A thinking doctor

DR. Farokh Erach Udwadia gave ample evidence in an earlier work, Man and Medicine A History, that ascent to the heights of his profession, as one of Indias foremost physicians, does not benumb his sensitivities, nor does a punishing daily schedule of work preclude scholarly effort. That is the excuse of those who lack the aptitude for scholarship.

The first of the essays sets the tone for the rest. It reflects the outlook expressed in the preface: Confronted by the hubris of great scientific achievements in medicine and in a world of changing values, many feel that medicine without its science and technology amounts to nothing or next to nothing. This is not true. There is an art to medicine, an art based on human values, which immeasurably enriches its science, an art which when combined with science not just cures, but also heals. Sadly, it has become an increasingly forgotten art and I felt an urge to express my views on it hence the title of this book as also that of the first of the nine essays.

Society depends on medicine, but medicine has its limits, despite its impressive progress. New issues involving moral questions such as euthanasia have come to the fore: Medicine has been influenced most of all by the natural sciences and also by many other human endeavours notably philosophy, economics, art and religion. Perhaps my fascination and love for art prompted me to explore the relation between art and medicine, particularly the relationship between art, disease and artistic creativity. I have discussed this relationship with examples from Western art. Much as I wanted to, I sadly could not draw examples from Indian art, because the records on this subject are either meagre or non-existent. I have also written on Religion and Medicine, for religion has influenced medicine ever since it came into existence. Also, religion implies faith, and faith is an important cornerstone of medicine.

The essays are well researched and the book is richly illustrated. It is meant not only for the specialist, the physician and surgeon, but also for the reader educated and intelligent enough to reflect on the worth and meaning of life. Medicine is intimately related to it. All the essays are well written. Every reader will select his favourite. This reviewers is the very first on the forgotten art of healing.

Its opening paragraph sums up the authors thesis: The stupendous advances of science and technology have changed the face of medicine. Medicine is capable of performing amazing feats deemed incredible 50 years ago. Yet paradoxically there is today a deepening disillusion, distrust and even antagonism against medicine and the medical profession. The paradox is indeed striking for around the middle of the last century when science and technology hovered merely in the background and medicine had achieved little, the profession was held in the highest regard and the doctors image outshone that of any other profession. Today, when science and technology envelop medicine in an all-embracing grasp and when medicine has achieved a great deal, the respect for the profession has plummeted and the image of the physician is increasingly tarnished. To my mind the main reason for this paradox is because medicine has strayed from its path, has lost its way, has lost its goal. The mechanisation of medicine, the hubris of its technology and science has submerged its art, robbed it of its raison detre, its humanism. The physician no longer ministers to a distinctive person, but concerns himself with separate malfunctioning organs. The distressed patient, the human being, is frequently forgotten or relegated to the background.

Things that seem elementary are of fundamental importance, for example, listening with empathy and examining closely. A physician steeped in the art knows the value of kindness, sympathy and caring in the healing of a patient. The art of medicine remains all-pervasive even when its science fails or has reached its utmost limits. For when all the marvels of science are of no avail to unfortunately ward off the fatal end, it is no small portion of a physicians art to rid his patients path of thorns if he cannot make a bloom with roses.

The author adds: The art of medicine is the art of healing, not just treating, nor even just curing. Yet it is only when art and science join hands that healing is best accomplished. It is only then that a physician can engage the unique individuality of a particular human being so that a sick patient becomes much more than an illness or a disease that needs to be treated. The point is driven home by a quote from Trousseau, a famous French physician: For mercys sake gentlemen, let us have a little less science and a little more art. This spirit animates the book, specially the essays on art and religion and medicine.