This is the arc: Person > Time > Physician. Not a cycle of regression, but of reinvention.

Phase One: The Person at the Center

The roots of modern medicine were personal. The physician was a familiar figure—a generalist who treated generations within a single household. Medicine was relational, grounded in trust, and delivered with a deep sense of continuity. Perhaps reflective of Life Magazine’s 1948 article about “The Country Doctor” described in the story as “chronicling the day-to-day challenges faced by an indefatigable general practitioner named Dr. Ernest Ceriani.”

Diagnoses came as much from conversation as from tests. The clinician listened first, treated second, and followed the arc of a life over the years. Care in this phase wasn’t perfect. It lacked the diagnostic precision and computational power of today. But it was holistic and even economical, or at least tried to be. It honored the complexity of the person, not just the pathology.

Phase Two: Time as a Dominant Force

As medicine scaled and systems matured, priorities shifted. The explosion of specialization, regulatory oversight, and insurance complexity transformed the clinical encounter. Time—finite, quantifiable, and billable—became the axis around which care revolved. The physician’s role narrowed. The 10-minute visit became the norm. Clicks replaced eye contact. Patients became entries in digital fields, and clinicians became overburdened intermediaries between policy and protocol.

Technology, introduced with the promise of efficiency, often had the unintended consequence of distancing the doctor from the patient. In this era, quality wasn’t often measured in trust or presence, but in throughput and compliance.  And perhaps most importantly, often counter to the desires of both patients and clinicians.

Phase Three: The Return of the Physician—Reimagined

And yet, here we are again, on the edge of a new transformation. Surprisingly, it’s not nostalgia driving the shift, but innovation. The very technologies that once fragmented care may be offering a path back to the human core of medicine.

Artificial intelligence, automation, predictive analytics, and remote monitoring aren’t here to replace the physician. They’re here to liberate them. These tools offload the administrative weight, surface meaningful patterns, and support decision-making. They create space—cognitive, emotional, and temporal—for the physician to re-enter the room fully present.

This isn’t a return to the physician of the 1940s, but the emergence of something new and discover a digitally enabled, intellectually unburdened clinician who has time to think, listen, and connect. 

We’re Not Going Back—We’re Going Forward, Differently

The arc of care doesn’t circle back—it spirals forward. Today’s renaissance of the physician isn’t about nostalgia. It’s about design. About recognizing that the highest expression of technology in medicine is not automation, but amplification of the human.

This is physician-centered care, powered by artificial intelligence and yielding the much sought-after patient-centered dynamic. It’s a model where AI works in the background, allowing the clinician to lead with insight and empathy. Patients are known not just by their labs but by their lives.

A Full-Circle Revolution

So here we are—completing the arc. From person to time to physician. The system that once de-centered the doctor is now making space for their return—not because we missed them, but because we need them. And not as clerks or data jockeys—but as guides, partners, and thinkers.

The future of medicine may be high-tech, but it is also can be—once again—deeply human.

The post Back to the Future of Medicine: The Physician Reimagined appeared first on Medika Life.

A panel of licensed healthcare professionals preferred ChatGPT responses 79% of the time and rated ChatGPT responses as higher quality and more empathetic. Gulp. Understandably, some doctors are not happy with this study. And many were not pleased with me for not diving deeper into the complexities inherent in the research in my initial LinkedIn post. Message heard. Understood!

The news headlines and the initial study callouts overplay the immediate importance of ChatGPT in the physician-patient relationship. Physicians do not fair poorly.  However, the authors provide an inflection point that should not be ignored and must be acknowledged – Communication is Part of the Care and Cure! Physicians must be trained and have time to deal with patient curiosity and urgencies. #Patientexperience is different. They do not want to sit idle or silent. They are curious and concerned.

