Education and the soul of medicine

Excerpt

Surgeon and writer Sherwin Nuland (2010) published a collection of first-person narratives of various medical specialists entitled The Soul of Medicine. Nuland does not explain the title, but the stories illustrate his point. Physicians cannot merely be technicians. They play a diversity of roles: pastor, counselor, advocate, guide but also friend and confidant. Only at the closing page of the book, Nuland concludes that while diagnosis has been much improved, and is faster and more accurate today than ever before, something has been lost. More data, information and perhaps knowledge will enable to categorize patients but what is more important is clinical judgment: what is best for this individual patient? Another medical writer, internist Jeremy Groopman (2007), points out how medicine desperately tries to combine an objective, disease-centered and a subjective patient-centered dimension. Healing requires a mixture of science and soul. Other authors are more explicit. They argue that modern medicine has lost it soul. It has become ‘sick care,’ and does not create health (Botha 2017). It does no longer provide holistic care, focused on the whole person. It is guided by a materialistic and mechanistic ideology that reduces the patient to a complex body machinery. Many patients are therefore dissatisfied and appeal to alternative approaches for a broader vision of health (Accad 2016). The focus of medicine is primarily on treatment and cure, neglecting the wider context of the life story in which illness has emerged (Kuczewski 2007). Furthermore, the context of health care itself bolsters this trend: economic pressures, lack of time for interpersonal communication, fragmentation of care lead to dehumanizing experiences for patients. For example, increasing attention for prevention without a population perspective will only reinforce the individualistic orientation of healthcare, over-emphasizing personal responsibility for health and individual choice, thus violating the soul of public health (Wiley 2016). …