The Enigma of Medicine

 

by Dr. Mike Ellis

 
 

It may be true as Gary Zukav said in Seat of The Soul…. That we are more than purely animals with five senses. We have at our core, he says, 'multi-sensors'. It is the multi-sensory perception which artistic pursuit cultivates in us, opening the door to a wider vision of life and existence.

Art enables us to explore the deeper hidden aspects of our minds.

This inner exploration gives deeper meaning to the nature of our own existence as well as the existence of our patients.

There is an enormous connection between theatre and drama, poetry and music in the sense of awe and order which we perceive in everything around us.

This kind of realization often occurs when we are relaxed or in beautiful surroundings. A lot of people often have these experiences of epiphany in their lives, where it seems that during that moment of breathlessness or inspiration time stands still.

This may occur for us when we become deeply involved in empathic communication with a patient or when we are talking to a close friend.

Music, literature, fine arts and performance all tend to express the enigma of the human condition.

Perhaps this is what is missing in our practice of medicine nowadays. Recent reports by the Medical Board of Victoria show that a lot of doctors are so extremely stressed that they are yelling and screaming at their patients. They are not able to cope with the rapid through-put of patients and cannot create rapport or even understand what is going on in their patients' lives.

The Journal of the Royal College of Physicians has recently emphasized the need for doctors to have an education in the arts and humanities as well as medical science, which is becoming more and more a technology and losing its human appeal.

'Medical humanities' now denotes a growing area of engagement and exchange between the humanities and medicine covering:
· use of the arts in therapy and human comforting - painting, poetry, music and creative writing
· the arts as foci for meditative appreciation, decorative enjoyment and environmental improvement in an otherwise uninteresting - sometimes bleak - health services environment
· the value of the arts in health promotion, as forms of artistic and communicative display which can embody welfare messages relevant to the health of the public
REF The contribution of the arts and humanities to interdisciplinary research and teaching in health care. Medicine, the arts and humanities Brian Hurwitz Clin Med 2003;3:497-8

The way the system is structured in hospitals is such that people become secondary to the process. Is this why there is such a high rate of iatrogenic and doctor-caused illness in hospitals, An estimated 80,000 people are admitted to hospital each year as a result of being given the wrong medication or incorrect doses. This costs the health system $350 million.( Dr David Brand, co-chair of the Medication Safety Taskforce) Daily Telegraph (Australia), 3rd November 2001, p.3. Sixteen per cent of patients who enter hospitals come out with increased morbidity, as a result of iatrogenic illness (Australian Medical Journal).
In America, you are three times more likely to be killed by a doctor than by homicide.

We have all seen the drama and frenetic activity of emergency wards on television, and indeed television drama does appear to highlight the degree of stress that doctors go through.

Recent reports have highlighted the high incidence of depression, mental illness and suicide in doctors. This must be because, as doctors, we are forgetting the humanity, the art and the enigma that is inherent within the practice of medicine.

It has indeed often been said that medicine is a combination of art and science.

Technology, double blind trials and computerization in medicine are leading us away from the prime focus of primary medical care, which is the doctor - patient relationship.

There is an art in observing the human condition as it flows and moves through birth, illness, old age and death.

Our society has no rituals to adequately express the profound meaning of life apart from artistic expression. It is a well-known fact that attendance at churches is falling and wide-spread sexual abuse of children in the church's care has probably led to people loosing their grip on the conventional sense of church ritual

I believe we have also lost the art of medicine. Doctors have a tremendous capacity for service and care for their patients and precision in diagnosis, However the time restraints of a busy general practice, threats of litigation and the consumer mentality of patients requiring a quick fix, prevent the development of greater empathy and intuition in the practice of medicine.

What would happen if doctors became artists or even artistic? We are as doctors in a unique position to observe the human condition in every conceivable aspect. In this respect we have a profession that gives us an opportunity to observe and influence from, some may say, a position of power. How do we use this power wisely?

We all know the story of the patient with the galloping heart. When the consultant was on a ward round in a teaching hospital with his medical students, he pointed out to his following that this lady had a galloping heart. He said this with interest and passion. The patient thought this was an indication that she was getting better. And indeed, the next day she had recovered so much that she was discharged. Of course, a galloping heart is indeed a disturbance of cardiac rhythm and is in fact an abnormal heartbeat. The positive attitude and intention towards healing of the patient has a tremendous effect on the prognosis of an illness. The power that the patient has in belief and faith in the curative process also creates healing

We are, as doctors, agents of change, transformation and healing.

It was Michael Balint who founded the Balint Seminars, which enables doctors through a group process to try and understand the motivations of their patients' behaviour and the psycho-dynamic cause of illness, who coined the phrase that the doctor is the prime therapeutic agent.

We all know that in quantum physics the observer influences the event which we observe.When we look at a great work of art we will always see the human being portrayed as the summation embodying all that is in the artist`s expression

Leonardo DaVinci's drawing studies of old age gave dignity to the process of aging, with for example the form of gnarled fingers and the beauty of the face of the old man.

Balzac, in his Comedie Humane, expresses in this novel the utter diversity of human expression, thought and emotion, as people weave their lives through his intricate narrative.

Michelangelo, portrays the cross section of the brain painted on the ceiling of the Cistine Chapel where gods hand is reaching out to the hand of adam.


The figure of God is on the areas of the cortex that mirror the head arms torso and legs. The cross section is especially apt as the medulla, pons and pituitary represent the basic instinctive tendencies of Human Beings . However the cross section also delineates the limbic system which is the oval on the diagram between the sulcus and the pons. This is the basic transformation point integrating the instincts with the higher levels of consciousness. the limbic system modulates feelings and emotions through the hippocampus and the amygdala and then the higher sensory and expressive functions occur in the neocortex especially the frontal lobes of the brain.The painting is saying that Human beings are God like and is pointing to the powerful source of higher creativity, love . compassion and expression of perfection in the hardware of the brain.

It is an astounding revelation , The hand of God -the creative imagination of the cosmos from within the deepest depths of the brain reaching out in love to the true form of perfection the embodied truth of the Human Being---Adam also representing the Human form incarnate on Earth.

Indeed the role of the true culture and art and healing is not only to ennoble the human condition, but also to give some meaning to the enigma of life.

---------------------------------------------------------------