As generations have become more familiar with technology in their day-to-day lives, perhaps they place more trust in machines’ “unbiased nature” over humans. That assumption has led to the rise of “#misinformation.” We believe our Twitter feeds if we don’t explore the facts further. But, our screens reduce the press of needing to engage with people at the moment – they give us time to think and check in with this “on-call” information aggregator. To let the information sink in without being confronted about the next step. Doctors are too often pressured into an eight-minute per-patient provider reimbursement model. It’s not their fault – it’s the system that they must co-exist within. But that tilted system leads to the consumer seeking – needing – alternatives. If so, even imperfect ChatGPT4 and beyond will be a go-to.

There are changes afoot that we need to make happen sooner rather than later by moving minds, systems, and behaviors so that life-sustaining and life-saving approaches to patient care may eventually tip the scale of human survival toward health and wellness. However, we see data from a human perspective – sometimes self-interests or emotional needs for control. ChatGPT is the aggregate of data and human input. It is not divorced from us but a faint mirror of the human experience.

Yes, this study is worth reading. Yes, many have criticized its design and the intent of the authors. Yes, many are fearful that machines may replace physicians. But, the latter assumption is doubtful. Reading between the lines reinforces that, as industry colleague Ritesh Patel often says, “If it moves, digitize it!” People get their information in ways that are quick and convenient. That is a reality everyone in the health community must face!

The medical community and health communicators must rise to the moment if they want to harness this technology. Learn about ChatGPT and how it operates – its prompts. Also, read words from experts on the digital health news platform Medika Life including the insightful words by innovation theorist John Nosta. John will rock your boat; however, often, he points to where this is going.  Read the words of Tom Lawry, former head of Microsoft’s AI team, author of the best-seller Hacking Healthcare, and a global counselor on the practical application of AI.

Almost one year ago, I penned a piece titled: Health Possibilities We Cannot Afford to Block. There were 10 ideas/technologies included in that piece – #1 was #AI. That’s the heart of ChatGPT. Fixing one part of the healthcare puzzle is encouraging – but is it transformational? What can we do to make things work better for patients? Medicine can harness the power of ChatGPT to make it work even better for patients seeking healing solutions. Perhaps we can give physicians more time to help patients feel their doctors have and always are among their greatest advocates. We can also bring technology companies and leading medical associations together to talk about ChatGPT influence on trusted people-to-people connections, particularly with physician-patients.

Why do consumers turn to machines instead of people for medical counsel?  Well, we haven’t been able to clone or at least develop teaching models drawing upon the many outstanding physicians who demonstrate incredible patience and empathy for patient woes and questions – doctors like WebMD’s John Whyte and NHS’s and Microsoft’s Junaid Bajwa—many answers to consider. Among the most important are skill, collaboration and empathy.

Consumers may feel that devices are better listeners and work with them in partnership. We should expect this outcome due to the fragmented health ecosystem that consumers must navigate with difficulty. We must recognize that ChatGPT’s interest and popularity among health information seekers didn’t just happen. It is possible to realize that these same information seekers feel they are not getting what they seek.

Keep learning! This is not the end of humanity and the beginning of the Matrix – where people, software and machine battle for survival. The world will be changing in amazing ways in the short years ahead. Collaboration and communications go hand-in-hand as essential tools for healing.

The post Does Artificial Intelligence (#AI) Chatbot Outperform Physicians in Patient Experience? appeared first on Medika Life.

Medical malpractice “standards of care” are the generally accepted norms and practices that healthcare professionals are expected to follow when providing medical treatment to patients. These standards are based on the medical community’s collective knowledge and experience, as well as on established medical guidelines, protocols, and best practices. It’s the basis for our expectation of quality care, or at least average care.

The specific standards of care that apply to a particular case depend on various factors, such as the patient’s medical condition, the nature of the treatment being provided, and the relevant laws and regulations. For example, a doctor performing surgery would be expected to follow established surgical protocols and guidelines, while a psychiatrist treating a patient with depression would be expected to follow established guidelines for the treatment of mental illness. In any instance, if often is a human standard — as a personal judgment or interpretation of an aspect of technology.

