Gems from Dr Prof Farokh E Udwadia, MD

Gems from Dr Prof Farokh E Udwadia, MD, FRCP, FAMS, MFCCP, FACP. Beach Candy Hospital, Mumbai.

"Medicine is an equal measure of art and science. Curing and healing are not exactly synonymous. Curing is science intervening to get rid of a disease or infection. But healing involves the whole mind-body complex. That’s the important distinction.

"Medicine has lost its path because it’s so enamoured of machines and technology. The doctor relates more often to these than to the patient. He's making his diagnosis in the laboratory rather than at the bedside.

"Advances in technology have led to a decline in the profession. If there's one reason for this decline, it's the lack of empathy, or deep caring. Today, the doctor fails to realise that unless he listens to the patient at length, and examines the patient carefully, only then can there be the doctor-patient bond which lies at the core of medicine.

"The old GP asked you probing questions, looked at you, listened to you, and stood by you. And he was pretty good. You must remember that when specialisation started, those great individuals who did neurology or cardiovascular or respiratory disease, were great general physicians too. Meaning, they were well-versed on a whole gamut of diseases. Until very recently, all these specialists had a large general ward and a small speciality unit. Today, you get your MD degree and lose touch with everything except your speciality. Medicine has become compartmentalised, that’s the sadness of it.

"Medicine is learnt at the bedside. It is never learnt from books. I could hand you a huge tome on medicine and ask you to study it for two years. You'd be able to answer everything from it, but would you be a good doctor at the end of it? No. Why? Because you have had no contact with patient.

"If a poor person comes to you and says, ‘Sir, I can’t afford your fees’, you must not say, 'Then I won’t examine you.' There’s a famous quote on this: 'Don't enter the temple of science with the heart of a moneylender.'

"When it comes to a chronic patient — say, one who has cancer — and he’s absolutely against chemotherapy, I tell him I cannot promise that it will cure you, but it will certainly extend your period of quality living. Think about it, ask others, but don’t take a hasty decision. If he comes back and tells me, ‘No, doctor, I still don’t want it’, I will respect his decision.

"Unfortunately, modern medicine, very often, wants to fight death to the very last. This is what is called cultural Iiatrogenesis: A physician-made condition. Ivan Illich, a professor of sociology in Mexico, wrote a fantastic book which I made compulsory reading for my registrars in JJ. It is called Medical Nemesis. The second edition was called Limits to Medicine.

"Active euthanasia -- giving something to a sick patient with the express purpose of killing him -- is unquestionably, in my opinion, morally wrong. Because you lose the respect for life, and that is the basic tenet we doctors live by."