Dr. Jeff Kane: ‘Cure sometimes, relieve often, comfort always’
As a patient, here’s what I might tell my doctor: “Your long, intense schooling demonstrates not only mastery of a huge body of information, but your commitment to humanity. You’ve seen the mysteries of birth and death up close. We trust you to see us naked and raw, and to probe us with intimate questions, instruments, and even your fingers. Your white coat and stethoscope add six inches to your height, and your every word bears weight. If science were a religion, you’re the priest we’d most often see.”
That is, docs are placebos, whether they know it or not. And that’s terrific, but they’re not priests. Consider how much more potent their ministrations would be if they were taught priestly skills along with traditional medicine. By “priestly” I don’t mean religious rituals, but the compassion required for genuine care. As things are now, medical training remains imbalanced, focusing almost exclusively on physical processes while virtually ignoring patients’ beliefs, emotions, attitudes, experiences, and relationships. Of course, some docs are marvelous exceptions. Their manner developed, though, from their personal evolution and actually despite their professional training.
Once I’m aware of my patients as more than their bodies — as fleshy beings of meaning — how comfortable can I feel limiting my work to chemistry alone? If I were to widen my view and then address patients literally personally, what might that look like?
A century ago, when healthcare’s nemesis was incurable tuberculosis, Dr. Edward Livingston Trudeau established the first sanitarium, at Lake Saranac, New York. He reasoned that if he couldn’t cure TB, at least he could make patients’ remaining days more livable, with rest, fresh air, healthy diets, and respite from cities’ tenements. The two months my own aunt spent there afforded her sixty more years of a healthy life. Trudeau’s motto was “Cure sometimes, relieve often, comfort always.”
Comfort always. Trudeau was what my old psychologist friend, Larry LeShan, would call a “gardener.” Larry wrote a book called The Mechanic and the Gardener, in which he defined two styles that all docs deploy in varying degrees. The mechanic attempts to fix what’s broken. The gardener offers full attention, nurtures, and patiently facilitates natural healing. LeShan concludes, unsurprisingly, that both styles are necessary.
Let’s face it: today’s docs are more familiar with the tool shop than the garden. This must frustrate dedicated medical mechanics, since most visits are for chronic—that is, unfixable—illnesses. Maybe that’s why I’m noticing more new docs wandering into the garden. I imagine they’ve rediscovered that a medical career’s juice lies in deep human contact. Said Dr. William Osler (1849-1919), still regarded as the patriarch of North American medicine, “The good physician treats the disease; the great physician treats the patient who has the disease.”
Jeff Kane is a physician and writer in Nevada City.
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