Doctors Taught To Be Humane
Daily Observer
“Have
you read the reports by Coggeshall, Willard and
Millis on medical education?” I asked Lapius while
leafing through some excerpts.
“Hogwash,”
Lapius said.
He was busy trying to assemble a contraption of sticks and Styrofoam
balls.
“What
are you doing anyway?” I asked, “Trying to make a mobile design?”
“Not
a bad idea, Harry. After I am finished
perhaps we can use it as such. However,
if you would examine this closely, I am trying to make a model of amino acids
and hook them together to form a hemoglobin molecule.”
“The
room isn’t big enough,” I said.
“Perhaps not. But I
can’t help but be intrigued that the difference between a healthy hemoglobin
molecule and one that confers sickle-cell disease is the result of the simple
inter-position of two of these amino acids.
Remarkable, isn’t it?”
“Sure
is,” I said admiringly. The different
colors made an almost inspiring design.
“Anyway,”
I continued, “the new thrust in medical education will be away from science and
into behavior patterns. The idea now is
that the new educators have come to believe that the highly academic and
specialized training is becoming increasingly irrelevant to medical education
and the training of doctors.”
“Hogwash,”
Lapius said, rearranging the colored sticks on the frame.
“They
want to humanize medicine so that the doctor will see the patient as a whole
organism rather than as a collection of symptoms.”
Lapius was busy with his molecules, but it didn’t stop him
from expounding.
“I’ll
never understand the attack on scientific medicine,” he said.
“The
schools are fooling around with the curriculum, shortening it, abbreviating the
college prerequisites, making the combined college and medical school
experience six years instead of eight. All foolishness.”
“They
want to turn doctors out faster so there will be enough to go around,” I said.
“Go
around what? The
Maypole? The medical curriculum
should be longer not shorter. The
medical student should be thoroughly grounded in the sciences of mathematics
and chemistry, statistics, and biology, comparative anatomy, embryology and
ethnology.”
“You
would forsake the cultural courses?”
“Who
said that? What do you mean by
culture? What is uncultural
about science about the history of living matter, about the derivation of the
scientific method, about the struggle of man to develop precision in
thought? What do they want to do, create
a generation of physicians who will lean on their intuitions, without providing
a scientific background as a guideline?”
“That
is the trouble with the soft-sciences and the humanities. Everyone is entitled to come up with his own
definition of what Shakespeare said, or a personal definition of the sermon on the mount.
Medicine can’t be reduced to the chaos of unsupported personal options. It must be based on science. The more the better.”
“But
don’t you think that the humanities play a role in making a physician a better
humanitarian?”
“Of course, of course.
These are the matters they can take up at night. Music is available to everybody. The great literature can be read in bed at
night. But the
laboratories of chemistry, physics, the biological sciences – where can the
student obtain these facilities except in college?”
“The
net result of forsaking the sciences in medicine will be to create a profession
as diffuse as nursing. You can’t teach a
person to be humane – that comes from the experience of living. You can’t wave a magic course in front of a
medical student and make him suddenly a humanist.”
“But
don’t you think that the medical profession is over burdened with specialists?”
“Sure
it may be. But that isn’t the fault of
the medical curriculum. That occurred
the day the dusty brains in the mold bins of medical training decided to do
away with the two year rotating internship where each young doctor had a chance
to serve in each of the medical specialties.
Return the rotating internship, and you will suddenly have a highly
trained group of young men equipped to bring their well-rounded training into
the general practice of medicine.”
“What
nerve to foist upon the public the so-called family physician trained more in
behaviorist theory and empathy than in science. The patient expects compassion in his
physician, but not at the expense of expertise.”
“If
they want an echelon of family practitioners to look in ears and peer in
throats, then they should elevate their nursing profession to that level, not
lower the standards of medicine.”
“That
hemoglobin molecule is getting pretty big,” I observed.
“Don’t
worry. We’ll have enough room for it if
we open the doors to the kitchen and bedroom, and perhaps a few windows.”