This leads to a fundamental medical and legal question: How do we define and debate the evolving standards of care in the context of available medical technology—particularly artificial intelligent and platforms like ChatGPT? 

The first and critical perspective is the liability for using artificial intelligence and machine learning in medicine. While certainly in flux and given the rapid emergence of GPT, the concerns are significant and relevant. And even papers published only months ago fall short for a comprehensive and timely discussion. A 2021 paper provides a succinct analysis.

The relatively unsettled state of AI/ML and its potential liability provide an opportunity to develop a new liability model that accommodates medical progress and instructs stakeholders on how best to respond to disruptive innovation.

These issues are arriving quickly than expected and the inertia of progress will demand action. But it’s essential to look beyond this point in time and consider the trajectory of AI in medicine. There’s little doubt that AI will become “augmented intelligence” that will expand the cognitive domain of all clinicians. Artificial intelligence and language models like GPT have the potential to advance the practice of medicine by helping clinicians make more accurate and informed decisions. AI can assist in medical imaging, clinical diagnosis, and other areas where data analysis is critical. 

In fact, one can argue that AI in medicine is here. Even Harvard Business School recognizes the fundamental reality of AI in medicine today.

Medical artificial intelligence (AI) can perform with expert-level accuracy and deliver cost-effective care at scale. IBM’s Watson diagnoses heart disease better than cardiologists do. Chatbots dispense medical advice for the United Kingdom’s National Health Service in lieu of nurses. Smartphone apps now detect skin cancer with expert accuracy. Algorithms identify eye diseases just as well as specialized physicians. Some forecast that medical AI will pervade 90% of hospitals and replace as much as 80% of what doctors currently do.

Radiology is another good example where AI is driving significant changes. From workflow to post-scan image reconstruction, radiology is at the leading edge of how AI-based medicine is shifting from an option to an imperative. And today, there are over 500 FDA approved AI algorithms with the vast majority in radiology.

A fundamental question that emerges: what is the expectation of care are given a growing body of evidence for the utility of AI? Should every differential diagnosis have a “computer assist” as part of the process? Or should the distant lub dub of a heart sound live only in the ear of the clinical or be cognitively amplified by technology? And most importantly, what are the consequences for failing to leverage lifesaving technology that has clinical validation and availability?

Today, new questions will be asked regarding the best care, the available care, and the standard of care that medicine will be held up to. New standards and expectations for excellence will challenge the core capabilities in the practice of medicine. The cognitive domain of the clinician—once held as sacrosanct—will come under scrutiny as AI offers the accuracy and speed that is fundamental to care.  The path is defined by ambiguity.  But what maybe be most important about that early path are the guardrails that are put in place for all stakeholders.

The post Physicians Aren’t Becoming Obsolete, The Standards Of Care Are appeared first on Medika Life.

The power of the painting is the gaze of the doctor on his patient. Now is the place, the time, the person – he has no other thoughts or concerns except to assist her back to health if he possibly can. We do not know the medical problem, but we can infer it is serious. And we do not know the outcome, although there may be a clue because through the window comes a faint ray of light.

I did not fully appreciate the implications of this work of art when I first received it, but I came to understand that this physician was a healer. He had listened; he was nonjudgmental; he had earned trust. He has done his best but understood that he alone would not be her cause of cure should a cure ensue. He understands that he is but a humble person entrusted with the most important of all missions – to assist others in finding health. He has done his best and, in doing so, exemplifies the characteristics of a healer.

My maternal grandfather, Leonard McClintock, MD., was a general practitioner in New York state. He graduated from Albany Medical School in 1898. He set up his practice in what was then a small town on the Hudson River, Beacon, N.Y. He built a room on the side of their home to serve as his office and used the large wraparound front porch as the waiting room. There were no appointments; you came and sat on the porch until it was your turn. Office hours lasted until the last patient had been seen. 

