2016 Dr. Ida S. Scudder Essay Competition 1st Prize Essay
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Compassion - a Paradise Lost? By Dr. Riddhi Das Gupta Assistant Professor, Department of Endocrinology, Diabetes and Metabolism Christian Medical College, Vellore
“If you want others to be happy, practice compassion. If you want to be happy, practice compassion.” His Holiness the Dalai Lama. The setting is 19th century England. A doctor is hurrying to a graduation ceremony at Oxford in full academic regalia. On his way, he is stopped by his childhood friend who implores him to have a look at his son apparently suffering from untreatable whooping cough.
...Though running late, the doctor agreed to examine the child. As he arrived at the bedside the child seemed spellbound by the doctor’s opulent dress. After examining the child and finding that he had not taken food for two days, the doctor sat down, peeled an orange and fed the child lovingly and chatted with him for some time. He told him that the orange was magical fruit that would cure him in no time. Though the illness looked grave, the Doctor comforted the boy’s father and left for the ceremony. For the next one and a half months while the child battled with the deadly disease, the doctor came to meet him every day. Each time he was dressed in his magnificent robes, as if to enchant the child and wean him away from the clutches of death. The child recovered over time and the family remained grateful to the doctor for as long as he lived. The physician in question was Sir William Osler, and this true story is one of incomparable compassion for an ailing human being.
Practicing medicine in an era unblemished by the lure of wealth and luxury, unhindered by the omnipresence of technology and machines, Osler and many of his time practiced what they preached: offering compassion to the sick and empathy for the wounded, listening to their sufferings, sharing their
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pain -- virtues entrenched deeply in the heart and soul of medicine. And then came “modernization,” a tsunami, a cataclysmic change that that shook the roots of tradition, challenged the norm, and ventured into hitherto-unmapped territory. Modern medicine, like many of its equally-distinguished scientific disciplines, had set out on a breathtaking journey. Treading new ground, discovering the unimaginable, realizing the impossible...medicine had started soaring to unparalleled heights. The marriage of technology and medicine was a godsend. While countless numbers of the sick and needy got new leases on life, doctors seemed to have the answers to every question like the mythical Oracle of Delphi. Ironically, in the quest to decipher the unknown, in the relentless journey to success, the care that Osler’s patient received was left behind; the values on which the edifice of modern medicine had prospered were obscured. Compassionate care for the sick became the lost sheep of modern medicine, buried under the monumental success of modern medicine.
What exactly do we mean by compassion? How does it affect our care for the patient? “Compassion,” or “karuna” as the Sanskrit verses call it, is defined by Webster’s Dictionary as a feeling of wanting to help someone who is sick, hungry, or in trouble. Obviously the question to us as doctors is, are we not practicing that every moment? Are we not caring for the patient when we discover a new drug that can cure a dreaded disease? Isn’t the very act of battling the most difficult of diseases an insurmountable act of care and kindness in itself?
The answer is both yes and no. And herein probably lies the irony of modern medicine. With each step towards curing human disease, have we managed to be equally humane? In this frenzied world of technological advances, awe inspiring machines and path-breaking molecular discoveries, are we treating the disease or the diseased? As someone famously said, “The world is a great show and physicians have a front row seat.” Medicine has moved away from man’s primal sympathy for man; out of the desire to help those in sorrow, need, and sickness. We cannot deal with our patients, our fellow human beings, as one would deal with corn or coal. Medicine is sustained by the ability to recognize amidst brutal struggles, life’s beautiful poetry, the poetry of the commonplace, of ordinary men and plain toil-worn women, with their loves and their joys, their sorrows and their griefs. The great psychiatrist Dr. Carl Menninger said, “The best treatment for depression is to go to the other side of the railroad tracks and ask what you can do to make a difference.”
The gargantuan leaps in modern medicine have brought back the smiles to millions of sick, distressed and needy. But have we as doctors had the time to stand back and watch them smile? Have we had the time to
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hold their hands, knowing that their diseases are incurable? Probably that is where modern medicine has lost its Midas touch. And much of it has to do with the decadence that has gripped civilization in general.
