collision...

I love being involved in a field where so many different academic disciplines collide. Historically, there were only four academic disciplines: theology, medicine, jurisprudence, and the arts. If you look for a definition of "medicine" on wikipedia, you come up with this:

"Medicine is the branch of health science and the sector of public life concerned with maintaining or restoring human health through the study, diagnosis, treatment and possible prevention of disease and injury. It is both an area of knowledge -- a science of body systems, their diseases and treatment -- and the applied practice of that knowledge."

While this is a decent and concise definition of what I do on a daily basis, I would submit to you that it is much more. When you talk about "restoring human health through the study, diagnosis, treatment, and possible prevention of disease and injury," there just isn't one magic pill that I can prescribe that will take care of all of that. The restoration of health often involves taking much more interest in how and why the patient is sick, rather than just diagnosing and treating their illness. Restoration of health also requires that when a patient comes to see me in clinic with a chief complaint of "hypertension and refills," I need to distinguish if that is her real complaint, or if her true complaint is that she can't afford the $59 a month that she has been paying for her medications. And then I need to figure out how I can help her.

I think if I ever decide to go back to school in the future (I mean, um, after I get out of school), I would want to get a Ph.D. in sociology or social anthropology, studying the effect of inequity on access to medical care. It is easy to document an "outcome gap" (which is a horrible euphemism that basically means given a certain medical condition, a poor person is more likely to have a worse outcome than a rich person) and show that it is caused, at least in part, by differential access to increasingly effective technologies [Paul Farmer in Pathologies of Power: Health, Human Rights, and the New War on the Poor]. I think that what I can do now is make sure that I am providing equitable care for all of my patients, regardless of their race, sex, socioeconomic status, etc.

There is a famous statue depicting Lady Justice, where she holds the scales of justice and wears a blindfold. I do not have the luxury of wearing the blindfold of Lady Justice, and I'm not sure if I would want to. I want to be able to truly see people. I pray that I will not be blinded.

So here's my definition of medicine: medicine is the collision of science and sociology, affected by business and law and politics, and beatified by the arts and theology.

When we come to you
Our rags are torn off us
And you listen all over our naked body.
As to the cause of our illness
One glance at our rags would
Tell you more. It is the same cause that wears out
Our bodies and our clothes.

The pain in our shoulder comes
You say, from the damp; and this is also the reason
For the stain on the wall of our flat.
So tell us:
Where does the damp come from?
--Bertolt Brecht, "A Worker's Speech to a Doctor"