Advances in Medicine
As the history of medicine has evolved, a number of trends and prevailing opinions have swept the profession. One of the most subtle, and yet most revealing results of these sweeping trends manifests itself by altering the tone in medical conversations and dialogues, often available to the non-medical person in the form of texts and literature. A relatively current example appears in the form of Perri Klass' A Not Entirely Benign Procedure, a text dedicated to the experiences of the author at Harvard Medical School. Published in 1987, Klass' work offers an interesting, if not shocking comparison to Philippe Pinel's "The Clinical Training of Doctors," an article published in 1783. It seems that, despite the obvious advancements and progress in medical technology and general care, the modern Klass presents less certainty about the profession and its abilities than does the eighteenth century article. In Pinel's article, however, a distinct tone of holistic healing pervades the proposed training of physicians-the lack of which Klass bemoans in her work. The contrast between the two works affords the reader a view into two parallel transitions in medicine: the decline of certainty and the decline of holistic care.
shocking aspects of Pinel's article involves the specificity in patient setting and observation he demands. Pinel advocates only the simplest medications and interventions in an attempt to cure, and notes that most often, as in the example of Hippocrates, diet is the source of cure. Heisenberg's Uncertainty Principle was a watershed moment in the general paradigm of science in that it posited a limit on the accuracy of observation. Pinel's demands range from the sensible to the seemingly outrageous. Klass laments the fact that modern physicians, in the face of failing diagnosis or treatment, request more tests and more adventurous invasive procedures, rather than adjusting to a role of comforter and caretaker. " The true sense of physician only comes with cure, but Klass, and many other physicians come to realize that there exists much they cannot cure. The more extreme requests and propositions, however, offer a more penetrating insight into his and his time's beliefs concerning the potential of medicine. The implications of Pinel's suggestions include the assumption that a cure can be found, and precise scientific scrutiny will inevitably reveal its location. From precise measurements of the weather to room orientations, Pinel seems to imply that precision in observation and care-giving will lead to precise diagnoses and eventual cures: "It is obvious that medical observations can be precise and conclusive only if the evidence is reduced to the smallest possible number of facts and to the plainest data. Her reasoning is simple: "It's frustrating to want to cure, to carry with you the expectation that somehow you should be able to cure, and then not be able to cure. Advances have led to some understanding, as evidenced by Klass, that the search for cure should not serve as the model for the role of the physician. Without the benefits of technology and, more importantly, without the benefits of the radically influential ideas of Heisenberg and others, Pinel hopes and writes assuming that every cure can be found through careful scrutiny and observation. To function accurately and properly, the physician must account for all possible influences on the health and condition of the patient: "Notes on celestial observations, meteors, and the phases of the moon should complement the daily recordings from these [meteorological] instruments. An odd, but unmistakable parallel begins to emerge from a comparison of these two works by Klass and Pinel. She does not deny that the expectation of cure still represents the model of the physician, but she does mention that this needs to change.
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Acceptance Essays
