourishes. Patients and their loved ones come to me consumed
with fear, guilt and sometimes even anger and resentment. It falls to
me to be their comforter and guide. I never imagined that I would be a
preacher, either, and, in fact, I was never aware that I was a spiritual
person at all. My good friend Dr. Nagarathna, Chief Yoga Therapist and
Chief Medical Officer of Prashanti Kutiram, a 150-bed hospital in Bangalore,
India, recently asked me, Why are you so spiritual? I answered that I
did not know I was spiritual. That all I was doing was what is needed
for my patients. I realize that there is a force above humans and I am
trying to figure out myself how this superior force can help me take care
of my patient’s pain. If that is being spiritual, then, yes, I am
spiritual. And where this will end, I have no idea. Practice makes man
perfect and hopefully I am headed toward perfection. Author Felix Marti-Ibanez
sums it up well, To be a doctor, then, means much more than to dispense
pills or to patch up or repair torn flesh and shattered minds. To be a
doctor is to be an intermediary between man and God.
The Doctor As Artist & Bliss-- Paracelsus was born
in what is now Switzerland the year after Columbus set sail to the New
World. He was a man of medicine and a surgeon who, to the best of our
knowledge, never took a medical degree but learned medicine both from
his physician father and on the battlefield. Back at the beginning of
the sixteenth century, even without the benefit of medical school, he
already knew what I soon came to learn in my own practice. Medicine is
not only a science; it is also an art. It does not consist of compounding
pills and plasters; it deals with the very process of life, which must
be understood before they may be guided. And it was Voltaire who said,
The art of medicine consists in amusing the patient while nature cures
the disease. I have spent my twenty-plus years in practice learning from
life and learning from my patients and incorporating all that I have learned
into my practice. All of my experiences since I was born – what
I have seen, heard, touched and tasted - have made me an artist. And as
an artist, I now have the freedom to integrate and incorporate all my
life experiences into the ultimate expression of who I am. And, like an
artist who as long had in his mind what he wants to produce, at long last
when it is produced, the artist reaches to the ultimate freedom and that
is bliss.
Fifty centuries ago, medicine took root as an art and
flourished as the purview of the wizard, the shaman and the priest. Around
the time of Descartes, the pendulum swung to the opposite pole as the
church relinquished ownership of the body to the scientists while retaining
authority in matters of the spirit. With all the benefit of five thousand
years of experience and trial and error, we know now that medicine is
not either an art or science but rather part art and science. I for one
am grateful that my patients have helped me learn and live that delicate
balance.
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MAHESH
KANOJIA, M.D.
