“It is evident, that all the sciences have a relation, greater or less, to human nature: and that however wide any of them may seem to run from it, they still return back by one passage or another. Even Mathematics, Natural Philosophy, and Natural Religion, are in some measure dependent on the science of man; since they lie under the cognizance of men, and are judged of by their powers and faculties.” — David Hume in A Treatise of Human Nature
One of the demands constituting the credo of the doctors that went on strike recently in New Delhi was for regulated and humanly working hours. An article published in The Indian Express on July 8, 2015 captures the vehement voices of resident doctors who grumble over working 36-48 hours shifts and at the end, are left enervated, burnt out and as per studies, prone to ‘medical mistakes, car crashes and surgical injuries’.
Personally, at my workplace, I’ve seen how convincingly veracious and accurate this picture could be. Relentless working hours, overwhelming patient load and multiple half-starved nights have become synonymous with residents, and at times interns. But as the consequences of this picture are cited in the language of medical mishaps by scientific studies, I intend to bring out another baleful ramification of this disconcerting picture — something that takes the element of ‘heart’ out of patient care and reduces it to an act of precarious juggling.
Coming back to the essence of Hume’s words, the impact of human nature on any sphere of activity, let alone science and philosophy, cannot ever be disdained — since it is the driving force behind everything: from massive innovations to petty crimes. It’s surprising to see how little we take into account the facets of human nature while we talk of laws, rules and principles governing the society, simply because any talk pertaining to human nature is largely intangible, elusive and fugitive. Extrapolating Hume’s sense into medicine, the closest facet of human nature that impacts medical practice is benevolence and empathy. Beyond rules, professional codes and incentives, it is empathy towards the patient that drives and actuates the doctor’s duty, and any attempt to negate its importance would demolish the very picture of being a doctor. Empathy and medical practice come hand in hand inseparably, and no professional or legal obligation can surrogate the kind and compassionate ear the doctor brings to his patient’s afflictions. Not even the most disbelieving critic of philosophy could deny the healing effect of compassionate words that can go beyond pharmacological treatment — and that on the ground zero of medical practice, it is empathy that largely determines the quality of healthcare delivery.
Now, though being an inbred quality, how much empathy can you expect coming from an unduly stressed and pressurized mind? It’s easy to impose exorbitant moral standards that remain unscathed by worldly events upon anyone, but in reality, empathy requires a sound mind in addition to a well-meaning heart — a poised, balanced mental state where it finds the room and space to manifest vividly. To expect a half asleep doctor, who carries the stress of a 48-hour duty over his face, to exhibit things like empathy on the 49th hour is unrealistic to say the least.
Don’t mistake me as someone who is trying to validate depraved, corrupt doctors and cover up heinous cases of medical negligence. But the extant system, which sees residents getting enfeebled by incessantly long hours of work, desolates the concept of empathetic medical practice. It’s obvious why the hospital has turned into a multi-storey pressure cooker that can extract every bit of empathy out of an empathetic doctor and instil every desire to escape this seraphic temple of patient care. No wonders if you see patient care becoming a mindless act of juggling. Crumbled under an inhuman work load, a doctor becomes vulnerable to more than just car accidents and needlestick injuries: he stands a chance of being defamed for the decisions he took, and the things he did, with only a half-sound mind.
There’s a part of us that has always ridiculed philosophy. It’s something that has kept talks on desires and passions away from scholarly and erudite discussions. But every time we’ve undermined the importance of human nature — we have either plunged down a blind alley or met head first with rejection. This instance of decaying empathy in patient care is another slap to our faces; it’s a snub to our pragmatic mind which, in the process of running the show, has fallen blind to the mental state of its dramatis personae. In this pensive mood, my mind is enticed by the news that the government plans to establish 200 new medical colleges in the upcoming decade to meet the shortage of doctors, and I decide to turn the page.
The writer, Dr Soham D Bhaduri, is an intern at Chhatrapati Shivaji Maharaj Hospital, Kalwa, Thane; an avid thinker on medico-social issues and a blogger at freethinkingmedic.blogspot.com.