In my years of training as a physician and an oncologist, I encountered and absorbed a vast amount of information. I also learned and mastered many different tools, technologies, and clinical skills, and a great many questions were asked and answered. But in all those years of study and preparation, the most fundamental question of all for a physician was never once raised:
What Is the Purpose of Medicine?
Why are we doing this? What exactly are doctors trying to accomplish with all their hard work?Perhaps it was assumed that everyone knew the answers to these questions: the purpose of medicine is to fix people - to replace illness with health. When a patient presents with a problem or symptom of some kind, medicine ought to return the patient to the condition that existed before the problem or symptom occurred. With respect to cancer, the purpose of medicine should be to eradicate tumors, normalize blood tests, alleviate pain, create clear CT scans, and prolong life. These, I believe, are the unspoken, culturally sanctioned notions of what physicians are supposed to do - and as a corollary, these objectives should be accomplished with the least possible effort, expense, and sense of personal responsibility on the part of everyone involved. Despite its great achievements, the success of modern medicine in achieving these goals remains limited. This is especially true in oncology, where the challenges encountered by patients and family members alike can be extreme. Partly because of these challenges, millions of Americans - and cancer patients in particular--are turning to alternative and complementary forms of medicine. But this trend is not motivated simply by the inability of mainstream doctors to cure their disease. It also arises, I believe, from a fundamental shortsightedness in medicine's understanding of what its purpose should be.
At present, doctors focus primarily on the physical characteristics of their patients--bones and organs, test results, height, weight, and age. Yet in each of us there is a rich mental, emotional, and spiritual reality that influences and even directs the course of our lives. Often, for both patients and their families, cancer brings this inner reality vividly to life and to the surface. If the inner reality is devalued or ignored by modern medicine, the effects can be devastating.
When you are diagnosed with cancer, conventional medicine may respond with surgery, chemotherapy, radiation, or perhaps another leading-edge treatment: in short, whatever is necessary to "get rid of the cancer." Throughout treatment, your physical signs and symptoms are carefully monitored. But many other important areas of your life receive far less attention. How is the illness affecting your marriage, your work, or your ability to find meaning and enjoyment in every day? What are your thoughts, beliefs, fears, and expectations about what will happen to you?
For most doctors and in most hospitals, these questions are of secondary importance. Individual physicians may address these issues, but most feel inadequately trained to handle them competently. As a result, when patients feel anxious or depressed, doctors will often prescribe anti-anxiety or antidepressant medications. Certainly there are instances in which these medications serve a very important role in the care of people with cancer. But, out of frustration or habit, many physicians rely on them as substitutes for addressing deeper issues.
