Review Tuesday: 'The Pen & the Stethoscope'

Today’s ‘Review Tuesday’. Synchronicity. Wikipedia says it’s a concept first described by Carl Jung, i.e. the experience of two or more events apparently causally unrelated or unlikely to occur together by chance, that are observed to occur together in a meaningful manner [1]. Its meaningfulness distinguishes it from mere simultaneity. Last Thursday my cyberfriend Wordsmith [2] sent me an email titled: ‘Something fine to read’. That ‘something’ is an essay by a favourite writer of his – William Carlos Williams (1883-1963) [3] – on being a physician and a writer [4]. Williams’s essential premise is that doctors, being keen observers of all aspects of the human condition, are disposed to being writers and poets. The synchronicity? I received Wordsmith’s email as I was finishing The Pen & the Stethoscope. Published in 2010, it’s a 211-page collection of 15 short stories written by 15 doctors – including four Australians. Its nine non-fiction and six fiction stories vary in topic and writing quality – and thus their ability to attract and hold my interest. My picks are those by the three best-known medical writers: Atul Gawande, Peter Goldsworthy and Oliver Sacks. I don’t doubt doctors, at least good ones, are skillful observers of humans. But I don’t know if, as Williams suggests, doctors’ vocational skills give them the front-running in the writing stakes. For it’s one thing to collect material to write about, and quite another to craft it into beautiful writing. For all this, on balance I’m pleased I read The Pen & the Stethoscope.

farmdoc's blog post number 111

Art and science. The practice of medicine includes both, but the mix is changing. Since I began studying medicine 45 years ago, the proportion of science has been increasing and, commensurately, art decreasing. A prime cause of this increasing science is advancing technology, and adjunctively the emergence of evidence-based medicine [EBM] which is of course the bean-counters’ nirvana. I’m sceptical about the utility of EBM medicine in the consulting room, because each patient is unique, and so data obtained from a group may not apply to an individual. A letter in the 28 July 2008 British Medical Journal said: ‘…modern medicine will fail to confront therapeutic uncertainties unless its practitioners offer their patients what they need most as human beings in distress: time, empathy, and understanding…(and)…a successful medical man has to exhibit supreme confidence and decisiveness at the patient’s bedside, whereas a doctor-scientist (trying to confront uncertainties) is likely to present a picture of diffidence and self doubt…the processes that work for one are devastating for the other’. Of course the ideal practitioner is knowledgeable and skilled in both the art and the science. But such people are rare. Me? I’m content to remain well back from the cutting edge of the science and EBM; and if that means enriching my work with the art of medicine, then I’ll consider that a badge of honour.