Here is my favorite definition of medicine: the science and art dealing with the maintenance of health and the prevention, alleviation, or cure of disease. I like that it includes both science, which strives for repeatable data and results, and art, which is less tangible or predictable but which adds “soul” to science.
While we don’t know about healing practices before recorded history, archaeologists have found evidence that healers had some kinds of handheld tools, apparently giving access to the inside of the body by cutting. There are also findings of what appear to be needles, perhaps to close wounds. Our remote ancestors undoubtedly learned what herbs and fungi had healing properties, and acquired knowledge of dose amounts. With all these tools and plants, I bet that these ancient healers were at their best when they earned the trust of those whose ailments they tried to cure.
Today, we live in a world in which technology is developing new tools such as devices and software with breathtaking speed. Some of the tools, such as systems for robotic surgery, are about the size of the buffalos seen in cave paintings, or imaging equipment akin in mass to a small dinosaur. Yet we’re moving in the right direction, because often the bigger the tool, the more precise and less invasive its application.
We’ve probably all seen science fiction programs or movies in which medical detection, diagnosis and intervention occurs with a hand-held gadget not much bigger than a primitive flint knife. Such a gadget seems to generate an energy field that can be adjusted to suit the purpose of the healer. I don’t expect such equipment to come into existence in my lifetime. However, I’m seeing a major trend in medical practice as we move away from the large wounds that result from exploratory surgery (for diagnosis) and major surgery (for alleviation or cure). Even though the latest devices may require an entire room, rather than a hand, to hold them, they are stepping stones that bring us closer than ever to achieving our visions of healing patients without harming them. In fact, small portable devices are being created that can direct pure energy, such as laser light, for curative purposes.
So where does the art come in? I believe it lies in the ability to see beyond the symptom and the disease, and to connect compassionately with each patient. There is no imaging technology or tool that can substitute for trying to understand the fears, concerns and hopes of each patient; that can guarantee a doctor can rejoice with the patient and family as healing progress is made; or that can “detect and diagnose” a genuinely humorous moment over which doctor and patient can share a laugh.
I feel lucky to live in a time when the science aspect of my practice with prostate cancer patients is aided by my access to imaging breakthroughs like 3T multiparametric MRI, and to curative innovations such as focal laser ablation. As for the art, I believe my patients are my teachers when it comes to the human quality of connection that no machine, however large or small, will ever allow one heart to open to another.