|Genre||Treatise (187 pp.)|
|Keywords||Art of Medicine, Communication, Death and Dying, Disease and Health, Doctor-Patient Relationship, Empathy, History of Medicine, Medical Education, Medical Ethics, Medical Mistakes, Physician Experience, Power Relations, Professionalism, Suffering, Technology|
Jacob Needleman, a philosopher concerned with "applying philosophy to the questions of everyday life," taught medical ethics at the University of California, San Francisco (USC-SF). In this highly personal book he addresses what it means to be a "good doctor" and the role of physicians in contemporary society. The book is structured as a series of imaginary letters addressed to his childhood idol, the physician who treated him when he was 12 years old.
The aged Dr. Kaufman responds to these letters, although we see only the philosopher’s side of the correspondence. Toward the end of the book, Needleman makes a pilgrimage to Philadelphia to visit his ailing mentor. They talk for a while, then when the old man takes a nap, Needleman spends the rest of the day conversing with Dr. Kaufman’s daughter, a pediatrician who in some sense represents the "good" medicine of the future, just as her father represented the "good" medicine of the past.
In these letters the author addresses the deep questions of character and motivation in the form of a personal narrative. He recalls his experiences as a boy, his ambition to become a doctor, and several incidents from his life as an autopsy assistant and hospital orderly. For example, there is the bizarre story of the young man transporting an amputated leg by elevator; he accidentally drops the leg to the floor and the wrappings flip open, much to the astonishment of others on the elevator.
"People don’t trust science; people trust people." (p. 15) Similarly, Jacob Needleman writes, people don’t trust or distrust medicine as an institution; they trust or distrust doctors. "To be a good doctor, one must first of all be a good (person). And to be a good (person) one has to begin by discovering in oneself the desire for truth . . . truth is the only effective force." (p. 68)
To facilitate this quest for truth, Needleman describes in these letters a four-seminar sequence he teaches at USC-SF: "To whom is the physician responsible?," "The art of living and the art of medicine," "Care," and "The financial disease of modern medicine." (pp. 71-72) Through these seminars the author hopes to re-awaken in prospective physicians the quest for truth, and the possibility of care, that he believes have been submerged by technology and infected by the financial disease. Dr. Kaufman’s daughter serves as a real-life example of the possibility of cultivating the contemporary version of the "good doctor."
This book was published in 1985--the demise of the "good doctor" was already well advanced 18 years ago. Not surprisingly, the same was true in Arthur Hertzler’s The Horse and Buggy Doctor, published in 1935 [see annotation in this database] and in "The Care of the Patient," the famous essay published by Francis Peabody in 1927. In fact, no matter what time period you pick, the "good doctor" is always on the decline, receding into the rosy past.
The most interesting aspect of The Way of the Physician is the philosopher’s choice of narrative, rather than logic or philosophical analysis to carry his argument; or perhaps I should say, "his conversation." The technique of using a series of letters to present a form of narrative, while at the same time advancing a moral argument should be familiar from C.S. Lewis’s well-known The Screwtape Letters, as well as from moral philosopher Gilbert Meilaender’s Letters to Ellen (William B. Eerdmans Publishing, Grand Rapids, 1996). This device allows the author to present a "conversation," in which only one participant actually speaks. In Needleman’s version, the letter writing is supplemented by the appearance of a real life "good doctor" near the end of the book.
|Publisher||Harper & Row|
|Place Published||New York|
|Annotated by||Coulehan, Jack|
|Date of Entry||05/12/03|