The art and science of medicine
The recent incident of Iggy Agbayani’s incarceration and death has triggered a rethinking of the patientdoctor relationship. From a doctor’s standpoint, one might ask if all the time and sacrifices made to be one is worth it if a patient will go tooth and nail after your scalp for the slightest complication or unforeseen developments in the course of an illness.
The prevailing thought fostered by social media is for everything to be perfect, or so that’s what social media influencers make us want to think and therefore, expect. These expectations spill over into all aspects of life, including health. People might be of the mindset that if you go see a doctor, he/she will mend you to perfect health in due course.
Medicine is a two-way process. The doctor may have the knowledge and skills to treat a sick person, but that is not all there is to medicine. Modern science has made medicine a more scientific discipline compared to a few decades ago, let alone the past two centuries. Research is continually producing advances not possible just years ago. In the process, some of the methods and treatments that were applied before are now deemed outdated, even dangerous, based on recent studies.
In other words, medicine is not a pure science. When dealing with biological processes as in humans, there are variables that may produce a different outcome in one person, when treated the same way as other persons who experience the desired results.
Genetics plays a big role in our health. There are families where cancer runs through the generations. Genetics also determine our responses to drugs, even vaccines. Clinical trials determine if a drug or vaccine will be efficacious and safe in the vast majority of the population. Unfortunately, it also uncovers serious side effects in a few persons who, because of their genetic makeup, will respond adversely to drugs/ vaccines. There is no perfect drug or vaccine, but if we can demonstrate the safety and efficacy of a drug in 99.99999 percent of the population, this drug is deemed effective and can be marketed.
It is not possible to test everyone’s genetics to determine one’s response to treatments. Even if it were, it will be prohibitive and beyond health economics. Thus, the health system is bound to monitor side effects and complications of drugs and treatments, and to compensate those who were adversely affected, based on certain established criteria.
That is one of the variables in health care. Another is the role that patients play in their own health maintenance and healing when sick. What to expect of patients? That they adhere to the regimen of medication, diet, and exercise, and refrain from harmful habits as smoking, and excessive alcohol intake. It is important to emphasize that the damage caused by long standing and untreated diseases may no longer be amenable to cure or restoration of healthy organ functions. It is thus unreasonable to expect the doctor to cure the permanent damage done by smoking to the lungs or by alcohol to the liver.
Doctors can prescribe the most effective medicine and therapies but compliance with the treatment regimen is in the hands of the patient. If you miss taking your medicine, then try to make up for it by taking several tablets at once, it doesn’t make up for the missed dose, but rather, you will risk being overdosed and suffer the consequences, sometimes fatally.
Therein lies the art of medicine, in that doctors need to be sympathetic with the patient and make him/her a willing partner in the journey to healing. A doctor who has compassion, concern, and empathy will have better chances of healing the patient than one who is gruff, cold and clinical. Patients will also be more likely to follow the orders of a congenial and compassionate doctor and less likely to blame him/ her for any untoward developments which may occur in the course of the treatment.
Like it or not, doctors are only human and may make mistakes. Thus, charges of malpractice are made. But rest assured no doctor worth his Hippocratic oath sets out to do harm to a patient intentionally. Other mishaps occur in the hospital setting, where there are multiple players (nurses, attendants, midwives) who may commit an error. The “captain of the ship” principle is often applied, but in reality, the doctor does not have control over these hospital employees. Many times, to avoid prolonged litigation, expenses and waste of time, doctors settle out of court, even if they committed no wrong.
Malpractice suits are usually civil cases for damages and recovery of expenses for unintentional harm during the course of treatment. However, in Iggy’s case, a criminal case was also filed, which implies intent to harm. Now, there is no way a case like that should prosper, but it did. And doctors really feel a chill in their bones.
Doctors can prescribe the most effective medicine and therapies but compliance with the treatment regimen is in the hands of the patient.