Initially, there was no hospital, and he cared for all patients in the office or at home, although later in his career, he helped to establish a hospital directly across the street. In his day, a physician had relatively few tools to treat someone, so the skill was to make a diagnosis and inform the patient and the family what the situation was and what the course of that illness would probably be. Yes, he could do some things, including treating pain with morphine, removing an inflamed appendix, sewing up lacerations, and delivering babies much more safely than could have been done without the assistance of a trained clinician. 

But during the course of his practice, which ended with his death in 1936, medicine began to change toward a much more scientific basis. To a large degree, this was propelled by the influence of Johns Hopkins University School of Medicine and Hospital in Baltimore, MD. Founded in the late 1800s, it instituted the concept that medicine was and should be a science. Therefore, Johns Hopkins would teach a science-based medical practice during four years of medical school. In addition, Hopkins established what we know today as the standard residency training program following medical school. 

This was a dramatic change in medical education and training and, as a result, dramatically changed the way physicians thought about medicine and patient care. During my grandfather’s practice, he began to see the beginnings of those changes. For example, insulin was discovered in the 1920s, and the first antibiotics in the 1930s. After his death and the completion of World War II, the National Institutes of Health began to develop, grow and place large sums of money across the country in various medical schools and within its own walls to conduct basic biomedical research. 

The result is that today our ability to repair, restore to function or replace an organ, tissue, or cell has moved ahead at a dramatic pace and will do so even more quickly in the coming years. Concurrently, the pharmaceutical industry also became scientific, resulting in a continual outpouring of new drugs that can relieve suffering, reverse harm and cure many diseases while extending our life span. In addition, with the advent of the science of genomics, it is increasingly possible to predict the onset of illness before it occurs and thereby create a preventive approach for the individual patient.

Soon we will have immediate access any time, any place to our medical records, which will be fully digitized, and the safety and quality of medical care will dramatically improve. All of this is because of the science base of medicine, which was introduced over 100 years ago.

Something else has happened, but it has not been appreciated. In the past, illnesses tended to be “acute,” meaning that they occurred, were treated, and got better, or the individual died. For example, if your child developed “strep throat,” the pediatrician gave an antibiotic, and it got better. If it was an inflamed gall bladder, then you were referred to a surgeon who operated, threw away the gallbladder, and you were cured. But today, most illness is chronic and complex as well. For example, if a person survives a heart attack, he may still have some damaged heart muscle and so develops heart failure. This will be with him for life and will need multiple treatments, many medications, probably multiple hospitalizations with an ICU stay or more, and might even get to the point of a heart transplant.

Now that is chronic, and that is complex! So it is also with diabetes, rheumatoid arthritis, many cancers, chronic lung disease, kidney failure, and many other diseases are frequently seen today.

This is a major shift and enormously impacts how we should [but mostly do not] organize the treatment of the patient and their disease, how we should [but mostly do not] organize the payment system for that care, how we should [but mostly do not] use technologies wisely for maintenance, and how we should [but mainly do not] assure quality and safety in patient care.

This is a profound change, but most of the “healthcare reform” approaches do not address the implications of this change to chronic, complex lifelong illnesses. Although aware of the change toward more and more chronic diseases, physicians also tend to want to preserve their current practice patterns developed over the years to handle acute illnesses, even though the current chronic, complex diseases require a different approach.

But in that same time frame of scientific advancement and the rising frequency of chronic illnesses, we also began to lose something in medicine. That loss is the genuine “connection” between the physician and the patient. Most of us feel we do not have enough time with our physician; the physician seems busy and distracted, often by the computer, and not able or willing to listen to our story in full. 

From the physician’s perspective, they feel that there is not enough time to spend with an individual patient; not enough time to learn about the family and the environment in which that patient lives, and therefore in which the patient’s disease has occurred; that there is not enough time to focus on preventive instructions or to even talk thoroughly about the plan for the care of a specific illness or problem. But all too much time is spent following mandates, filling out forms, often repeatedly, and then being paid by the insurer well under what the time and effort were worth. Physician burnout has reached epidemic proportions.

