Doctors’ Dilemmas
Treat the Patient, not the CT Scan, advises Dr. Abraham Verghese in a recent op-ed piece in the New York Times. Verghese is a surgeon, a professor at Stanford Medical School and author of the best-seller, Cutting For Stone. Doctors have many dilemmas in treating patients, and a current one is keeping that treatment personal despite the plethora of diagnostic machines often needed for making a correct diagnosis.
Verghese reminds us that the physical examination, the laying on of hands, is a fundamental bond between patient and physician. That bond is a vital part of the treatment, and it can be weakened or lost if mechanical procedures like CT or MRI scans seem to be replacing the personal doctor-patient relationship. On the other hand, the patient certainly wants the doctor to be knowledgeable about the latest advances in medicine and employ them when they’re indicated. There’s a fine balance between too much and too little testing.
There’s also a fine balance in doctor-patient relationships between the personal and the intimate. The great physician William Osler emphasized the importance of bedside teaching, instead of sitting in a conference room and talking about the patients. My novel, The Dark X: a Medical Mystery and African Adventure, begins with two doctors on medical rounds engaged in bedside teaching for medical students, residents, and nurses. The two patients being examined and discussed are attractive young women. Since doctors, like patients, are human, at times they may be tempted to let the professional relationship become intimate.
Medical ethics strictly forbids this, and a physician who violates this stricture risks the loss of his license to practice. Hippocrates, the Greek physician who was the founder of modern Western medicine, required his students to take an oath that they would not use their medical role to seduce a patient. Various versions of this oath are still taken by many graduating medical students. But what if the patient, rather than the physician, wants to cross the line? The stricture still applies. Patients may feel they are in love with their doctors, but the doctor’s oath denies him the right to allow the professional relationship to become sexual.
The patient, Suzanne, an “ape lady” with a strange disease, and her doctor Tony, spend a month in the jungle together, seeking to find the cause and cure for her potentially lethal malady. Along with dangerous animals and politics, their feelings for each other are a source of tension throughout the story.
