When the Doctor is the Treatment

“To prevent disease, relieve suffering and to heal the sick – this is our work”        

                                                                                          William Osler

“The function of meditation practice is to heal and transform”        

                                                                                         Thich Nhat Hanh

I am not a terribly outgoing person, but more than occasionally in my day as a rural physician, there are expressions of joy and gratitude, hugs and pats on shoulders, moist eyes, failing voices and pensive moments of shared silence. I am never good at small talk in social situations in general, but in the exam room, I always seem to know what to say, no matter what the situation is.

It is as if my role as a doctor gives me the courage and inspiration to “be” the healing presence my patient needs in that moment. It is not an act, but more like being carried by a force that hones my senses and guides my efforts.

Medicine involves archetypal relationships, as there have been sick persons and healers through all of human history. Physicians embody an apostolic profession, with knowledge and wisdom passed on between generations of physicians since Hippocrates’ era.

In our lifetime, these aspects of medicine have been forgotten, ignored or disputed by many, but today’s neurobiology has brought them back into the discussion of what physicians are to their patients.

Eric Cassell, in his book “The Nature of Suffering and the Goals of Medicine”, tells the story of an asthmatic physician, whose disease was out of control until a wise physician treated him as a patient instead of a colleague:

“A physician I know told me about the treatment for his asthma. He was taken care of by a wonderful chest physician whose skills he had seen demonstrated many times before and since. He was on high doses of prednisone (a cortisone like drug) and other medications for many months but he could not seem to get off the drugs without getting sick again. He would meet his doctor in the hospital corridor and ask what to do next. The doctor-patient did what was suggested but to no avail. His own knowledge of asthma was not inconsiderable but that was no help either. He told me that he could not get his friend and colleague to treat him like a patient. Finally, desperate, he went to another doctor whose specialty was asthma. The new physician promptly made my informant into a patient. He told him what to do (what he said seemed the same as what had been previously tried) and scheduled office visits frequently and regularly, and within six months my friend was off all medication. What was the difference? It was not the medications or their schedule – they were the same (at least at the start). The difference, I believe, was that the second physician made him become a patient. Once that happened, the new doctor was able to begin “pulling strings” inside his doctor-patient’s body. No one knows how this comes about or how the physician is able to have an influence on the patient’s illness apart from explicit medical or surgical treatments, but this is the process involved. Current research is increasingly revealing the influence of thinking on immunity and other body functions, so there should be little surprise that doctors are also able to affect the patient’s physiological process. No one doubts that doctors have an influence on their patients’ mental processes – we are of a piece, and affecting one part alters the whole.”

The first physician gave competent clinical advice, but the patient was not helped. The second physician embraced the role and responsibility of the healer. He created, or entered, the space (metaphysical, meditational, Divine, Reiki – or quantum physical if you will) where healing is possible.

Hippocrates said these words 2,500 years ago, and modern science is now realizing the truth and wisdom behind them:

“Natural forces within us are the true healers of disease.”

All we do is facilitate.

2 Responses to “When the Doctor is the Treatment”

  1. 1 Henry Hochberg, M.D. December 3, 2013 at 7:53 am

    At times I have called this human acupuncture. I am the needle that must find the proper point(s) to pierce to promote the healing of the patient.

  2. 2 Sheri Clunan January 16, 2014 at 3:59 pm

    Very well said.
    I am a FNP and I have experienced the things you speak of but I’ve never successfully put this phenomena into words. Have never been able to explain it or even really begin to describe it so that someone else would “get it”. I, like you, am pretty reserved in social settings and have been known to have some mild to moderate social anxiety. However, in the exam room, everything is different. I do believe the intuitiveness and discernment is truely a gift. Thank you for putting it into words and thank you for sharing this. Hope you have a fabulous day!

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.


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