Today we need to preserve our newfound skills and techniques, drugs, and devices but also remember that patients are human and need empathy, caring, and attention, not just technology. Equally, providers need the ability (time) to give the care they were trained to provide, the care most wanted to give when they first decided on medicine as a career.

Unfortunately, rather than a true healthcare system, we currently have a dysfunctional American medical care delivery system. We need a healthcare system, but the cards are stacked against it. That said, it can be changed. Probably not by Congress, nor by the insurance companies but only by the unique interaction of doctors and patients demanding what is and could be the very best. Concurrently, one of the best ways to change the system is for companies to realize that they can secure better medical care for their employees while augmenting health and wellness, which will dramatically reduce the company’s and their employees’ costs. That is a win-win all around.

In later articles, I will outline further what patient and their doctors can do to improve care and what employers can do to create true healthcare for their employees.

The post Healthcare and Medical Care Are Not the Same – The Difference is Very Important appeared first on Medika Life.

My friend Susan in the first article of this series was a good example. Presenting to her PCP with a somewhat unusual symptom, she was sent from specialist to specialist without ever learning what was causing her symptom, much less resolve it. It was a true waist of time, money and her emotions when the answer was there if only a doctor spent some time to listen to her.

To further exacerbate the problem, the doctor and patient no longer have a “contract;”. The patient and doctor are bystanders to the decision-makers. Frustration by doctors and patients is high, and physician burnout has become rampant.

 Add to this is a significant change in the common serious diseases – complex, chronic illnesses, mostly preventable, for which American medical care has not established suitable methods of prevention or adequate methods of care. In addition, what should be the role of the primary care physician has been compromised by the insurance industry (both commercial and government-sponsored) that puts the incentives in the wrong places. The result is a sicker population, episodic care, and expenses that are far greater than necessary.

Our current delivery system was designed early in the past century with the expectation that the patient would pay the doctor a reasonable fee for the effort, skill, and time involved.

Insurance developed during the past 70 years initially to pay for unexpected, highly expensive care, such as surgery or hospitalization. But over time, insurance transitioned into what is essentially prepaid medical care and along the way eliminated the financial “contract” between you and your primary care physician (PCP or Nurse Practitioner.) The contract today for both you  and the doctor is with the insurer The patient and doctor are bystanders to the decision-makers. Frustration by doctors and patients is high, and physician burnout has become rampant.

Worse yet, insurance pays primary care providers a pittance, driving them to “make it up in volume” by seeing too many patients per day, often 24 or more. Of course, this means short visits, perhaps three per hour, which translates into about 10-12 minutes of actual face time with you.

The delivery system was developed to deal with acute medical problems, where it is reasonably effective. For example, consider the pneumonia that a single internist can treat with antibiotics, an appendicitis that can be cured by the surgeon, or the fractured arm that the orthopedist can cast. But our medical care system works poorly for most chronic medical illnesses and costs far too much. Chronic illnesses include diseases like diabetes with complications, cancer, heart failure, chronic lung and kidney disease, and Alzheimer’s.

These chronic illnesses are increasing in frequency at a rapid rate and consume the bulk of health care expenditures. They are largely (although not entirely) preventable.

A century ago, the most common causes of adult death were infections – pneumonia, typhoid, and tuberculosis. Today these are uncommon and treatable. Now the most frequent causes of death are chronic illnesses – heart, cancer, and stroke, with Alzheimer’s and diabetes just behind. Other than some cancer, most others are not curable.

Most chronic diseases are related to lifestyles and are preventable. A myriad of social, environmental, financial, and personal reasons has led to non-nutritious diets, lack of exercise, chronic stress, inadequate sleep, smoking, and excess alcohol. Obesity is now a true epidemic, with one-third of Americans overweight and one-third obese. The combined result is high blood pressure, high cholesterol, and elevated blood glucose, which, combined with the long-term effects of the above behaviors, leads to diabetes, heart disease, stroke, chronic lung problems, kidney disease, and cancer.

