Possibilities for Faithfulness in the Partial Vision
Peter Gunderman, MD, MTS, MA, and Richard Gunderman, MD, PhD, Indiana University, Indianapolis, IN
No human possesses a God's-eye view. We all see only part of the picture. And yet a great deal of discourse at the interface of medicine and religion focuses on a holistic vision and holistic care of the patient, as though seeing only part of the patient were somehow inadequate and perhaps even a form of betrayal. Yet some medical disciplines that play an outsize role in diagnosis, such as pathology and radiology, by their nature see only part of a larger whole. The pathologist often encounters the patient in the form of a tissue specimen, yet it is to pathology that internists, surgeons, pediatricians, and other types of physicians look for a definitive diagnosis. Radiologists typically see only part of the patient's internal anatomy, yet they function like in vivo pathologists, using morphologic features to diagnose injuries and diseases in living tissues. In both cases, other physicians and patients often regard pathologic and radiologic diagnoses as both more objective and more accurate than hypotheses grounded strictly in the history and physical examination -- as though pathologists and radiologists provided a more dispassionate view of the case. Consider, for example, Hans Castorp, the protagonist of Thomas Mann's novel, The Magic Mountain, who carries his chest radiograph like a sacred relic. In fact, however, these medical disciplines are neither as objective nor dispassionate as they might appear. For one thing, both are privileged to behold the beauty of the human form in ways that are not accessible to the unaided eye. Moreover, we know practitioners of both fields who see themselves as something far different from machines grinding diagnoses out of collections of images. In fact, both pathology and radiology can and sometimes do evoke a sense of wonder, in part because they are able to see things that eluded the gaze of physicians for most of the history of medicine, and in part because they glimpse aspects of the human reality that are as divinely ordained and both as valuable and stunning as anything that meets the physician's naked eye. At a time when burnout and alienation plague many health professionals, recognizing such aspects of these two fields can restore a sense of coherence and fulfillment.