Medicine sits at the vertex of art and science.
The tremendous success of molecular biology over the last three decades has fueled astonishing growth in Medicine’s scientific elements; often (though not always) this detracts from its more artistic renderings.
For some of us (doctors and patients) this is no doubt a good thing. We want our medicine based in science-it offers an exactness that we covet and a feeling that our actions, based on the best available evidence, are right.
For others, the increasing dominance of science has come at the expense of Medicine’s art. Not from direct competition per se, but more from benign neglect. With so much science and technology to learn about (dare I say master?), it’s not a big surprise that doctors struggle to learn the more artistic aspects of Medicine: compassion, empathy, communication, healing touch, and of course, uncertainty.
These aspects relate to emotion, never a strength in a data-driven culture.
A recent story in the New York Times explored how the field of psychiatry has almost completely shifted away from Freud and talk therapy toward psychopharmacology and efficiency. Upon reading it, I felt a sense of loss over the changes. Progress is never easy; people, places and ideas are inevitably left behind.
The story symbolizes for me that in our workaday world of medicine, there just isn’t much time or space for emotion. We want answers to our medical questions, without expressions of doubt, or at least as few as possible.
Yet emotion and medicine are laden with doubts:
- Will I be OK?
- What disease/condition do I have?
- Can you help me understand and treat this pain?
The term “touchy-feely” is used pejoratively in most of Medicine. I often hear students and residents lament that certain classes or even whole specialties are “too touchy-feely.” This usually occurs with “messy” situations like birth, death, divorce, emotional trauma, substance abuse, mental illness, and chronic pain.
Problems like these don’t confine themselves to pat diagnoses or straightforward therapies. Nor do they get “solved,” if at all, in single episodes. Clinicians in broad fields like Family Medicine, Psychiatry, and both general Pediatrics and Internal Medicine contend with these types of issues on a daily basis.
It’s not a surprise that in a world valuing technology and clear answers over emotion, students choose fields that offer the promise of discrete and solvable problems.
“Touchy feely” may not be valued by those in medical training, but good doctoring requires it.