Suffering, Meaning, and Healing: Challenges of Contemporary Medicine

Abstract

This essay explores the thesis that changes in contemporary society have transformed the work of doctoring and challenge doctors to be physician-healers. Medical advances in the prevention and management of acute disease have wrought a growing population of chronically ill patients whose care obliges physicians to become holistic healers. Holistic healing involves the transcendence of suffering. Suffering arises from perceptions of a threat to the integrity of personhood, relates to the meaning patients ascribe to their illness experience, and is conveyed as an intensely personal narrative. Physician-healers use the power of the doctor-patient relationship to help patients discover or create new illness narratives with fresh meanings that reconnect them to the world and to others and thereby transcend suffering and experience healing. Physician-healers equipped with the attitudes, skills, and knowledge to assist patients to transcend suffering are indispensable if contemporary medicine is to maintain its tradition as a healing profession. In the process, physicians may discover meaningful connections with patients that bring new and refreshing perspectives to their work. Also, I would like a doctor who is not only a talented physician, but a bit of a metaphysician, too. Someone who can treat body and soul.Anatole Broyard 1(p40) * D uring 30 years of teaching family medicine residents, I have witnessed many changes in medicine and the image of physicians. As refl ected by television, the warm and understanding Dr Marcus Welby (whose program debut was the year family medicine became a specialty) has morphed into the arrogant, cynical Dr Gregory House. Whereas Welby helped patients struggling with transformations in their lives through the strength of his humanity, House condescendingly rescues them from death by sagacity and technology. This evolution seems to mirror changes in medicine grown more technically sophisticated and powerful while physician morale has plummeted and public trust eroded.2-4 What happened? Contemporary society has entered a postmodern era in which economic, philosophical, and technological advances have transformed medicine, doctoring, and the doctor-patient relationship.5 A growing service economy rendered physicians "providers," patients "customers," and medicine a "product." A belief in the relativity of knowledge categorizes biomedicine as but one of a variety of legitimate healing models that vie for patients. The authority of the patient's story of illness now competes with the doctor's story of disease. Doctors are confronted with medical information garnered from the Internet, often of dubious quality and unrelated to the patient's clinical condition. A colleague recently reported having a 171 SU F FER ING , ME A NING & HE A L ING9-year-old patient request a hypnotic by brand name, thanks to television advertising. The world of contemporary doctoring has changed! It seems today's physicians are expected to be an amalgam of Welby's warmth and House's brilliance. As advance...

Power to Advocate for Health

“…88(p136) Berry goes even further in emphasizing the relationship, communal, and ecological aspects of health, declaring that health is membership in community. 58 Egnew 89,90 and Scott, 91,92 using both theory and empirical evidence, defi ne healing as the transcendence of suffering.…”

“…These defi nitions include connection with self 93 and with transcendence of self, 94 and thus allow for health-promoting efforts that consider the good of the whole community and include the possibility of a meaningful death. 89,90,95 I would simplify the defi nition as follows: Health is the ability to develop meaningful relationships and pursue a transcendent purpose in a fi nite life.…”

In This Issue: Practice, Research, and Reflection

“…8 Healing is more than clinical services, prevention, and management of chronic disease. [9][10][11] Physicians who can help patients transcend suffering are essential, he argues, to preserving medicine as a healing profession in the contemporary world.…”

Religious Perspectives on Human Suffering: Implications for Medicine and Bioethics

“…Palliative care, anaesthesia, pharmacology, psychology, and psychiatry all have as their goal the relief of suffering -be it physical, emotional, psychological or, even, existential. Historically, and in recent years, a large body of literature has concerned itself with issues relating to the management, prevention, and relief of pain and suffering (Boston, Bruce, & Schreiber, 2011;Cassell, 1991;Edwards, 2003;Egnew, 2009;Norris, 2009;van Hooft, 1998). But while the relief of suffering seems laudable, some question whether medicine can, or should, aim for a world without pain, sadness, anxiety, despair or uncertainty (Breggin, 2003;Elliott, 1998).…”