Tuesday, January 29, 2013

What Makes a Good Family Doctor?

     1.  A good doctor has the ability to go to where a patient is, find the place of suffering, and open it, gently.
          a)  The true place of suffering may be very different from the place the patient points to.
          b)  The route is indirect.
          c)  The doctor must approach with caution and sensitivity, as though the patient were a rabbit or mouse, so as not to cause him or her to run away.
     2.  A good doctor understands that medicines are tools, but not treatment.  Without treatment, a patient will get sick in the same way over and over, no matter how modern or powerful the medicine, or how quick the apparent, initial recovery.
          a)  Real treatment requires a relationship between two people.
          b)  A transformation in a patient's physical state requires that the relationship between two people--doctor and patient--be mirrored internally as a relationship between the patient's deep and superficial aspects.
          c)  The relationship must be caring.
          d)  None of this can be spoken about in a direct way.
          e)  Stories, symbols, myths, religious accounts, dreams, local lore, humor, references to one's personal life, or to other people's maladies and cures may present themselves as material for finding the right path to a healing center, in the same way that birds, tracks, other spoor, or totem animals may show up to guide a person through the woods to the deep interior, where there is water.
          f)  The trip through the woods is one way a person can get to know himself.  It applies to the doctor and the patient, since knowledge moves in both directions.
          g)  Water is healing.
     3.  Possessing many manual skills, and having expertise with a wide range of simple, modern methods for looking at the bodies of patients and conducting treatments is a good thing.  It inspires confidence, and fulfills the expectation of patients in every age that the doctor be well-trained and capable.  This was as true in medieval times as it is now, although the nature of "modern" methods is always changing.
     4.  The longer a doctor and patient know one another, the better.  A relationship over years and decades makes for much more efficient treatment.
          a) After awhile, a simple word or the doctor placing a hand on the spot that is sick can adjust the patient's broken place--the brokenness is making him sick--so that it is set right, and the patient gets well.
          b)  Trust, and a history of getting well many times in the past, make it easier to get well again, if the surroundings and doctor are the same.
          c)  Having to find a new doctor is jarring to a patient, and can bring on new problems.  The next doctor is unlikely to have the same kind of mirror, which therefore may take years to get used to.  Sometimes, however, it's the only option.
     5.  You can tell whether you have a good family doctor if, when the doctor comes in the room and sits down, and looks at you, and asks you questions, and you answer them, and more things are said, or there is a thoughtful silence, you notice your lungs filling up.  Then, the air comes out as though of its own accord in the form of a deep, restful sigh, and your posture relaxes, and you have the feeling that you want to smile.  

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