I recently had a long consultation with a patient. He was struggling with a variety of symptoms which he’d been investigated for and despite multiple scans he hadn’t received the answers he’d hoped for. This had started to affect his mood.
He talked about his career briefly and how much he enjoyed his work as a mathematician. He felt it suited his personality as he found comfort in knowing that there were set outcomes for every question. A complex equation could be brought to a definitive answer. Unlike medicine, where often symptoms were left unexplained and the only option was to learn how to cope. All the while wondering: will it worsen? Will it ever improve? Will it become something else?
He said something else that caught my attention, ‘I guess that’s why they say medicine is more an art than a science’. I’ve come across that phrase a few times and I’ve never stopped to actually think what it meant. But after he said it, I felt this dawning realisation. Like the feeling of suddenly working out the answer to an exam question the day after. Just talking to the patient in front of me, and watching him almost crumble under the weight of several uncertainties, it reminded me yet again how important it is to have these open conversations.
Treating a condition goes beyond just treating a part of the body. Every time we try to help, and we dive in with good intentions sometimes we cause more issues. Some therapies don’t work and sometimes there are side effects. So, we trial different treatments and hope for the best. But there has to be a balance, an awareness of the impact that this might have on an individual. I think good doctors are the ones who truly put their patients at the centre of decision making and try to maintain that balance whilst juggling the multiple other issues each patient brings (family, job, finances). That is the art.