The Genie in the Syringe

Throughout the Christmas season, pantomime performances are one of the UK’s most favoured traditions. The pantomime has a long history with a genesis in Ancient Greek times. In our modern era, pantomimes are often adapted to feature contemporary twists and understandings about the unique and special meanings which have structured certain folk tales with a strength to survive the centuries.

In parallel, modern medicine has its roots in Ancient Greece and has seen many transitions and contemporary adaptations in the knowledge we possess about the human body.

Separated by worlds of fantasy and of reality, I have been struck by how the fables of pantomimes and the facts of medicine collide much closely than one would initially imagine.

“Aladdin” and “Ali Baba and the Forty Thieves” are some of the most famous tales taken from the “Book of One Thousand and One Arabian Nights”. Both of these are underpinned by the magic of transformation. The human body is suddenly enabled to perform the impossible and change the fate of our earthly physical determinants. Magic is also used in reverse to cast illnesses.

In Arabic folklore, the powers of changing fate and the body are called “djinn”, or the infamous “genie” in “Aladdin”. These are narratives reflecting some of the basic teachings in Islamic philosophy about our human condition. Djinns or genies, humans and angels are the three sentient creations of Allah. Like humans, djinns can be good or evil. In medicine, health is good and disease is the invasion of evil djinns.

The divide between creation and destruction, fate and transformation and good and evil is a common theme structuring the opposing worlds of fantasy and reality, pantomime and medicine. Modern medicine, however, does make me wonder. If medicine was not real, what would it be?

Another famous pantomime story is “Sleeping Beauty”, originating from the 16th century. During this story, a princess is felled to sleep for hundreds of years and then awakened with the touch of another human being. Is this so different to modern medical metaphors? It is a practice in intensive care units to induce a coma and then to return consciousness to a patient.

Medicine is writing its own pantomime with fantasy of restoring life to a person through transforming the sick to the healthy.

There are many interventions akin to Aladdin’s lamp, hence the title of this blog “The Genie in the Syringe”. We insert substances, produce images from radio and sonar waves, manipulate the causal relationship between molecular processes to produce a transformation and create our own audiences in the operating theatre to the inner secrets of the body’s anatomy.

Medicine is a central character in our personal narration, sometimes featuring as a tragedy and at other times, as a miracle. As the meanings of folktales have changed over the centuries and changed from representing an integral part of life to forming entertainment, I wonder how the meaning of medicine will be perceived in future years. Medicine is already showing us performances between the doctor and patient that would have been beyond the imagination of the writers of “Aladdin” or “Sleeping Beauty” in the same way as their relevance exists in a different domain to the place from where it was written.

Thus, as the fantasy and reality of medicine grows in an evermore interweaved nature, it will be increasingly important to ground the roots of medicine’s own narrative in the stories that have stemmed from our curiosity and wonder about our own existence; how much we can change and how much is subject to an inevitable fate is the rule guiding the possible versus the impossible in medicine’s fight between good and evil, health and disease.