It seems that we know a few things in medicine that are true.  Years and decades and centuries into our medical experiment, we have a few good ideas about what is, and is not, true.  It is true that we can bleed to death.  It is true that we can stop bleeding in many cases.  It is true that infections may be fatal, and it is equally true that we can halt some infections with certain drugs.  It is true that schizophrenia is a terrible disease, and cancer is a terrible disease  It is true that gravity pulls us to the earth, especially in our old age, with unfortunate orthopedic results.  It is true that cancer is a horrible affliction; as is malaria and river blindness.  It is true that death takes all; and that pain is equally disdained by humans with the capacity to feel it.

We have experienced and experimented.  We have studied and dissected.  We have constructed researh projects clumsy and elegant, ethical and terrible, in our search for the truth.

Now, in an ‘evidence-based’ era in medicine, we believe we are closer than ever.  To what?  To truth, of course.  To some growing body of objective reality about how to keep humanity healthy and happy, functional and useful.

Alas, we have left so much unexplored.  We have surrendered so much in our search for truth.  We have failed to ask relevant questions.  We are frightened to ask, ‘Why does suffering even matter?  Why does pain matter?  Why does extending life, or improving it, matter?’ We have contented ourselves with the minutiae of human existence; the molecular and cellular, the anatomical and pathological; all of which are necessary and noble, but all of which are component parts of the larger issues of humanity.  Just as we have erroneously worshipped science as an end, rather than a means to truth.

Do we want to search for truth?  If we do, we must search for it beyond the lab, and beyond the disease.  We need to stop lying to ourselves, and saying, ‘this drug, this radiation, this surgery are all that matter…the rest is beyond my knowledge.’

Our search for truth, in all its evidence-based glory, has to carry us into frightening precincts of the heart and soul.  There have been philosophers who said that there was spiritual truth and scientific truth, and that they could be contradictory but equally true.  But other philosophers have railed against this, and said ‘NO!  Truth is truth.’  Notably, St. Thomas Aquinus.

We do well to listen to Thomas.  Do we really want to know why our patients suffer?  Do we really want to know why we care?  Do we desire to heal their broken hearts, or only to mend their conveniently broken bodies and collect our salaries?  Do we hope to understand why they slash their wrists and cry in the corner, overcome with their self-hatred?  Do we dare explore why they kill themselves, why they lie paralyzed with anxiety?  Do we care to know what it is that drives them to drugs or alcohol?  Do we ever hope to grasp even a little bit of why they are so incredibly sad, so incredibly broken, so tragically lost in a bright, shiny, scientific, evidence-based world?

Truth is truth.  Only when we will transcend the needle, forgo the stethoscope, put down the prescription pad and look after the hearts and souls of our patients, only then will we become physicians in every sense.  And only then can we say we were really, truly concerned with what is, and is not, truth.

Edwin