PHYSICIAN

Modern medicine’s focus on the mechanics of disease to the exclusion of the emotional and spiritual dimensions of illness and healing remains both its greatest strength and a growing weakness, according to this historical study.

Kurapati (Unbound Intelligence, 2014), a doctor, frames his discussion with his patients’ persistent questions about the meaning of their suffering and frustration at physicians who view them as assemblages of malfunctioning organs rather than whole human beings. He examines the centurieslong development of that mechanistic mindset. Ancient medicine, he argues, was a deeply religious and philosophical enterprise: healers, who were often priests, attributed disease to divine (or demonic) intervention or explained it in terms of a whole-life balance of elements and energy flows. Unfortunately, while these systems comforted the sick and embedded their anguish in a meaningful worldview, they hardened into unverified dogmas that seldom healed patients physically and sometimes, as in the practice of bloodletting, hurt them badly. That all changed starting in the Renaissance: an understanding of the body as a machine with a blood-pump at its center took hold; empirical observation began to eclipse received wisdom; dissection and new scientific instruments revealed hidden structures and processes in the body; and controlled experiments and statistical analysis made objective verification the gold standard in medical practice. Kurapati’s loose-limbed, erudite, but accessible exploration of this history ranges back to ancient Greece, India, and China and forward to the latest trends in robotic surgery and implanted sensors. He leavens the narrative with vignettes from his own clinical experiences, which are vividly observed—during his first Code Blue resuscitation, “in the farthest corner of the room, medical students huddled among the comfort of their clan”—and deftly illustrate his scholarly themes. (He notes how the dissection of cadavers in medical school inculcated in him a callousness and detachment that enable a dispassionate clinical attitude.) His case that scientific “dehumanization” is a serious drawback in modern medicine is not as strong as his argument that it was an indispensable breakthrough: as one of his illuminating anecdotes shows, a good hospital chaplain works wonders at salving a patient’s despairing soul, letting the doctors deal with patching the body.

A stimulating account of how medicine advanced by getting physical.