No one pays for prevention, for maintaining health and wellness. Insurance is for disease care. Government does little (except with tobacco) to assist. As a result, as a country, we do not attend to actual healthcare and maintaining wellness, which in turn means greater pressure on the medical care delivery system. We don’t have a health care system, it is a medical care system that focuses on disease, its diagnosis, and treatment. Wellness and prevention are largely ignored. That is unfortunate because most of today’s chronic diseases could be prevented. Attention to prevention is the logical method to maintain and improve health and is much less expensive than treating a disease once it occurs.

When any of these chronic diseases develop, except for some cancers, it usually persists for life. These are complex diseases to manage and are often very expensive to treat – an expense that continues for the rest of the person’s life. Preventing them is equally complex but a lot less expensive.

Although not adequately appreciated, primary care physicians can handle most of today’s chronic illness care. They have the knowledge, experience, and skill level to do so. But this does not happen with short visits. All too frequently, the patient is referred to one or multiple  specialists when the PCP could have dealt with the problem had they had enough time. That extra time would not have cost much, but the referral, of course, means an increase in the costs of care, often substantial.

Some patients with chronic illnesses will need a team of caregivers, but the various specialists and the PCP are not a true team working in a unified manner. For example, consider a patient with lung cancer who may need a surgeon, radiation oncologist, medical oncologist, pulmonologist, pain specialist, palliative care team, nurse practitioner, and many others. Primary care physicians generally do not have the time needed to coordinate the care by the specialists. This is very unfortunate because coordination is absolutely essential to ensure good quality at a reasonable cost. You might think that one of the specialists might take on that role but that rarely occurs. More often the patient starts with a surgeon who refers him on to a radiation oncologist who then refers to a medical oncologist who then may or may not call-in others as needed. 

Any team needs a quarterback, and in general, that person is or should be the primary care physician. The PCP needs to be the orchestrator of the various specialists when needed in these complex patients. This need for a team and a team quarterback for the patient with a chronic illness is much different than the needs of the patient with an acute disease in which one physician can usually suffice. A team quarterback dramatically reduces the total costs of care if only because it means continuity and organization of care, keeping the patient’s welfare upper most in mind.

This shift to a population that has an increasing frequency of chronic illnesses mandates a shift in how medical care is delivered. Unfortunately, our delivery system has not kept up with the need. This is no way to run a railroad.

Join me with the following articles as I address more of the Whys and Hows and What to Do.

The post Complex, Chronic Diseases Are Rampant Today appeared first on Medika Life.

Each and every day, I am witness to the awesome power of the Lord’s Healing in the ICU. I am humbled by His Omnipotence when, despite everything I do, my patient is not going to survive. And I am awed by the overwhelming beauty of His Grace, as He comforts those suffering the loss of their loved one.

That does not mean that I would ever – ever – impose my religious faith on anyone else, most especially my patients. That would be unethical and inexcusable. My patients’ beliefs, values, and preferences may not align with my own, but it is my duty to practice within the red lines of the beliefs, values, and preferences of my patients.

“We are believers,” my patients’ families say. “I believe in God,” many of my patients say. It does not scare me, or make me uncomfortable in the least. On the contrary, my response is: “I am a believer, too. I also believe in God.”

In fact, our shared belief in the Precious Beloved is an asset, not a liability. We come from the same Fountainhead of Life; we share in the Warmth of His Grace; we bask in the Light of His Love. And so, when my patient or their family says they are believers, I welcome it wholeheartedly.

And I am comfortable with the language of faith. I understand its frame of reference, and of all the situations of life, critical illness is one in which the flame of faith – even if long extinguished – frequently is rekindled anew.

We doctors should not shy away from faith. If it would be of benefit, we should share our faith and spirituality. Some of my colleagues have prayed with their patients; others have offered counsel within the same faithful frame of reference.

