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.