Doctors Taught To Be Humane

“Have you read the reports by Coggeshall, Willard and Millis on medical education?” I asked Lapius while leafing through some excerpts.

“Hogwash,” Lapius said.  He was busy trying to assemble a contraption of sticks and Styrofoam balls.

“What are you doing anyway?” I asked, “Trying to make a mobile design?”

“Not a bad idea, Harry.  After I am finished perhaps we can use it as such.  However, if you would examine this closely, I am trying to make a model of amino acids and hook them together to form a hemoglobin molecule.”

“The room isn’t big enough,” I said.

“Perhaps not.  But I can’t help but be intrigued that the difference between a healthy hemoglobin molecule and one that confers sickle-cell disease is the result of the simple inter-position of two of these amino acids.  Remarkable, isn’t it?”

“Sure is,” I said admiringly.  The different colors made an almost inspiring design.

“Anyway,” I continued, “the new thrust in medical education will be away from science and into behavior patterns.  The idea now is that the new educators have come to believe that the highly academic and specialized training is becoming increasingly irrelevant to medical education and the training of doctors.”

“Hogwash,” Lapius said, rearranging the colored sticks on the frame.

“They want to humanize medicine so that the doctor will see the patient as a whole organism rather than as a collection of symptoms.”

Lapius was busy with his molecules, but it didn’t stop him from expounding. “I’ll never understand the attack on scientific medicine,” he said. “The schools are fooling around with the curriculum, shortening it, abbreviating the college prerequisites, making the combined college and medical school experience six years instead of eight.  All foolishness.”

“They want to turn doctors out faster so there will be enough to go around,” I said.

“Go around what?  The Maypole?  The medical curriculum should be longer not shorter.  The medical student should be thoroughly grounded in the sciences of mathematics and chemistry, statistics, and biology, comparative anatomy, embryology and ethnology.”

“You would forsake the cultural courses?”

“Who said that?  What do you mean by culture?  What is uncultural about science about the history of living matter, about the derivation of the scientific method, about the struggle of man to develop precision in thought?  What do they want to do, create a generation of physicians who will lean on their intuitions, without providing a scientific background as a guideline?”

“That is the trouble with the soft-sciences and the humanities.  Everyone is entitled to come up with his own definition of what Shakespeare said, or a personal definition of the Sermon On The Mount.  Medicine can’t be reduced to the chaos of unsupported personal options.  It must be based on science.  The more the better.”

“But don’t you think that the humanities play a role in making a physician a better humanitarian?”

“Of course, of course.  These are the matters they can take up at night.  Music is available to everybody.  The great literature can be read in bed at night.  But the laboratories of chemistry, physics, the biological sciences – where can the student obtain these facilities except at a college or university? The net result of forsaking the sciences in medicine will be to create a profession as diffuse as nursing.  You can’t teach a person to be humane – that comes from the experience of living.  You can’t wave a magic course in front of a medical student and make him suddenly a humanist.”           

“But don’t you think that the medical profession is over burdened with specialists?”

“Sure it may be.  But that isn’t the fault of the medical curriculum.  That occurred the day the dusty brains in the mold bins of medical training decided to do away with the two year rotating internship where each young doctor had a chance to serve in each of the medical specialties.  Return the rotating internship, and you will suddenly have a highly trained group of young men equipped to bring their well-rounded training into the general practice of medicine. What nerve to foist upon the public the so-called family physician trained more in behaviorist theory and empathy than in science.  The patient expects compassion in his physician, but not at the expense of expertise.”

“If they want an echelon of family practitioners to look in ears and peer in throats, then they should elevate their nursing profession to that level, not lower the standards of medicine.”

“That hemoglobin molecule is getting pretty big,” I observed.

“Don’t worry.  We’ll have enough room for it if we open the doors to the kitchen and bedroom, and perhaps a few windows.”