Frequently, when speaking about goals of care and the end of life, I will say, “If his or her heart stops, despite everything we are doing, then that is God telling me that He wants him or her back more than I do. Why, then, should stand in the way?”

I recently saw a nurse ask for a moment of silence after a patient did not survive cardiac arrest. I was so moved by this that I have started doing it myself whenever I attend a “Code Blue.” I wrote a prayer – in the form of a poem – to honor organ donors, and I try to read it whenever we honor a patient on their way to donate organs to others.

My faith strengthens me as a physician. It was solace for me through all those dark days of the pandemic. And, I pray, that my faith makes me a better physician for all those entrusted to my care.

On some level, there should be distance between my patient and me; there should be some level of objectivity, so I can think straight and do all that I can to help my patient survive critical illness. And, there should be no room – whatsoever – for my imposing my religious beliefs on anyone else, patient or otherwise. Ever.

At the same time, my faith and spirituality allows me to connect on another, deeper level with my patients and their loved ones. It helps me be more compassionate. And, if my faith allows me to be a better instrument of God’s Healing Presence, then that is something that should be embraced and celebrated.

The post Doctors Should Not Shy Away From Faith appeared first on Medika Life.

This same “lather, rinse, repeat” cycle has played itself out again, and again, and again, and again, and again for the past 18 months. It is exhausting. It is exasperating. And it makes me want to say, when yet another patient follows the same path outlined above, “Why even bother? They’re going to die anyway.”

I am sure many of those on the frontlines – doctors, nurses, respiratory therapists, techs, medical assistants, and others – have asked themselves the exact same question. And perhaps the answer to the question, “Why even bother?”, has led to the dramatic shortage of healthcare professionals across the country.

Yet, when I think about this question, “Why even bother?”, it makes me wonder: would I say that about life itself? I mean, in all reality, the human condition is ultimately fatal: all of us, down to the very last one, is going to die one day. And so, given this fact, would it be right for me to just give up on life and say, “Why even bother? I am going to die one day anyway.”

Absolutely not. It would be criminal of me to do so.

Yes, I am going to die one day. I don’t know when. I don’t know where. I don’t know how. But, one day, I am going to die. But that doesn’t mean that I should just throw up my hands in defeat and not live my life to the fullest, saying “Why even bother?”

On the contrary, I should do my very best to live the very best life possible. I must do my very best to be the best husband I can be, the best father I can be, the best son I can be, the best brother I can be, the best neighbor I can be, the best citizen I can be, and the best believer I can be.

And, yes, I must do my very best to be the best physician I can be: to do all that I can to help alleviate my patients’ suffering as much as possible, even if I know that they will die one day. No where in this equation does the statement, “Why even bother?”, ever even come up.

That would be, in the words of Hamilton, “The moments when you’re in so deep/It feels easier to just swim down.” We must resist – with every cell in our body – the urge to “just swim down.”

Now, for some, the urge to “just swim down” – to give into the hopelessness that is inherent in the question, “Why even bother?” – leads them down a dark path to self-harm and suicide. Dear reader, please, if this is you, please, please, please seek help. Please, please, please talk to someone. Please, please, please don’t follow that dark path.

We must stop focusing on the outcome and start focusing on the path to that outcome. Even if I know this latest patient with COVID-19 will ultimately die, I need to make sure that I do all I can to care for them in the very best manner possible. I need to make sure I do all I can to minimize their suffering as much as possible, and then – if their death is inevitable – I need to make sure that death is a “good death,” one free of suffering, pain, and anguish.

And if I do that, then I should stand tall and feel proud: I did all I could to the very best of my ability.

On so many days, it absolutely “feels easier to just swim down.” It is tiring having to swim upstream all the time. And it is absolutely essential that I do just that. My patients need me to do that; my family needs me to do that; my country needs me to do that; my world needs me to do that. There really can be no other way.

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