Laura Burkimsher: The art of medicine

laura_burkishmer“The art of medicine consists of amusing the patient while nature cures the disease.” — Voltaire

This was the opening sentence of my personal statement for my application to medical school. At the time it fitted the brief of being catchy and unique for my application and it appealed to my sense of the “treating the person” type of medicine I thought I’d be practising.

I didn’t think about this quote again until I was doing my F1 Palliative Care rotation. Nature didn’t seem to be doing a very good job at healing the disease. Yet the hospice staff excelled at “amusing” the patient. I don’t mean they were cracking jokes or prancing around in silly costumes (although they did sometimes), but they were treating the person psychologically and spiritually to ease the suffering whilst the disease eventually defeated nature.

When I did my medical on calls I thought that the idea had finally come unstuck—nature wasn’t healing the patient, the cardiology registrar administering adrenaline and the anaesthetist providing oxygen were.

But maybe nature has to exist and be functioning for these interventions to work. Maybe this was the science of medicine, but the art of medicine was the dignity the patient was shown even as multiple repetitions of CPR were performed, the holding of the patient’s hand as they reverted to sinus rhythm and started gasping for breath, the soothing words as what had happened was gently explained, the clear supportive advice given for lifestyle changes and new medications to prevent it happening again.

If that was the opening line of my medical career then there is no surprise that in the middle acts I have become a GP. I can think of no other medical arena where we literally amuse the patient whilst nature heals the disease. How often we reassure patients and ask them to come back if the symptoms haven’t resolved (they rarely come back).

“Amusing” comes in many forms in general practice. I learnt early on that patients like to leave the room with something, maybe a validation of their presentation, so they leave with patient information leaflets, phone numbers for counsellors or directions to the nearest leisure centre. Sometimes patients don’t feel “amused” when I advise doing nothing for their sore throat whilst nature heals the disease. This is the art of medicine as well as the science.

Of course there is more to our job than offering a soothing word or a funny quip but remembering this quote always brings me back to the humanity in what we do: however fancy our drugs or techniques, the patient is always the focus of what we do and how we treat them as people is the art of our profession.

Laura Burkimsher is a general practitioner. 

Competing interests: none declared.