What book, no make that, what
novel, could possibly make a young person decide to become a physician? As much
as I love fiction, I’d never considered it an incentive for anyone’s career choice.
Not at least until Dr. Abraham Verghese convinced me that the tools in a
writer’s toolbox – conflict, character and metaphor – are also essential to a
practice of medicine that involves not only curing but healing.
Verghese was the featured speaker
at this year’s Literature + Medicine conference at Texas Health
Presbyterian Hospital Dallas. Half the members of my book group were there –
Verghese fans since we read his 2012 New York Times bestselling novel, Cutting For Stone. And although I’ve
become a fan of this seemingly unlikely conference on the confluence of
medicine and literature, this was the first time I remember a featured speaker
talking about the importance, the essential importance of fiction to the
practice of medicine.
“I will begin with a story,”
Verghese told the audience packing the Fogelson Forum Auditorium at
Presbyterian Hospital. . “Story is so fundamental to medicine. When we meet a
patient, we take a history, and the word story
is embedded in history.”
And so he told a story about one
of history’s most famous physician-writers, Anton Chekhov. Ill with
tuberculosis, which was incurable in his time, Chekhov and his wife decided to
visit a spa in Germany’s Black Forest. A medical crisis occurred during the
visit, and the spa’s doctor, who would have been more likely to treat cases of
indigestion, Verghese told us gently, suddenly found himself responsible for
the care of another physician. And not just any physician, but the most famous
one of his time.
Chekhov assured the doctor
that he realized he was dying, and that any palliative efforts would be futile.
But they were in a spa, after all. So, perhaps doing what he knew best how to
do, the doctor ordered a bottle of champagne. “How long it’s been since I had
champagne,” Chekhov said. And raising his glass, he drank it slowly, turned on
his side, and died.
Beyond the charming anecdote
lies one of Verghese’s great concerns: the difference between curing and
healing. Chekhov could not be cured. He could be – and was – healed.
Verghese experienced this
difference for himself, becoming a physician in the era of HIV, of being “caught
up in the conceit of a cure and we had no way of dealing with a disease for
which there was no cure.”
When one of his patients was
too ill to come in for an appointment, Verghese made the radical decision “for
my own closure” to visit the young man at home. The patient’s reaction taught
him “what the horse and buggy doctors of 100 years ago did so well. I
understood for the first time the difference between healing and cure.”
It was the sense of this
difference, of the need not only for cures for physical diseases, but of the
necessity of healing in an empathetic relationship between patient and
physician that has become the focus of his career. And among his tools for
healing are those of the writer he also is: story (conflict), character,
metaphor.
“The situation (facing a
patient) may be routine for you, but for the patient, it’s not. When they come
to see you, there is story,” he said, urging medical professionals to listen to
their patients and to “the words patients use to tell us their story.”
No comments:
Post a Comment