Re-enchanting Pathos
Lydia Dugdale, M.D., Assistant Professor, Associate Director of the Program for Biomedical Ethics, Yale School of Medicine
The technological forces at play in the practice of medicine today compel doctors to approach the “art” of medical practice with the calculating exactitude of science. This necessarily creates a tension – if not an obstacle to good patient care. How can the physician at once dissect and determine a diagnosis, drawing on algorithms and taxonomies for the mastery of human disease, while simultaneously caring for a unique, suffering human being? How does the physician obey the dictates of the ever running clock, with its 15-minute office visits and electronic ordering systems, while tending to a particular patient whose anxieties know no limits? How does the physician determine to destroy all that is diseased and broken while still appreciating the beauty that penetrates brokenness? In short, how might the physician perceive medicine as enchanted when the system and structures and demands of modern health care have supplanted the mysterious and the sublime with the intellectual and the rational?
This essay builds on the assumption that the practice of medicine has become disenchanted, and it seeks to address the question of whether the isolated clinician can re-enchant her own medical practice. I suggest that re-enchantment requires the following: an interaction with the sublime; a glimpse of beauty amidst decay; freedom; and an experience of the extraordinary while trudging through the mundane. Having shown how these four qualities lead to re-enchantment broadly considered, I conclude by considering whether it is possible for the physician to create these experiences within herself, whether she must seek them from without, or whether they must be received as gifts.
The technological forces at play in the practice of medicine today compel doctors to approach the “art” of medical practice with the calculating exactitude of science. This necessarily creates a tension – if not an obstacle to good patient care. How can the physician at once dissect and determine a diagnosis, drawing on algorithms and taxonomies for the mastery of human disease, while simultaneously caring for a unique, suffering human being? How does the physician obey the dictates of the ever running clock, with its 15-minute office visits and electronic ordering systems, while tending to a particular patient whose anxieties know no limits? How does the physician determine to destroy all that is diseased and broken while still appreciating the beauty that penetrates brokenness? In short, how might the physician perceive medicine as enchanted when the system and structures and demands of modern health care have supplanted the mysterious and the sublime with the intellectual and the rational?
This essay builds on the assumption that the practice of medicine has become disenchanted, and it seeks to address the question of whether the isolated clinician can re-enchant her own medical practice. I suggest that re-enchantment requires the following: an interaction with the sublime; a glimpse of beauty amidst decay; freedom; and an experience of the extraordinary while trudging through the mundane. Having shown how these four qualities lead to re-enchantment broadly considered, I conclude by considering whether it is possible for the physician to create these experiences within herself, whether she must seek them from without, or whether they must be received as gifts.