I had this idea to write a post about quality, linking to the characterization of quality in the classic book Zen and the art of motorcycle maintenance. On a whim, I gave ChatGPT the task, formulated like this:
Write a 500 word essay with the title Zen and the art of doctoring, borrowing the major concept of the book Zen and the art of motorcycle maintenance, applying the principles to the practice of medicine
The post below appeared within seconds. Let me know in the comments what you think of it.
In Zen and the Art of Motorcycle Maintenance, Robert M. Pirsig explores the philosophical concept of “Quality,” a state of harmony that transcends dualities—subjective and objective, rational and romantic. This Quality, though elusive, serves as a guiding principle in life and work, merging the precision of rational thought with the richness of emotional experience. When applied to the practice of medicine, this philosophy encourages a more holistic, mindful, and compassionate form of care—a way of doctoring that goes beyond technical expertise to embrace presence, empathy, and moral responsibility.
Modern medicine, much like motorcycle maintenance in Pirsig’s narrative, often emphasizes technical accuracy, protocols, and measurable outcomes. Doctors are trained to diagnose, prescribe, and perform with efficiency and precision. However, as Pirsig argues in his book, focusing solely on the mechanical aspects of any practice—be it fixing a motorcycle or treating a patient—risks losing sight of the human element that gives the work its meaning. The true art of doctoring, therefore, lies in integrating the scientific with the philosophical, the measurable with the immeasurable.
“Quality” in medicine is not merely reflected in lab values or surgical success rates but also in the subtle, often unquantifiable connection between doctor and patient. When a physician sits quietly, listening to a patient’s fears, or takes time to explain a diagnosis with care, they are practicing medicine with a Zen-like awareness—fully present, attentive to detail, yet attuned to the broader context of human suffering and resilience. This presence transforms routine care into something meaningful for both patient and practitioner.
Pirsig’s idea of “the knife that cuts too fine” is especially relevant here. In modern clinical environments, the fragmentation of care into ever-smaller specialties can lead to loss of coherence. A patient becomes a collection of organs rather than a whole person. Zen and the art of doctoring would urge us to resist this fragmentation and instead cultivate an integrated view, where physical health, mental well-being, and social context are interwoven threads in the diagnostic process.
Moreover, Pirsig emphasizes the importance of caring about one’s work. A mechanic who cares about his motorcycle treats it with respect and patience, and through this care, finds peace and purpose. Similarly, a doctor who views each patient encounter not as a transaction but as a sacred opportunity to heal, learns to derive meaning from the practice itself. In this way, doctoring becomes not just a profession but a discipline of the spirit—an ongoing meditation on suffering, healing, and the mystery of life.
Ultimately, Zen and the Art of Doctoring invites us to approach medicine not merely as a science, but as a craft rooted in attention, compassion, and humility. It is a call to rediscover the joy of presence in an age of protocols, to honor the artistry in healing, and to recognize that in the quiet space between diagnosis and cure lies something ineffable—a fleeting but profound glimpse of Quality.
I agree with Elizabeth's comment. You are masterful at using stories from your clinical activity to reveal the inner mind and soul of Family Practice. I do like the "word salad," and it aligns well with a new book by Alan Roth DO and Andy Lazirs MD A Return to Healing. They use the terms Oslerian vs Flexnerian medicine to describe the difference in approach to caring for people
As for your "Zen and the Art of Doctoring" - a meditation on Robert Pirsig's thoughts applied to the practice of medicine, I write occasionally about Pirsig's philosophy at "Atarxia or Bust." And, although I'm not a doctor, I'm married to one, and I serve as the uncredited editor of her Substack, "Doctoring Unpacked." So, I think I have a bit of insight into your subject.
I think what's here is AI BS.
Pirsig's idea of Quality isn't a distinction between the "mechanical aspects of any practice" and the "human element that gives the work its meaning." While the technical aspects of medical practice are in the domain of Classic Quality, Classic Quality extends to the patient interaction. It is closely involved in what gives medical work its meaning. Remember, Phaedrus' Romantic-preferring motorcyclist friends eschewed motorcycle maintenance. They were just there for the ride. The Romantic Quality of seeing a typical shaman is probably greater than that of seeing a typical internist, but the internist has the advantage that most of what they're doing has efficacy beyond the placebo effect and entertaining the patient while nature heals them.
No one needs AI to decree that "the true art of doctoring, therefore, lies in integrating the scientific with the philosophical." The very first doctors who attempted to be scientific were well aware that what they were doing was integrated with philosophy. Galen wrote a book on this topic. The Greek schools of medicine were joined at the hip with the Greek schools of philosophy. That the Pyrrhonist philosopher Sextus Empiricus had an agnomen indicating he was an Empiric physician was no coincidence.
Pirsig’s idea here of “the knife that cuts too fine” is pure AI hallucinated BS. Pirsig never said any such thing. Google it and you'll find your article is the only mention.
Moreover, medicine as a practice is not a science and never has been. It's a techne, just like motorcycle maintenance is. This is not to say that it doesn't occasionally employ the scientific method. Pirsig himself elaborates on the scientific method using motorcycle maintenance as an example.
There's a "quiet space between diagnosis and cure" that contains a "fleeting but profound glimpse of Quality." Pure deepity hogwash, lacking in any meaning.