The Noble Art of Healing
Reprinted from the Indian Journal of Medical Ethics Vol. XI No 3 July-September 2003 with kind permission of the Editor.
Our medical conferences come and go with great regularity all over the country as monsoon departs, and the chill begins to set in. We meet and rightly discuss medicine, socialize, and return to our various corners. But how often during these meetings or at other times do we seriously think about or discuss the ethics-the characteristic spirit of our profession and what it means to be a good doctor?
Ours is designated as a 'noble' profession, if not the noblest. It has been considered so for centuries since the first 'physician' started cleaning the wounds of the sick, helping them with whatever means he had at his command. If that image has been sullied, the blame is entirely ours; though I understand that in these troubled days, it will not be easy to uphold the timeless values of integrity, honesty, caring, etc., when all around us, these have given way to baser instincts.
Nothing really stops an individual from pursuing the noble art of healing in the spirit it was always meant to be. The unshakable credibility he will establish will lead to respect and even adulation from the community in which he professes, a reward uncountable in monetary terms and a source of continuing happiness.
Most of us, if not all, became doctors because of a call that came from within to learn the art of healing the sick, the desire to combat disease and to reduce suffering if healing was not possible. Look back and ask yourself how you began your journey and with what motivation, and find out if this motivation still consumes you.
There are many qualities that make a good doctor, some of which I would like to mention. Care and concern for your patients, compassion, and giving your best effort regardless of the gain are, I believe, the leading qualities. This may not always be easy, as it is not possible to maintain consistency day in and day out, but there are any number of examples of physicians who have exhibited these virtues; you just have to look around to find them. You must, at all times, understand the fears and anxieties of the sick and, as importantly, of their families and make all efforts to assuage them. You must develop immense patience and allow enough time, even in a busy practice, to talk to them and explain honestly and truthfully what you believe is the cause of and treatment for the affliction. Remember, the patient has a right to know; after all, it is his body and, at times, his mind, which he has given in your care. Develop the art of being a good listener. Seek advice and help from colleagues when your expertise runs short, and do not feign knowledge when there is none. However skilled or learned you may become, avoid an intolerant, arrogant attitude of mind, believing that what you do not know is not worth knowing. Realize that you can truly cure only a few, give relief to some, help others to manage their illness and live with it gracefully, and still help others to die with dignity when the time arrives.
Maintain equanimity as much as you can. Be calm and confident in an emergency, whether it be in an operation theater or intensive care unit (ICU) or the roadside. Your calm eases tension in others. Accept your failures and genuine mistakes and learn from them. Nobody can be constantly brilliant or skilled. Even the most renowned surgeon makes mistakes from time to time. Be humble, regardless of how high you rise and how esteemed you become. Do not cheat to get practice, you will defile your noble profession.
Keep up-to-date with your subject, put some time aside daily for study and for reading. Try and learn from everyone. Many professors learn from their students. Add daily to your experience, as experience is a learning process. Simple book knowledge is not enough. I enjoy repeating Cowper's oft-quoted lines:
Knowledge and wisdom, far from being one have oft-times no connection,
Knowledge dwells in heads replete with thoughts of other men,
Wisdom in minds attentive to their own.
Knowledge is proud that he has learned so much,
Wisdom is humble that he knows no more.
Most of you will undoubtedly be busy in your own way, with long hours of attending to your patients, but do enjoy your family life as also ties of friendship, because at life's end, they are a sustaining force. Practice your profession not as a trade but as a vocation, getting rightful pleasure from the art of successful healing and caring. It is said that there are few professions where daily novelty, utility, and charity are combined. We are the fortunate few among millions, toiling for their daily bread, who are being paid to do what we enjoy doing the most.
Those of you who are teachers, share completely your knowledge with your students, for there are only a few greater gifts that a man can give another than the gift of knowledge. Believe me, a good teacher receives much more from his students than what he gives.
Let me end by quoting the great and wise early 20 th century physician and teacher, Dr William Osler who, having exhorted his students about the virtue of idealism in the practice of medicine said:
The choice lies open, the paths are plain before you.
Always seek your own interests, make a high and sacred
calling a sordid business, regard your fellow creatures
as so many tools of the trade, and if your heart's
desire is for riches, they may be yours; but you will
have bartered away the birthright of a noble heritage,
traduced the physician's well-deserved title of the
Friend of Man, and falsified the best traditions of an
ancient and honourable guild. On the other hand, I
have tried to indicate some of the ideals which you
may reasonably cherish.
One cannot say it better than this. I wish you all success, happiness, and enjoyment in your careers. May your earnest toil be rewarded.