God created the vast greens, the clear blue sky and gave man the liberty to run and explore. Man found solace in his air conditioned room, his Sony Bravia TV and remote control. God created for us a plethora of fruits and vegetables: the cauliflower, the spinach, the broccoli and the potatoes. But man came up with McDonald’s, pizza, the double cheeseburger and Coke. Generation Y, the neo-Homo sapiens, is a generation that thrives on running late, pushing its luck, sidestepping responsibility and jumping to conclusions. In the rat race for success, the all-engulfing desire to succeed, values and virtues have gotten trampled upon. Compassion is not the “in” thing, it does not trend on Twitter, and it is not liked on Facebook. So why bother? Doctors are but an integral part of the same society.
Somewhere this unfortunate desire to forego emotion and march on like automated machines has affected the noble profession of medicine also. Not that our healing powers have ceased; not that our diagnostic abilities have diminished. The touch no longer has the warmth; the smile has lost its innocence; the eyes seem distant.
It is at this crucial moment of introspection in healthcare and modern medicine that an institution like Christian Medical College, Vellore (CMC) emerges as a torchbearer of humanity and compassion. “Three knocks in the night” were all it took to light the flame of unwavering faith and compassion, a flame that has slowly become a gigantic cauldron of hope, determination and excellence. While breaking barriers in research and innovative healthcare, CMC has not wavered from the unflinching zeal to help the poor and the needy, to create an environment where the joy of caring transcends the joy of achieving. However, like the darkness beneath the brightest of the lamps, it would be foolhardy to sit back in a shell of complacency and self-indulgence. As the number of patients thronging to CMC keeps increasing; as the burden of disease outweighs the benefits of cure; as the demands of an unrelenting profession take a toll on even the most dedicated of healthcare professionals; it is probably time for a changing of the guard, a time to reinvent, to rediscover the magic wand that binds the ‘hurt’ to the ‘heart.’
But how do we achieve this perfect balance between care and cure? How do we maintain our energy and enthusiasm in the midst of patient demands and the time constraints? One solution is to enjoy the journey and not always focus on the destination. Tucked away in our subconscious is an idyllic vision. We see
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ourselves on a long train journey that spans the continent. Out the window we drink in the passing scene of cars on highways, of children waving at a crossing, of cattle grazing on a distant hillside, of smoke pouring from a power plant, of row upon row of corn and wheat, of flatlands and valleys, of mountains and rolling hillsides, of city skylines and village halls. But uppermost in our minds is the final destination. On a certain day at a certain hour, we will pull into the station. Once we get there many wonderful dreams will come true and the pieces of our lives will fit together like a completed jigsaw puzzle. However, sooner or later we must realize there is no station, no final place of arrival. The true joy of life is in the trip. The station is only a dream. It constantly outdistances us. "Relish the moment" is a good motto, and the time has come to stop pacing the aisles and counting the miles. Life must be lived as we go along. The station will come soon enough. So where do we stand today? Has modern medicine turned from patient-centric to disease-centric? Despite the gloom and despair, all is not lost. As Dr. Martin Luther King, Jr. famously said, “We must accept finite disappointment, but never lose infinite hope.” The courage of Dr. Martin Salia who selflessly lay down his life while caring for patients with Ebola, reinforces our faith in the innate goodness and compassion that embody the spirit of medicine and its practice.
Closer to home, the innumerable community outreach programs of CMC bring joy to millions of the forgotten common people. The armamentarium of Mission Hospitals is providing affordable care to the most neglected and downtrodden of society and fighting the relentless battle to establish health and wellbeing in the remote areas of Jawadhi or the North-East. These daily victories come from the indomitable spirit of humanity that has been embodied by the likes of Aunt Ida and other like her. The aim should be to ensure that the practice of Dr. Ida S. Scudder become the rule and not the exception. The kindly word, the cheerful greeting, the sympathetic look - even when the patient is past all hope- these are the needs of the hour. It is time to bring back “Paradise Lost;” to tell the child left behind that he is not alone; to reverse the wheels of progress and reinvigorate medicine with the compassion and kindness was its forte since time immemorial.
In the words of the great Mohandas Karamchand Gandhi: “You must be the change you wish to see in the world.”
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