We must do all in our powers to bring back the glory of medical practice of yesteryears where the patient and the doctor were two trusting human beings

“I therefore, the prisoner in the Lord, beg you to lead a life worthy of the calling to which you have been called, with all humility and gentleness, with patience, bearing with one another in love, making every effort to maintain the unity of the Spirit in the bond of peace"—Anon

Has modern medicine lost its heart? With the advent of hospitals in the 18th century modern medicine has been going at a tangent vis-à-vis its avowed goal of “curing rarely, comforting mostly, but consoling always.” With the advent of corporate care in a hi-tech set-up in the last couple of decades, modern medicine is no more a calling; but a trillion dollar industry—the sickness industry. The word hospital derives its sustenance from hospitality. Today’s corporate hospitals are anything but hospitable, they are down right inhospitable and live to sell disease care at a premium! What was once a “bunch of corrupt, incompetent, and nepotistic” lot of doctors in London, in the words of Dr James Wakeley, in 1823, the medical fraternity today has become a “Corporate Monstrosity,” according to medical historian-journalist, Hillary Butler in 2011. William Wordsworth, the romantic English poet, traces the root of present rot in money minded society thus:

                   “The world is too much with us; late and soon,
                    Getting and spending, we lay waste our powers;
                    Little we see in Nature that is ours;
                   We have given our hearts away, a sordidboon!...”

Medical claptrap and its pseudo science
Ever since modern medicine was taken to the market place, market forces, especially advertisements and jargon, tried to sell the idea to the gullible public that modern medicine is the only saviour of mankind in the disease setting. People also seem to be fully convinced that modern medicine is “scientific.” The industry is fully cashing in on this colossal societal ignorance. Truth is that modern medicine in particular and biology in general are in search of their Holy Grail, the true non-linear holistic science base.

Most of what we do in medicine today is simply palliation—putting a lid on the smouldering fire. We are also obsessed with the search for a label, called the diagnosis, which in itself has become a prohibitively expensive disease. With the mad push to get at the final accurate diagnosis, the industry has devised thousands of tests, scans and scopes that together make a mockery of clinical bedside medicine. Reductionist ideas to replenish every drop of every thing that changes inside according to our tests denies the role of mother nature in setting things right with the help of the healing powers of the human body including its capacity for transmutation of elements!

The rise and fall of the corporate culture
The concept of hospitality in hospitals has been killed by the rise of the money-centred corporate culture in hospitals. Anything that goes up has to, per force, come down; since gravity is a very powerful force. Sooner the corporate culture comes down in the sick room the better for patients, doctors and nurses in every hospital. Illness itself is bad, to be seriously ill is worse enough but, to get into a corporate hospital today in that scenario is almost fatal, to say the least. All sided anxiety rules the roost in a serious disease setting in the hospital, but today’s corporate hospitals have a new breed of men and women who have had no training  in patient care or compassion at all, who are the corporate money masters. Young and well paid as they are, their sole training and directive is to make profit irrespective of consequences in any setting-agony, death and dying not excluded. Their motto is that “hospitals are built by money, of money and for making money.” They have not heard of that old man Hippocrates who averred that “one should not try to make money in the sick room.” Corporate money spinners have only heard of hypocrites all around them. It is a sight for the Gods in any corporate hospital when a seriously ill patient is being wheeled into the pinnacle of curing glory of these hospitals—the intensive care unit—the weeping relatives, patients struggling between life and death, compassionate doctors and nurses (majority of these two castes are still compassionate) trying to help and revive the patient, and these corporate vultures waiting for their pound of flesh in the whole bargain. Another novel money spinner is the present avatar of health (sickness) insurance, which looks like a boon but, works like a curse when the chips are down!

Technology plays an important role to add to the patients’ and relatives’ woes. A couple of decades old study done in Bristol and Sheffield Health areas in England by Mather and his colleagues showed that following a heart attack at home, a good risk patient (who does not have cardio-genic shock, heart failure and/or serious arrhythmias) is better off left at home than being rushed in a hi-tech ambulance to the hospital. A recent study in the US showed that the leading cause of a stroke today is getting admitted, following a heart attack, to a hospital where they have the technology to sell coronary bypass surgery. Immediate post heart attack coronary bypass surgery would increase stroke risk four fold! I can go on like this ad infinitum but, suffice it to say that most of these hi-tech new stuff do precious little to add to patient comfort in the long run. A study of chronic myeloid leukaemia at Christy’s in Manchester showed that the per capita death rate of patients registered there between 1900-1940 and 1950-1990 was almost identical with a marginal benefit in the first group. All that they did for those patients between 1900 and 1940 was tender loving care sans hi-technology.

Plea for Parsimony
Medicine being a worthy calling and the best God-given opportunity to do good to others in distress, we must do all in our powers to bring back the dead glory of medical practice of yesteryears where the patient and the doctor were two trusting human beings. That trust is being seriously eroded with patients being treated as buyers and doctors as sellers of disease care, the latter having become a saleable commodity in today’s corporate world. Happily the majority of doctors are still not fully sold to this corporate idea. It is only the venerated wealth generators who distort this good image of doctoring by their business designs of the sickness industry. I do not understand the words “wealth generation”. The only way one could generate large wealth is by printing currency notes. There is no way you could become stinking rich otherwise. To make big money you have to loot some one. In the name of wealth creation through sickness care would be looting the dying patients and their broke relatives. Let us be parsimonious in our effort to help others. It is in giving that we get. Have a heart.
 “Go to you bosom: Knock there, and ask your heart what it doth know”— William Shakespeare

(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS. He is also Editor-in-Chief of the Journal of the Science of Healing Outcomes, Chairman of the State Health Society's Expert Committee, Govt of Bihar, Patna. He is former Vice Chancellor of Manipal University at Mangalore and former professor for Cardiology of the Middlesex Hospital Medical School, University of London. Prof Dr Hegde can be contacted at [email protected])