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"If medicine continues on its present path and evolves, or I should say devolves, into a business, it will represent the first time since the Hippocratic revolution that those entrusted with the care of the sick and weak are not members of a profession with all the virtues and values this implies. However effective and even equitable the future business of medicine might become, the authentic practice of medicine as a healing art will no longer be possible, since the essence of doctoring is the exercise of compassion in the relief of suffering. As Eric Cassell writes in one of the most important books in the postmodern history of medicine:

Suffering is personal and medicine is a personal profession—one doctor and one patient—each incomplete without the other. All medicine—all care and caregivers, all medical science and technology—rests on that special relationship. . . . Current descriptions of physician and patient as adversaries struggling over a commodity called medical care bear no relation to the actual care of sick persons because of this special connection."[8]

[8] Cassell EJ. The Nature of Suffering and the Goals of Medicine. New York: Oxford University Press; 1991.

GP Notes

Physicians are incomplete without their patients just as teachers are incomplete without their students. Mutual creation is at the core of both relationships. But how many practitioners of either profession understand?

Relate to William Carlos Williams' The Practice (in The Doctor Stories, New Directions, 1962):

All men one way or another use a dialectic of some sort into which they are shut, whether it be an Argentina or a Japan. So each group is maimed. Each is enclosed in a dialectic cloud, incommunicado, and for that we rush into wars . . .

Do we not see that we are inarticulate? That is what defeats us. It is our inability to communicate to another how we are locked within ourselves, unable to say the simplest thing of importance to one another . . . That gives the physician . . . his opportunity. . .

The physician enjoys a wonderful opportunity actually to witness the words being born. Their actual colors and shapes are laid before him carrying their tiny burdens which he is privileged to take into his care with their unspoiled newness. He may see the difficulty with which they have been born and what they are destined to do. No one else is present but the speaker and ourselves, we have been the words' very parents. Nothing is more moving . . .

We have grown used to the range of communication which is likely to reach us. The girl who comes to me breathless, staggering into my office, in her underwear a still breathing infant, asking me to lock her mother out of the room; the man whose mind is gone--all of them finally say the same thing. And then a new meaning begins to intervene. For under that language to which we have been listening all our lives, a new, more profound language, underlying all the dialectics offers itself. It is what they call poetry. That is the final phase . . .

We begin to see that the underlying meaning of all they want to tell us and have always failed to communicate is the poem, the poem which their lives are being lived to realize . . . It is actually there, in the life before us, every minute that we are listening, a rarest element--not in our imaginations but there, there in fact.

-- (pp. 124-125)