In my junior year of college, I had the opportunity to shadow a family doctor for half a week. Sitting in his office one day, looking at his medical school degree, I noticed the degree read “Doctor of the healing arts”, or something similar. At the very least, I remember clearly that it read healing arts – and not medicine.
When people go to the doctor, they generally expect that the doctor will have the answer for their problem. The doctor is the expert, and is the person to go to when you have a medically related problem you need taken care of. For many people, health care is a lot like any other service industry: consumer driven. The fact that the service is on me, rather than on my car, my house, my back deck, computer, etc., only makes it more personal. In the end, I have a problem, I go to the expert, I get it fixed, and I pay the expert. However, just like the service industry, if the service rendered is insufficient, doesn’t fix the problem, or worse still, damage or destroy the item, then we expect some sort of compensation. When that service is being rendered on your body, it becomes a very personal matter indeed when things go wrong.
This week’s case featured a baby girl with a congenital anomaly of her heart. In reality there were two anomalies (it’s hardly unusual, in some medical problems, for bad things to come in twos or threes). One of the anomalies was initially found, surgery was performed, and the doctors (the experts referred to previously) pronounced her cured. But the baby girl remained symptomatic for the next year. The mother fought with the heath care team that initially operated on and treated her daughter, telling them her daughter was not well and being told in return that her daughter was fine and had been fixed, that she was crazy, and when she began pursuing care outside of the first health care team accused of endangering the child. The mother pursued angiography of her daughter’s heart and vessels, which revealed finally the true problem, and next pursued corrective surgery against the wishes of her daughter’s health care team. Surgery was performed in Chicago by a surgeon who had already done several identical procedures that year alone with high success. Today, that daughter is asymptomatic and healthy, and appeared yesterday during our week’s case wrapup meeting with her mother, who answered any questions we might have.
One of the questions asked of the mother was whether any legal action was pursued on the original health care team that operated on her daughter for failure to fix the problem. I was both surprised and glad to hear that her answer was no. The mother’s reason, which had a large part to do with the fact that she worked for University Hospital and understood healthcare, was that her daughter had not been harmed by the first surgery and because failure to find the cause of the problem is not unforgiveable.
I think the mother’s thinking is contrary to what a lot of people think when they think of medical care. For one, medical care is incomparable to fixing a computer or car or house. Items designed by man are obviously fixable since their complete working mechanics are understood (I sure hope my computer doesn’t work solely because some junkie threw together a pile of transistors, capacitors, and circuit boards, but at times I think that may be the case. Anyhow…). The human body, however, is so very complex and to this day still stumps the scientific community with how it works. How then can doctors be expected to know precisely what is going wrong in an unwell body, when we’re not even sure about all the details of a well functioning body? But this is exactly how doctors are treated, and it is not the ignorant who hold this mindset, it is pervasive all the way to the very top of the scholarly circles.
I wonder whether those people who choose to blame the doctor for any failure to get well are merely looking for someone to blame. There are indeed some situations where malpractice suits are warranted; if a doctor blatantly refuses or fails to provide necessary and proven care and injury or harm results as a consequence, then malpractice may indeed be warranted, although every case must be investigated individually. If a doctor does everything within their power to help a patient, and because of countless other factors that are unknown in a time of emergency or at all the patient fails to become well or fails to show improvement, malpractice does more harm than help.
As technology improves, and our understanding of the human body and the myriad disease processes that harm it increase, maybe one day it will be possible to practice medicine in black and white, with problem-solution efficiency. Until then though, if that day even comes, medicine will be practiced almost at all times within the grey, and healing will remain an art form to be learned and practiced to the best of one’s abilities.
