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The art of the doctor-patient relationship in the COVID-19 era

Michael C. Luciano, MD
Physician
April 17, 2020
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This a famous painting named “The Doctor” from 1891 by Luke Fildes. I was first introduced to this by my grandfather, the first physician in our family, an old school traditional family doctor. He cared deeply for his patients, and they loved him for it.

My grandfather gave me this painting on the day of my graduation from medical school. I always cherished it because of the great respect and admiration I had for him. However, I never hung this painting in my office. My initial interpretation was of a doctor incapable of helping his patient in a time of need. I saw the short-cummings of medicine at the time and was uncomfortable seeing the grieving family in the background. This was over a hundred years ago, before antibiotics and all of the modern innovations we have today. I thought to myself, that’s not why I got into this.  All that schooling, grueling exams, never-ending hospital call, being pushed to the brink to be your best for your patients. I put my time in to do better than my predecessors. I was going to work harder than anyone else, learn everything I possibly could, and help this patient so that I never experience this feeling of inadequacy or witness this grief because I didn’t have the answer. I didn’t realize at the time it’s not always about having all the answers.

It took me over 16 years of practicing medicine to finally realize the significance of this timeless painting. At the time, this painting was viewed as iconic due to the public’s desire to be cared for with a single-minded attentiveness. It brought the focus back to the doctor-patient relationship. Simply put, it is about the physician being there for his patient. Letting this patient know they are not alone. Sometimes that is all we have to give, but it can be exactly what is needed.

You often hear about the practice of medicine which, by definition, is the repetition of a skill set to gain proficiency. All the education, hard work, and countless patient visits are part of this practice.

The art of medicine is the application of all this information and skills we learn and relaying this in a humane way to this one patient in front of you, which is the only thing that matters at this moment. I am here for you is what each patient deserves to feel. This, in my opinion, is what separates the good doctor from the great doctor. That skill is innate. Those going into the field for the right reasons have this within them.

Today, we have more knowledge and innovations in medicine than imaginable.  Yet we still find ourselves back to a place familiar within this painting. In the midst of a pandemic without a cure and at the mercy of this novel virus. At this moment, all we have to give to our patients is ourselves. The fact that the doctor is risking his own health to be there to take the burden of suffering away is the art in its purest form. The compassion to see this patient as a unique person is truly an art which can never be taught in school or learned from a textbook. Knowing they are not alone and with someone who is truly there for them is all that can be done at this moment.

This profession is respected because of the trust instilled in us. We eventually will have a cure and vaccine for this novel coronavirus, but what is most needed from us now is to be the type of physician depicted in this painting. The practice of medicine will always be changing, but the doctor-patient relationship is an art form that will always be constant.

Michael C. Luciano is a family physician.

Image credit: Wikipedia 

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