Physicians Must Respect Life
Simon Quentin Lapius nibbled tentatively on the endive. “I know of no dressing that quite conquers the bitterness of endive,” he said. “Anyway Harry, with respect to your question so vulgarly stated, ‘Where’s it at with medicine?’ Am I supposed to answer that between mouthfuls of salad? It’s rather broad you know. But I think it starts with a reverence for life. Lord C.P. Snow returned to that theme recently. I quote:
‘I believe that we have to act as if each individual life was significant.’
“You remember of course that driving force in the life of Schweitzer was ‘reverence for life.’ All the turmoil of his feelings during the war and at the start of his self imposed exile were finally crystallized in the phrase ‘reverence for life’, without which no physician can function.”
I remember reading about Snow’s statements at a recent dedication of the new 188 bed wing of St. Barnabas Hospital for Chronic Diseases in New York.
“Snow expanded on this theme. He said that:
‘In many conditions, most of all in those when one is face to face with mortality, there is no substitute for one good doctor.’
“Snow went on to say that a doctor with empathy can do more for a patient than anything medicine can do. Of course there are those who would argue with this. But there is no substitute for empathy, sympathy, a small degree of identification with the feeling of one patient. Snow felt this couldn’t be taught, and I would agree. But Snow felt that a literary thread should be introduced to the medical education.”
“How do you feel about that, Dr. Lapius?” He finished his morsel of salad and poked at a drop of oil that slithered down his chin. This gave him time to think.
“I don’t quite agree. I think that qualities such as empathy and feeling for fellow man cannot be taught, but somehow result from personal experience, which include personal loss, the pain of aging, disease, anxiety. In other words, experience. Show me a doctor who has been a patient and I will show you a kind and friendly doctor who will be concerned with his patient as a person.”
“You think that is most important?”
“No.” Lapius had become distracted by a slightly overdone chopped sirloin, and was appraising it carefully before tasting it.
“What do you mean no? After the long speech about empathy.”
“No! First he has got to know what the heck he is doing. He must be a trained doctor. There is no substitute for that. We can’t turn incompetent nurse-maids loose on the public. But if after a doctor has achieved his competence, if he develops some motherly instincts, all the better. He must rage to protect the health, dignity, and comfort of his patients, but must also be able to inflict painful procedures if necessary. He must achieve a sense of balance so that the risks he imposes on his patients balance the risk of no treatment at all. It’s judgment my boy. C.P. Snow had to live a lifetime to come to his value judgments. Each of us in areas of serious responsibility must reach maturity by the same painful process. It can be indicated as a goal, but it can’t be taught. Pass the rolls please.” He chewed for a moment, then suddenly blurted out an angry stream of indecipherable syllables each surrounded by specks of food.
“What was that you said?” I asked. “I didn’t catch all of it.”
He dabbed at his chin carefully, then swallowed the bolus of food. “I said, Harry, that Snow would like to introduce mere art into the medical curriculum, but there’s scarcely enough time for the science, to say nothing of literature, music, philosophy and the like. And now there’s talk of doing away with the premedical college years, and shortening the medical curriculum. Phooey.”
“That wasn’t what you said, when you talking with your mouth full. Come on, Simon. Out with it.”
“I said the last thing we need in medicine is a Snow job.” He looked sheepish, because he hated to be caught in a bad pun.