Tuesday, June 26, 2012

Ancient Mission – The Art of Medicine

There is a story in every life. There is time, space and a multitude of conversations embedded within. From a medicine's perspective, it could be a crippled limb, a diseased heart, an aging kidney, a ravaged lung or a shrinking brain; all share the common thread of history with a tincture of the spice of life. Every story is a colorful rainbow to be explored. Life, however limits some of the rainbows. Disease comes scampering, nudging and irritating at the doorstep all too often. It is our task as physicians to heal, where possible, comfort where not and above all drown doubt with a clarity of purpose.

"We work in the dark – we do what we can – we give what we have. Our doubt is our passion and our passion is our task " ~ Leo Tolstoy

For disease is not some mysterious wrath of God, or extroversions of internal vagaries of human thought, or the punishment for limitless joy. It is the perversion of a physiologic process, a manifest function of precise circuitry, gone awry.

"Medicine like “(Art) is a discovery and development of elementary principles of nature into beautiful forms…?" ~Frank Lloyd Wright.

Medicine invites passion. It is purity of purpose. It is raw with emotions on both sides of the disease spectrum. It is humanity in suffering. It is a rejoicing in the discovery of new perspectives. These discoveries lead to new principles of patient care for the benefit of all.

“To labor in the (Medicine) arts for any reason other than love is prostitution”. ~ Steven Pressfield  (Substitution mine)

The art of medicine resides in the desire. It is all encompassing. It is a virtuoso experience. Medicine is all consuming. It becomes life. 

"As with other tastes, taste in science will only be found in people with a genuine love of science." ~ W.I.B. Beveridge

The charlatans and the snake oil proponents continue to obfuscate the real medicine. There is a dire need for the pursuit of real science to improve the overall health of medicine and that of its physicians. Failing which, the unintended consequences will overrun the banks of reason. The shores will get muddied and appearances will confound. Only passionate individuals, who are passionate for the survival of this science of humanity will be able to steer the course. 

"Art (of medicine) resides in the quality of doing; process is not magic."~  Charles Eames (Substitution mine)

Medicine invokes such a passion that it becomes life. It is a continuum. It demands, moderates, brings joy and is most rewarding amongst all of human endeavors. The slow methodical plod through time is a gift to humanity. Real science brings real discovery. There is never any magic involved. It is hard work, a daily grind and focus that directs the vision to brighter days for humanity.

"Art (of Medicine) is not a thing – it is a way." ~ Elbert Hubbard (Substitution mine)

Medicine is a composite of give and take. It is two life forms bartering at alter of health. It is the best understanding and knowledge from one and the total reliance of one’s life and a future life of another. The art of medicine denies selfish behavior. The way of medicine is the profound desire to know and the ultimate "want" to heal. 

"Art (of Medicine) enables us to find ourselves and lose ourselves at the same time."~ Thomas Merton (Substitution mine)

In medicine as in any process of nature, there is risk. The risk of uncontrollable disease, the risk of frustration and despondency, the risk of potential harm, the risk of alienation and diminished life itself. The thread of hazard exists entwined into the very fabric of our existence.

"An essential element of any art is risk." ~ Francis Ford Coppola

The art of medicine suffers from a myriad of mystical thoughts. There is an ever bloating, burgeoning cavern of “do this or that” rather than what is best in the wisdom of knowledge. There is a constant state of perversion to the best endeavors that seek only for reasons other than true reason. There are voices that push and pull. There is anger and disdain from passionate self interest groups. There is talk of change in the corridors of power. Yet medicine flows from the soul. It has to transgress these limitations imposed upon it. To survive at its penultimate propensity it must defeat resistance and the confounding entanglements of self-serving interests.

"Art (of Medicine) begins with resistance – at the point where resistance is overcome." ~ Andre Gide (Substitution mine)

The care of a patient is embedded within the shell of his being. Nature, life, history and the world interacting to create the disease all become a continuous composite of the diseased and the infirmed. Disease has an autobiography that must be delved into and understood. Without that autobiography, medical intervention is only a snapshot in time - meaningless. In a single event intervention, the visible shell is cared for and not the history of the illness, which can rear its ugly head again.

"All art (as in medicine) is autobiographical; the pearl is the oyster's autobiography." ~ Frederico Fellini (Substitution mine)

The axiom that holds the truth; the healing art of medicine in its pure form is both joyous and rewarding to the physician and to the patient. No pecuniary amounts will make it any better, but will damage it for the worse.

"Art (like medicine) suffers the moment other people start paying for it." ~ Hugh MacLeod (Substitution mine)

It is in this ring of truth where most have turned up a blind eye. All of modern medicine is in the rigor of power and control. The competing forces, those that wish to do the right and those that wish only for their own self-serving benefits are in a modern day battle to wrest the soul of medicine.

"This is the power of art (of medicine): The power to transcend our own self-interest, our solipsistic zoom-lens on life, and relate to the world and each other with more integrity, more curiosity, more wholeheartedness." ~ Maria Popova  (Substitution mine)

The age-old "carbon-dated" thought holds true, that the power of medicine lies in the well-reasoned, well-researched, well-executed realm of good science and patient's trust. Manipulating good science as well as destroying the trust between the patient and physician with intermediary firewalls of "opportunities" established by "outsiders" and self-serving "insiders" is the slow bleed of the "Destruction of Medicine."

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