What is the idal doctor? From the film “The Doctor” a point to reflect upon.
Which human and professional virtues must doctors possess? What is the correct patient-doctor relationship? How is the illness perceived?
These (and not only these) are the questions which emerge in the film “The Doctor” (directed by Randa Haines, USA 1992). The story centres on an ill surgeon, Jack, who while suffering a tumour on his larynx, learns to see the world around him and the people in his life in a different way, no longer as a doctor, but as a man. Before his illness, his behaviour towards his patients is cold and cynical, he seems indifferent to their emotions and incapable of EMPATHISING with the people in front of him. He fears emotions and avoids all emotional contact, using the best of human defences: sarcasm. The tumour makes him temporarily mute and this moment of silence, being ill and this new role as a sufferer liberate him from his fear and his emotional block. During his radiotherapy he makes friends with a girl who, because of a brain tumour, has only a few months to live and from her he learns to make the most of small things and to taste what life has to offer him. His illness sees him born again: through his doctor’s coat there is now a compassionate man, capable of accompanying his patients along the difficult path of recovery, offering them both medical and psychological support.
The central theme is the dual role of doctor-man.
Every doctor must remember that they are not just a vessel for information or a giver of drugs. Acting only on the technical is certainly easier, but it is not the best way to treat a sick person. Jack taught his students that a surgeon “goes in the operating theatre, cuts and leaves”. This is their only job.
“Doctor” should not just mean “health professional”, but also “friend”, “protector”, “ally”. This means one of the indispensable virtues to have the best medical practice is, without a doubt, COMPASSION, the ability to live through other people’s ills as though they were your own, sympathising with the patient, travelling on the same long wave. To do this necessary work, doctors must have inner stability to avoid the emotional involvement becoming too much and risking entering a dangerous level of emotions and sensations.
A doctor must know how to communicate not just inform. They must establish a relationship of complicity with the patient, become their ally in their fight against illness, earn their trust (here credibility is essential) and decide with the patient the best care plan to take, explaining the advantages and possible side effects of each choice (they must be sincere and not give false hope), and always taking into account that they are in front of a man with an illness, not the pathology itself, who is suffering, scared and defenceless.
The patient knows they are ill, feels lost and has no more certainties. The perception they have of themselves and their illness depends on their social and family situation but must never be put to one side. Therefore, it is also important to be UNDERSTANDING and DISCERNING, able to analyse the picture in depth, the needs of the patient, how the illness will affect their lives and taking a determined decision to make sure they see the good in things.
The surgeon of “The Doctor” at the beginning does not know how to communicate, is detached from his patients, builds a barrier to protect himself from every emotion (the tumour maybe represents this emotional and psychological silence, a pathology of feeling and emotions). Only after having lived the full weight of sufferance and illness can he break down the wall which kept his away from relationships.
Another theme brought up in the film is the problem of allocating resources: the young woman, who befriends Jack, has a brain tumour which was not diagnosed in time because the test was too expensive to take. Unfortunately, this is often the case in reality. It is true that no price can be put on a life, but resources are scarce and in our society health has a cost. It is a dilemma which is current and relates to key theme of bioethics: justice. If everyone has the same right to treatment and a healthy life, how is it possible to decide who is it right to treat and who it is not? This does not relate only to emergency medicine, but also daily life, given the increasing cost of new technology and treatment. It seems a real contradiction, but unfortunately this is the reality of a society where health becomes a luxury.
It would be great if every doctor could learnt to look inside himself and find the man hidden behind the doctor’s coat, if they could other their hand to the patient, if they could remember they are treating a person and not an illness, if differences between who can be treated and who can’t didn’t exist… but dreams and reality are often light years apart and ethical dilemmas and increasingly difficult to resolve.
Certainly, with a good dose of positivity, humanity and humility everything would be a little simpler.