Monday, March 2, 2015

practicing medicine

Yesterday, on my favorite mainstream TV program, "Frontline," I watched a segment entitled "Being Mortal." I don't recommend it to anyone not planning to die and, come to think of it, I don't recommend it to anyone who does.

Oflate, dying is one of those au courant topics about which everyone from smarmy help freaks to scalpel-wielding doctors can offer sage and caring counsel in an effort to ameliorate whatever it is that needs to be ameliorated ... and it still doesn't work... or maybe it does; I don't know. I do know that "no one is getting out of here alive."

Anyway, I don't make a habit of reading yet another article or viewing yet another video about an au courant topic that is oh-so-au-courant. I guess I watched this one because I was short of mind candy and it was, after all, "Frontline."

The show was, by turns, touching and tender and full of tears. There was some interesting stuff and not the least interesting was the pickle physicians are put in... a pickle I have had a hard time trying to convey to the various doctors I see: It's nice to fix things, but it can also be a sign of neurotic fixation when there is no capacity not-to-fix things. "I don't expect you to fix what cannot be fixed," I sometimes want to say. But then I don't because doctors seem to be so dependent on their Johnny Fix-It persona.

In med school, like the Marine Corps, I imagine physicians-in-training have it ground in: Make it better; winkle out and apply the chemistry/pills; improve and with luck eradicate the offending realm -- from broken leg to brain tumor. That's your job and this benevolent Marine Corps ingests the training. But however expensive the training, doctors among other health professionals, are not trained in the fine art of failure.

A human being who cannot fail is not quite a human being yet. A mainline addiction to success is hardly a successful way of being. At a certain point, wanting to succeed or insisting on it simply compounds the problem, adds to the discomfort, and leaves the practicing physician abandoned in a world where success is ingrained at the expense of another perfectly possible capacity: Failure.

And of course the patient can compound the difficulty. Many don't listen, can't hear or are damned if they want to die. They pile up the doctor's plate with their cries for mercy, expressions of denial or anger and whatever all else ... what the hell, they aren't going to the doctor in order to fail!

The "Frontline" show was nice. A bit too white for my taste -- no one lived in unpleasant squalor or was less than well-educated or was subjected to machines that were less than perfectly sanitized -- but still it was nice because death is a shoe that fits all feet, even the feet of the well-heeled.

But one of the things I came away with was an imaginative image of suburban white whine gathering at what a doctor might be heard saying by way of introduction, "I practice medicine."

Yes, the patient goes to the doctor in order to be "cured." S/he too has had the expectation ground in over time -- doctors cure stuff. But a patient may, perhaps, be forgiven: S/he is not a doctor with an expensive education  in the rearview mirror. For him/her to believe is more understandable. And the doctor treads a fine line (when the doctor is any good) between encouraging trust and retailing honesty... an honesty that begins at home and only later can be doled out to the patient.

"Practicing medicine."

It can have a smooth, sleek feel to it -- a pretty kool pick-up line at an upscale get-together. But besides whatever self-aggrandizing component, I like it because it aptly describes what doctors do ... PRACTICE. It may be satisfying to "succeed" and a bummer to "fail," but that is the nature of practice.

Practice anyway and, rather than imagine all prayers have been or could be answered, pray a little. Setting aside smug humility or sparkly superiority ... practice.

What else can any of us do?


  1. For now, we practice living. I don't know if death is something we do or just something that happens to us. But i hope to practice gracefulness when the time comes.

  2. You wrote a rather refreshing approach to a topic that is hard to think about and hard to face. Thank you.

    OlCharlie, when the time comes I hope you are healthy enough and have your wits about to to "practice gracefulness."

    I worked as a hospital aid and was assigned a Catholic Monsignor with advanced pancreatic cancer. He seemed dignified but when I eventually had a chance to talk to him, he said he was simply play acting and that dying and being in great constant pain was just horrible.

    His response gave me no solace at the time. It lead me yet another step away from the Catholic Church, or, at least the mainstream Catholic Church.

    Nevertheless, the conversation lead me to think that it's probably best if we start practicing patience, endurance, gracefulness, dignity, etc. NOW so that, at least the force of habit will be in action for a while even as our reason, energy and the desire to spare others our misery declines. (Not to mention that such qualities are rather practical.)

    Genkaku, I think there are some honest doctors out there, but finding them must be as hard as finding "your one true love" on After all what would you do if one of your doctors says "that's it; game over." Even as the you know such a time is completely inevitable, certainly if you still have sufficient energy and your wits about you, you probably will still seek out some other health practice be it health foods, or medicine, or Deepak Chopra's form of healing meditation.

  3. Tully -- Thanks. In point of fact, I do imagine there are good doctors out there ... hell, I've even met one or two. But my own primary care guy agreed that doctors are between a rock and a hard place -- knowing that they are fixated on fixing stuff while likewise knowing that trying to fix stuff can be as much of a downer as any disease. I don't envy them the conundrum but I also really resent the ones who cling doggedly to their medicinal Catholic Church and imagine that just one more pill or one more 'procedure' will surely uphold a fix-it-fixation faith. I guess a little honest humility wouldn't hurt any of us.