I was thinking a lot today about what “the story” of medical school would be about. Many such stories have been written – for some reason, the ‘inside scoop’ on medicine, physicians and medical students fascinates the general public more than lawyers or sanitation workers – and I cannot fathom the reason. Maybe it is because of the scientific shroud we have thrown over what is, in essence, the simplest profession.
I think that if I were to write a book about medical school, it would be about faith, and not science. Everyone (in medicine) has heard the trite aphorism “medicine is an art, not a science”; what art kills hundreds of thousands of people every year? Sounds more like a Spanish Inquisition to me – a veritable war against our own countrymen – with only innocent casualties. There are no “KIAs” in Medicine, no death is excusable or forgivable. And yet everyone dies. A strange art – maybe my story should be titled “the Art of Failure.”
It is shocking to me how arrogant some physicians can be. It takes a special brand of chutzpah to have a measurable ego in the face of all of the unknown, unknowable, unnameable and uncontrollable forces that we engage with every day. Maybe we guard our egos by erecting these pseudoscientific walls and by obscuring and avoiding the limits and lacunae of our own knowledge. Maybe we save ourselves from lawsuits. I don’t know.
We are all faith healers, in one way or another. As physicians, we rely on our faith in ourselves to accomplish difficult and sometimes “impossible” goals. We do what we feel needs to be done, in the best way we can, even if we have never done it before. We rely on our patients’ faith when we ask them to undergo complicated, prolonged or painful therapies. Heck, we rely on their faith because what else would bring them to our doors? Evidence? Science? Hah. As if those things even existed. I don’t know how anyone chooses a doctor based on evidence or science. You, we, I, all choose by faith.
So, then, the story of medicine is keeping the faith. We can all think of physicians who have broken the faith, in ways small or sordid, and the outcry this has caused. No lawyer or sanitation worker will ever feel the wrath of a man’s family in the way that his assassin would. And we can all think of physicians who have gone beyond – by volunteering their time, or their resources or by showing uncommon dedication to support the most common pursuit: life.
Faith is a strong concept and a strong word. What place does faith have in a business plan (outside the state of Utah)? Can you have faith in a robot (not yet) or a drug (even, and especially, if it contains no active ingredients)?
Faith colors every waking second of a physician’s life. It’s time we owned up to it and owned it.