“Hello,” says a pleasant voice on the telephone, “this is (names are left out because of basic courtesy and, also, because what happens next has been happening way too often recently, all over the place).
“Hello,” the pleasant voice over the telephone says, “this is So-and-so from Dr. Such-and-such’s office. The Doctor has received the results of your tests today. He would like to arrange a telephone appointment with you to go over them with you.”
“Thanks,” thus the patient, “but I would prefer a face-to-face meeting. I have major issues with tele-medicine, such as, I don’t believe in it.”
The voice on the other side sighs: “I am going to tell him and will try to have you squeezed into his schedule somehow.”
A professional reply on her part. One must make do with getting crumbs these days.
Of course, the idea defies logic: the medical attendant would spend about the same time on the phone, talking to the patient, as he would, talking to him in his office.
But that is not the issue.
Progress my foot
The issue is that not everything that is new signifies progress. If improvement is what most of us understand the word ‘progress’ to mean.
These days, when a physician enters the cubicle where you had been sitting, waiting for her or him, s/he barely looks at you, perhaps just to say Hi, if at all.
The real situation looks like this: the physician logs in into the computer, and you get to see magnificent display of typing, using all ten fingers. Your medical attendant may even throw a question at you, from time to time, but what s/he is concerned with most are the data on the screen. Results of tests, some less reliable than others, some less necessary than others.
True, a physician looking at a computer screen usually does no harm to the patient, one of the most important pre-conditions of the Hippocratic Oath (first, do no harm), but treating people based on all kinds of tests just does not cut it.
Sir Arthur Conan-Doyle (himself a Doctor, by the way) based his Sherlock Holmes’s ways of detecting crimes on a physician’s methods of investigation. He would observe an internal medicine specialist’s ways, admire them, and then use them: both in his practice, and in his writing.
This is not a rhetorical question: how many of today’s patients have experienced that their Doctor would use what is known as the classical tetrad? This is a system of four steps any physician should follow when opening an investigation of a patient’s symptoms, even if s/he sees the patient the tenth time in a month. Here it is, and classic medicine prescribes it must be always followed in this order: inspection, palpation, percussion, auscultation. Meaning: look, touch, drum (a specialized trick, drumming using fingers on the physician’s hand positioned in the area of suspected illness: it’s the echo the physician is after), and only then comes the stethoscope.
Come to think of it: how many times has your physician listened to the sounds coming out of your body, using a stethoscope? Or even worse: how many times has your physician entered the surgery room, carrying a stethoscope?
How many times did your physician look at you, preferably straight in your eyes, when asking you a question?
Yes, medicine is a science. But only to a degree. It is also art. After all, Hippocrates, also known as the father of medicine, has been often quoted as saying Ars longa, vita brevis. It means that the art will survive longer than life. It has become a major motto for medicine, both ancient and modern, but today’s practitioners seem to have forgotten it. If they ever knew it, that is.
Not to generalize, there may be a physician or two still around who uses such outdated approaches as only jotting down a note or two in quick shorthand, while inspecting the patient, but the majority seem to have spent time learning quick typing instead of bed manners.
In the mist of memories
Long gone are the days when, if the patient was too sick to trudge to his medical attendant’s office, the Doctor would willingly drop by for a home visit. And only oldtimers and those who like novels from two centuries ago will remember such expressions as ‘medicinal brandy.’
This is not pining for good old times, nostalgia for days long gone by. This is a sad realization that way too many physicians must have forgotten the equation: they are here for their patients. It’s not the other way round. They are no more Gods than sundry politicians of all levels, those, who are convinced they ingested Solomon’s excrement. Even our medical attendants put their trousers on one leg at a time.
And no, the current artificial scare is not an excuse. It only added one more wrinkle to physicians’ attitudes and behavioural patterns, the so-called tele-medicine.
The longer the medical profession is blind to this development, the more people are going to rely upon what is known as ‘alternative medicine.’
Why it is called alternative is another of those many strange mysteries: most of the methods used by the sundry healers had existed long before the so-called Western medicine was even conceived.
It would behove the medical profession to realize that they are dealing with human beings, and that they are human beings themselves, too.