Medicine is normally understood by a majority of laypersons as a science comprising medical and technical aspects of treatment of illnesses. But according to Udwadia, there is an art to medicine – an art based on human values which enrich its source; an art which when combined with science “not only cures, but also heals.”
This book is a compilation of nine essays with the first one titled The Forgotten Art of Healing. This essay attempts to express the essence of the art behind medicine, where the doctor tries to achieve a “sympathetic communication with a patient’s spirit” by taking a good history of the patient for diagnosing the hidden clues to his problem. The art of medicine is in assessing the patient as a whole – the mind and the body but whose true origin is due to a disturbance in the mind. This is due to stress, worry, conflicts and frustrations plaguing modern existence. To fail to realise this is to perpetuate the patient’s problem, by ordering expensive tests that the patient can ill afford and induce him to run from doctor to the doctor.
A good history, a thorough clinical examination and relevant investigations have to be interpreted in the light of the knowledge and the experience of the doctor. A good clinical examination is the mainstay of the doctor’s treatment. A physician needs to be a judge and this comes with knowledge and experience. Today science dehumanises medicine if it is not mixed with large dollops of kindness, sympathy and caring by hearing a patient. “The art of medicine lies in hearing an unspoken subtle nuance in a patient’s history and in the ability to spot and appreciate the significance of one or more subtle physical signs that no gadget or machine can possibly recognise,” says the author.
There is a very interesting chapter on euthanasia (good death) where the author describes it as “assisted suicide” by a patient who expresses his wish to die due to pain or suffering. Here the doctor cites the case of a patient named Anthony Bland who suffered a crush-injury to his chest in the United Kingdom. He showed no signs of improvement or arousal over the next three-and-a-half years. In principle it would have been right to allow Bland to die. But the doctor took four points into consideration – It is absolutely unethical and illegal to take life in the terminal stage; whatever be the physical or mental state of the patient, there is a qualitative inference between killing on intent or on allowing the process of dying to take its natural course; patients who are unconscious, oblivious of their own self, of persons and world around, need protection from further erosion of their integrity by being allowed to die; cessation of treatment and artificial feeding should be considered neither illegal nor unethical. The author holds the view that reverence for life is a principle that should not be contravened.
Medical discoveries have been a fascinating topic for the lay public. In the chapter on ‘Landmarks in Modern Medicine’, the essay deals with the discovery of penicillin, cortisone and the structure of the DNA molecule. The doctor says that observation, single-minded devotion and a spirit of inquiry lay at the heart of these discoveries. Yet there was an element of fortuitousness, an element of chance which made each of these discoveries possible.
In the chapter on ‘Religion and Medicine’, the author tries to show that religion has influenced medicine ever since it came into existence and that religion implies faith, and faith is an important cornerstone of medicine.
Talking of the future of medicine, the author surmises that medical science will battle in the 21st century to discover the secret of our origin and the mystery of our morality. “The 21st century will be the century of biotechnology – genetics, molecular and reproductive biology will dominate research in medicine and strongly influence its practice.” He also talks of genetic science and cloning which would in future help to develop organs for transplants or healthy tissues to replace the diseased ones.
Thus the future of man and medicine rests with man, who should channelise it for the benefit of mankind, subjecting it to ethical and moral constraints. When he does so, a truly brave new world may emerge; if not, then mankind will once again be plunged into “a new Dark Age, made more sinister and perhaps more protracted by the lights of perverted science,” concludes the author.
-MG
(Oxford University Press, YMCA Library Building, Jai Singh Road, New Delhi-110001.)
