I grew up in an era of video game cartridges – large, plastic, square holders for prized video game technology chips. They were great as a result of their additive effect to the overall experience of trying to operate and play an early console such as Nintendo or Super Nintendo (among others). I’m sure that others will empathize, but the games didn’t always work 100% after being inserted into the console. As a result, we-console-owners developed our own methodical routine and ritual in trying to get our games to work. My personal ritual included first inspecting my game cartridge, then blowing the inside of the cartridge systematically in a vertical fashion to blow away any dust, and an occasional slap of the cartridge on my thigh as good luck. More often than not, success was achieved and euphoria ensued – I call this the art of blowing cartridges.
As in the case of gaming, most gamers see their approach to their specific games somewhat as a science. In order to beat a game like Super Mario Bros., if you did not die by getting hit by the enemy or falling down a hole, and if you defeated the enemy boss, your chances of success and winning was almost certain. In essence, having A plus B equaled an end result of C. However, how your approach of adding A plus B was often somewhat of a personalized experience. Whether it’s first-person-shooters or RPGs, there is always a clear objective with necessary steps in order to attain success, but we all know that it is in those steps which hold the secrets to formulations, tactics, principles, and the art of gaming.
This is also true of medicine. Just as how the cartridge meets the game console, likewise, the physician meets the patient. Physicians in this country (USA) must first graduate from an accredited college/university, upon graduation must learn through four years of medical school, and after, must complete at least three more years of residency (sometimes six and optional additional training called fellowships) in order to become a full-fledged physician. In those long years of hard work and training, physicians try to internalize the world of medicine including different diseases, treatments, protocols, principles, and more. What is learned through those years can be analogous to that prized video game chip. Once physicians are allowed to practice, they meet a system which we call “the real world.” We know that in real life, ultimately if two physicians were to treat two identical patients, the outcomes of treatment would be the same; however, slight differences can arise. How the physician approaches the patient and interacts with the patient can be different. If there are no evidenced-based protocols for a certain disease, then treatment approaches may differ between physicians. How the physician deals with psychological and social issues of a patient may also differ. We call these differing techniques and tactics that have evolved after learning the basics of medicine – the art of medicine.
What makes medicine so challenging sometimes is that in some cases, more often than not, situations arise where there is no black or white answer – it’s usually all different shades of gray (sorry for the cliché). It’s true that the medicine exists and that basic sciences form the basis for the approach of medicine, but over years of experience and training, many physicians have developed their own “art of medicine” in order resolve subjective problems in medicine. Sometimes, there isn’t always a right answer or method, but there is always single goal in mind and that is to treat the patient in his/her best interest.
-J.W.
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