“I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”
– Louis Lasagna, 1964, Modern version of the Hippocratic Oath
Compared to medicine as was practiced in the era of Ancient Greece, modern medicine is far more advanced as a science, thanks to millennia of groundbreaking discoveries in biology, chemistry and other fields. Yet, if an emphasis on the fact that medicine is just as much an art as it is a science was already worth making back then in what is undoubtedly the most renown oath taken by physicians even to this day, then it is all the more important to take heed of this piece of wisdom in our present era. The astounding scientific achievements of modern medicine have, beneath all the wonderful marvels they’ve brought us, caused people to see it, I believe to its detriment, as nothing much more than, if nothing other than, a science.
Physicians-in-training spend their time almost entirely on learning and practicing the prevention, diagnosis and treatment of physiological diseases, and for good reason; given the unimaginable complexity of biological organisms, it’s hard to see how else one can become a master of the medical craft. Yet, it isn’t sufficient. No matter how well you understand the sciences, no matter how effective you are in your dealing with diseases, there come times where physiological health dissociates from happiness and dignity, where your scientific knowledge alone will provide you with no help whatsoever in your mission to champion your patients’ well-being. I say well-being, because ultimately, it is well-being that constitutes the true core of the physician’s vocation: to do whatever in your knowledge and power to help your patients live good lives, lives that can very much still be good even in the face of incurable disease and inevitable death, lives that are still worth fighting for even when science has exhausted all of its wonders.
My hospice experience has made that as clear as daylight. Living out the last stretch of their time on Earth, hospice patients are in this rather unusual situation where continued medical treatment and life prolongation could significantly worsen their well-being, and for no greater good at all. It’s a situation in the face of which a physician could easily feel lost, for what is he to do, if not what he spent his entire education on? Truly, in such cases, the best recourse in the interest of the patient would be to take a step back, lay down your usual tools, silence your obsessive need to solve every problem, and bring out your most humane persona to make sure that, given the circumstances, your patient is given as much ease and help as possible to carry out the rest of his life true to his desires and values.
Interacting with hospice patients has shown me how, sometimes, there’s simply nothing you can do to change the circumstances, no way to solve a problem we’d all wish away if we could. But that is no excuse to be discouraged; it is rather an opportunity to bring out the art in medicine, to employ a maximal amount of caring and compassion for a seemingly minimal contribution that in fact could mean the world to someone. To step away from the selfishness of one’s desire to help, and to focus solely on others and their well-being. To realize that less sometimes really is more, and that truly, for me, medicine simply wouldn’t be worth it if it wasn’t for what lies beyond the sciences.