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Anales de la Facultad de Ciencias Médicas (Asunción)
versão impressa ISSN 1816-8949
An. Fac. Cienc. Méd. (Asunción) vol.50 no.3 Asunción dez. 2017
https://doi.org/10.18004/anales/2017.050(03)13-016
Articles
Humanization of medicine
1Consejo Editorial ANALES, de laFacultad de Ciencias Médicas,Universidad Nacional de Asunción. Paraguay
If you consider yourself satisfactorily paid with the smile of someone who no more suffers, then become a doctor, my son! (Aesculapius, year first)
The practice of medicine is, at the same time, courteous but suffering, and gratifying but disheartening. It has cyclical alternations among lights and shadows. Many centuries ago, Aesculapius -the God of medicine- already said it when he gave a piece of advice to his own son:
Do you want to become a doctor, my son? This is an aspiration from a generous soul and an avid spirit of science.
Your life will pass in the shadow of death, and between the pain of bodies and souls.
You will not have hours to devote to family, friendship or study… you will no longer belong to you.
I feel sorry for you, whether you feel desire for beauty. You will see the ugliest and the most disgusting thing in the human species. Allyoursenseswill be mistreated...
When the patient heals, it is due to his or her robustness. If the patient dies, you are the only one who has killed him or her.
Think deeply about it while you are still on time. But if you are anxious to know the human being in the tragic part of its destiny, then become a doctor, my son!
Medicine has a singularity: its object of study is the human being itself. Thus, the term "humanization of medicine" could show a contradiction. Although it is paradoxical, a doctor in the role as a "curator" does not always assume that humane position. On the contrary, sometimes a doctor appears before the patient and his or her inner circle as a "demigod", embedded in the zenith of science and in the highest summit of its vertical position.
It is necessary that a good doctor has the following basic requirements:
Solid academic training
Management of the principles of Bioethics
Ability to sustain an affectionate doctor-patient relationship
Be aware of the importance of teamwork
Deep knowledge of medicine´s legal aspects
It is correctly stated that the first "drug" that a patient receives is the doctor´s personality and that the first therapeutic "procedure" is to shake the patient´s hands. It is proven that the best drugs fails if a bilateral empathy -that initiates a granitic relationship with the patient- is not established.
The wise Spanish doctor and philosopher Pedro LaínEntralgó stated the following: "In the relationship among the doctor and the patient the entire medicine is founded."
You can know a lot, achieve a supreme technique, and a wide erudition, but you cannot be a true doctor. The quality of human relationships is so important that there are successful doctors with basic medical knowledge. In contrast, there are unsuccessful doctors whom are known for academic wisdom. The ideal physician must necessarily combine both qualities.
Unfortunately, the uncontainable advance of science has impacted on the human quality of care. It creates, conversely, a kind of inverse relationship. In other words, to greater technological development, lower quality in the relationship between doctor and patient. The key issue that we shall ask ourselves before each medical procedure is the following: How would we feel if we are in the same situation in which the patient and his or her inner circle are? What if we were on the other side? What if we walked that same path? The answers to these questions are the key to the humanization of the doctor.
If we compare the medical practice with a cinematographic film, the main central character over the centuries was the doctor, who is followed secondarily by two kinds of actors. First, there is the patient as mere "object" of his or her science. Second, it appears playing a minor role the "extras ", that is the patient´s inner circle.
Currently, there is a trend which it have changed the vertical position - the doctor above and all the rest below - into a horizontal standpoint: all the protagonists of the "film" are put on the same level of importance. This approach even considers the patient´s inner circle as a new component of the medical team, to whom we should assign a role that it traditionally did not have.
Nowadays, the patient´s inner circle is considered instrumental due to the relevance based on emotional support. This is a significance benefit to the patient.
There is a plentiful bibliography on this subject. Fortunately, “humane” medical practices have already begun, such as the Hospital “Amigo del Niño” at the Pediatric Hospital “Acosta Ñu”, the hospital school classrooms for leukemic children at the IPS Central Hospital, and the Hospital of Clinics, Faculty of Medical Sciences U.N.A head office at San Lorenzo. Others examples of this practice are the kindergarten for officials and students children of the academic community, as well as the "Escuelita Hope" for children with onco-hematological diseases of the Department of Pediatrics. In these both examples, there are provision of breakfast, lunch and dinner and supervision of teachers recognized by the Ministry of Education and Culture. These are just some instances of these laudable humanizing initiatives, which clearly reflect this plausible trend.
There is proven evidence that these protocols facilitate a fluid relationship among the patient and her or his inner circle with the medical staff. Ultimately, this relationship becomes a key component that facilitates the good evolution of the patient, instead of to be a doctor's concession.
An anonymous saying in the fifteenth century stated that the doctor´s role can be summarized as the following:
The consolation must never be absent.
The great William Shakespeare affirmed: "The best medicine of the unfortunate is hope."