The ancient Greeks had five core virtues and the Bible has seven. I don’t know that there is an official number of virtues among the medical community, but I recently started thinking that I need to give more thought to the ones I would like to consciously consider and strive to cultivate.
Somehow I ended up writing first about Brevity as a virtue. Perhaps that is an unusual choice, but certainly not a new one. Shakespeare’s “virtue is the soul of wit” in Hamlet stopped me in my tracks as a doctor today, increasingly frustrated with the logorrhea (a real word, think diarrhea of words) of computerized medical records with their defensive documentation and copious copy-and-pasting.
As I contemplated what my personal list of virtues would look like, I realized my first few choices started with some of the first letters of the alphabet.
So here, catching up to what then should have been the first installment in my series, comes my reflection on Artistry in Doctoring:
Artistry is not a word you commonly hear attributed to primary care medicine, perhaps more to procedural things like cosmetic surgery. But, going back to the dictionary, here as a direct quote from Merriam-Webster:
1
: artistic quality of effect or workmanship
the artistry of his novel
2
: artistic ability
the artistry of the violinist
a lawyer's artistry in persuading juries
I think most people recognize literature and music as art forms, but may not immediately think of a lawyer’s art of persuasion as real art. I insist that it is, and I also insist that a doctor taking a medical history, arriving at an accurate diagnosis, formulating an individualized treatment plan, explaining complicated healthy and pathological processes and motivating patients to change their habits or behaviors for better outcomes absolutely requires artistry. And I absolutely disagree with the notion that those things can be protocolized to such a degree that individual practitioners’ way of doing them don’t make a very significant difference in the effectiveness of their effort.
Seriously, if we use the word artisan in the context of baking bread (and if I ever buy bread instead of baking my own, that’s what I want), when no loaf looks exactly like the others, that is recognizing the craft and the individualization of even the most basic things that leave room for personal effort and expression. To continue this analogy just one step further, medicine is not always cookie cutter, or at least it shouldn’t be!