THE LOST ART OF HEALING - Practicing Compassion in Medicine, by Bernard Lown, MD, Ballantine, 1999, New York, 344 pages, $14, ISBN: 0-345-42597-9
Doctor Bernard Lown, professor emeritus of cardiology at Harvard, having used the most advanced technology in medicine for four decades, reverts to the basics of the art of medical care as Hippocrates counseled twenty-five centuries ago, "For where there is love of man, there is also love of the art. For some patients, though conscious that their position is perilous, they recover their health simply through their contentment with the physician." And as the great German physician, Paracelsus, in the sixteenth century included among the basic qualifications of a physician "intuition which is necessary to understand the patient, his body, his disease. He must have the feel and the touch that make it possible for him to be in sympathetic communication with the patient's spirit."
Lown pays tribute to Dr Samuel A Levine, who taught him the art of doctoring and started him on a lifelong love affair with medicine. Critical questions from more than two hundred postdoctoral fellows, who spent two years working with him, help to refine Lown's skills. But the ultimate teachers, he says, were his patients. In 1960 he observed SAL, as Dr Levine was called, tell a patient with SBE, as the disease was progressing from being 100% fatal to nearly 100% curable, with the advent of antibiotics: "You are seriously ill, but you need not worry. I know what is wrong with you. I know how to treat you. I know how to make you well. You will recover completely." He saw the importance of providing patient hope. Lown describes how one patient misinterprets a bad sign by seeing it as hope to help him get well. "You came in with your gang, surrounded the bed, and looked as though I was already in a casket. You put your stethoscope on my chest and urged everyone to listen to the 'wholesome gallop.' I figured that if my heart was still capable of a healthy gallop, I couldn't be dying, and I got well. So you see, doc, it was no miracle. It was mind over matter."
Bernie Lown has a unique ability to take us on a journey through his professional career, weaving in unbelievable patient stories that will break you up, sometimes laughing, sometimes in tears. He brings home clinical truths lost in our present practice realities, that he feels are not appropriate and he is spending time and effort to change. Just as this book is required reading for the Integrative Medicine Residents at University of Arizona, we should all read this to reevaluate the world of medicine that we once learned and should espouse again.
Del Meyer, MD