Casting spells

Anne Marie Hourihane (Irish Times 22 April 2013) laid into the Irish healthcare system: ‘It is truly dreadful’ she wrote, ‘to get into your car outside a celebrated Dublin teaching hospital, convinced that you might as well be leaving your loved one on the platform of Heuston Station.’ Not surprisingly Dr Shane Considine (24 April) took exception. I’ve been a hospital doctor, and was a medical educator for 30 years. Now I’m in the parochial ministry of the Church of Ireland. I can glimpse both points of view.

Some patients claim they are not told things that matter to them. Perhaps they don’t remember what is said to them: there is plenty evidence of how what we ‘hear’ is not always what is said. Perhaps the professionals can’t imagine how forlorn it feels to be a patient. The film ‘Wit’ has Emma Thompson as a dying patient whose feelings are trampled upon and whose suffering is observed rather than treated. Perhaps the prospect of litigation means that professionals won’t say anything until technology has provided evidence. Compensation culture catches up with us. Perhaps some doctors have been educated in medical schools where patient-centred concerns are not valued as they are here. This is ironical: Irish medical education is tailored to the needs of the home culture, yet a good proportion of doctors trained here emigrate permanently. I wonder why? And perhaps there is something that encourages doctors to think of themselves as set-apart, different from ordinary mortals. Speeches made at welcome ceremonies, oaths taken at graduations, and the very rituals themselves all point to a mystical ordination rite in which doctors are ‘consecrated’ as an elite.

This is not altogether their fault. It is ours too. We want medical professionals to heal us, to take away our misery. We want them to be gods, omnipotent and omniscient. Yet, when things go wrong and they retreat behind the veil of assumed divinity, we raise hell.

This is a partnership. Whatever the members of the medical profession might need to do, we need to take responsibility for ourselves. The body is a machine and needs to be properly looked after. We need to stop expecting abracadabra miracles, and accept that tubes get blocked, wiring goes wrong, and cells start to reproduce for reasons as yet unfathomed. And even when they are fathomed, and we don’t die of cancer, we can be sure we will die of something else. We need to remember that we are mortal—life is terminal.

I had a parishioner who was delighted—yes, delighted—when doctors told her there was nothing more that could be done. ‘At last’ she said, ‘someone has been honest with me.’