In the commentary by Susan Adelman, MD, “Tell your patients you’re not perfect” (AMN, Oct. 23/30, 1987), this author grapples with some very difficult concepts. True, physicians are not perfect, and yet in medicine there is an expectation that perfection ought to come at some level. Physicians are involved in an art form whose medium of expression is human experience, and the product we strive to create is something perfect – undefinable, yet perfect and desirable; a valuable human result.
The way we do our work is called a “practice” for precisely this reason – we have a professional dedication and a commitment to perfection, and we fail at it with great regularity. It is our practice. That our patients can’t seem to appreciate our efforts, and that they choose to sue us in spite, is simply a reflection of the clings and arrows of outrageous fortune typical of this contemporary period.
If our society had a cosmology that worshipped its divinity more than its technology, and were spiritual consciousness the rule rather than whatever else passes for the norm, a physician’s lot in this society would definitely be a bearable one – if not actually pleasant. Dr. Adelman wonders if the public is ready to live with such high ideals (patience, compassion, forgiveness). It is said of our world that things are supposed to evolve this way sooner or later. As a physician practicing medicine in America in the 80’s, I vote for sooner.