The Body Mechanic

I recently shadowed an intervention cardiologist and scrubbed in for two angioplasties for two heart attack patients. This experience reminded me about something which has been troubling me for some time: I think one of the most disheartening parts about being a doctor is listening to some people say that they don’t need doctors. They have a lot of ways of saying this: that doctors are “no better than mechanics,” that doctors don’t do anything that can’t be substituted or done better by a robot or an advanced computer system, and perhaps worst of all, that they don’t intend or plan to get sick (ranging from contempt and jealousy to ignorance to, for lack of a better word since “self-neglect” doesn’t quite cover it, stupidity). This is not to say that people shouldn’t be unhappy with the way that health care is provided – at great cost and inconvenience to almost everyone. However, I think that a lot of these critics fail to understand the reality of the situation:

1. People get sick. No matter how healthy you try to be or how much preventative medicine you take part in as a patient, you will, at some point or another, get sick or injured. Avoiding health care is a terrible decision to make, because it will only hasten your death, or perhaps worse, severe disability and pain. The cardiologist explained to his patients in the trauma center: “time is muscle”, and the longer the patients take in making a decision on whether or not to get an angioplasty (as opposed to intravenous medications which are effective but take longer to start working), the more the muscle tissue in their hearts dies (note: a myocardial infarction, or heart attack, results from a blockage of the supply of blood to the heart’s own tissue. If too much heart muscle dies, the heart fails to pump blood throughout the body, and most importantly, to the brain, which results in death.). One of the patients, a man in his early 40’s suffering from an anxiety disorder, was uncertain whether his chest pain and nausea was caused by a heart attack or his anxiety. Nonetheless, it was fortunate for him that he made the decision to go to the hospital. Much in life is unexpected and unpredictable, and as much as we might try to reduce the risk, there will always be risk because there will always be accidents and we will always have blind spots that we failed to cover.

2. You want a person to take care of you, not a machine or yourself. I personally believe in the utility of technology and the power of knowledge. I admit to using websites like WebMD and eMedicine to look up medical information related to my own health, and I think they’re a good thing. However, I go to the doctor and appreciate them for what they do and provide, even if I think I can come to the same conclusions based on my own research. Furthermore, actual doctors go to see doctors all the time. It’s not that they’re not smart enough to figure out what’s going on in their bodies. It’s just not possible to know everything you need to know to make the most educated judgment possible about what is wrong and how to deal with it without the help of an expert.

This argument is most supportive of specialists, but I have something to say on behalf of generalists (like family practitioners, pediatricians, and primary care physicians) too. I agree: doctors can be like mechanics, except for the human body. But what do you value more, a car or your life? You can live without a car, but you can’t live without your body. Furthermore, as much as it might be frustrating to have a car that gives you trouble, it’s much worse to have a body that isn’t working.
As for me, I was feeling tired of studying and in need of a pick-up when I went into the hospital to shadow the cardiologist. As soon as I walked in the door, he spotted me in the hallway and grabbed me as he was headed to the trauma center. Four hours later, having watched the saving of two lives, I went home, energized and with a smile on my face. If it feels this good standing beside the doctor and the patient’s bed and watching lives be saved, how much better will it feel to actually do the saving?

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