I’ve thought about starting a blog so many times in the past and even got so far as picking (and purchasing) a domain name once : I Art Medicine. The idea was that I was going to share both my left brain (the physician part) and my right brain (the wanna-be artist part). Ultimately, I decided that it was too complex a concept to simply be relegated to a blog title, unexplained. It needed to be explored and discussed and understood.
The Basilica de la Sagrada Familia, Barcelona. One of Antonio Gaudi’s most famous works, and which is an extraordinary example of art and science intersecting.
“The Art of Medicine” is a phrase and a concept that has provided the framework of clinical medicine for decades. It is the concept that medicine is a craft of both science and artistry. Healing involves both knowing the science (the anatomy, the physiology, the chemistry, the pharmacology, the pathology) and knowing how to apply it to a specific patient (a child, a newborn, an octogenarian, a woman, a man, a widow, a cancer-survivor, an athlete…). It’s this duality that uniquely defines our profession. This is why googling a medical question and accepting the top result as the answer isn’t medicine. It never will be. It will never be a substitute for the patient-physician relationship. This is why medical school is constructed the way that it is with only the first two years in classroom settings and the remainder of training (yes two additional years of medical school but many more years in residency and fellowship training) spent in clinical practice. The emphasis is to apply the science, to PRACTICE medicine, to strengthen the connections between the left brain and right brain, so to speak.
After 17 years of ‘practicing’ medicine, I’ve become so much more adept at recognizing the art in each patient encounter. I am so much more appreciative of each patient as a unique person– someone’s mother or a grieving son or a single-parent of twins or the family earner recently laid-off. Telling someone they now have a diagnosis of diabetes and need insulin has a far different meaning to a truck-driver who may lose his Commercial Driver’s License than to a newlywed who has plans to try and conceive.
The art part of medicine takes time, time that is slowly vanishing from each patient encounter. The art of medicine involves talking to the patient, understanding the patient and knowing the patient well enough to use the scientific evidence to make an artful, professional, sound recommendation; it involves showing compassion, interest, and understanding; it involves defining a partnership between the physician and the patient to achieve whatever health goals need to be addressed. Unfortunately, as the business side of medicine grows, the art side of medicine suffers. I feel it. My colleagues feel it. Our patients feel it. Medicine used to be the duality of science and artistry. Now it is becoming the trilogy of science, artistry, and business. We all want better. We all need better. Physicians want to be able to give more. Patients deserve more. And while the debate about how the future landscape of healthcare delivery in this country should be painted, what I hope we all remember is that the real art is between the patient and the physician. The unobstructed relationship between a patient and a physician is where the true art of medicine is found.
So in the meantime, we, in medicine, try to do the best that we can, for as many people as we can, with what we have, as gracefully and as artfully as possible. And if there’s time, I also paint 😊.
The Taj Mahal. Watercolor. A gift for a friend ☺️