Latest / Truth in Motion with Dr. Jocelyn / The Doctor, The Patient, and the Relationship Between Them

Transcript

The Doctor, The Patient, and the Relationship Between Them · Truth in Motion with Dr. Jocelyn

• 0:02
  SPEAKER_00: Welcome to Truth in Motion with Dr.
• 0:05
  SPEAKER_00: Jocelyn, where insight, clarity, and wisdom help you thrive.
• 0:10
  SPEAKER_00: Good to have you back.
• 0:12
  SPEAKER_00: In our first episode, I introduced myself and talked about who the podcast is for.
• 0:20
  SPEAKER_00: I gave you a taste of some of the ideas we'll explore in future episodes.
• 0:25
  SPEAKER_00: And I made you a promise that I'm not here to be the expert with all the answers, but as a fellow traveler walking this path of process with you every step of the way.
• 0:37
  SPEAKER_00: And at the end, I promised you that today we'd talk about what a doctor is, what a patient is, the relationship between the two, and why any of it matters.
• 0:48
  SPEAKER_00: So that's where we're going.
• 0:50
  SPEAKER_00: We'll look at where these words come from, what they used to mean, and what I believe they're meant to mean.
• 0:57
  SPEAKER_00: And I'm going to share parts of the oath I swore when I completed my doctorate.
• 1:02
  SPEAKER_00: Why this matters.
• 1:03
  SPEAKER_00: But before any of that, let me start with why this matters, because it would be easy to hear this as a vocabulary lesson.
• 1:11
  SPEAKER_00: It isn't.
• 1:12
  SPEAKER_00: The way you understand the words doctor and patient shapes what you expect when you walk into the office.
• 1:20
  SPEAKER_00: It shapes what you ask, what you're willing to say, and whether you leave with understanding or just a prescription and a follow-up date.
• 1:28
  SPEAKER_00: If you believe the doctor holds all the power, you'll hand yours over.
• 1:33
  SPEAKER_00: If you believe the patient is passive and the passive one in the room, you'll stay passive about your own body.
• 1:40
  SPEAKER_00: And your body is the one thing you can't outsource.
• 1:44
  SPEAKER_00: So if before we talk about what to do, I want us to get clear on who's who.
• 1:49
  SPEAKER_00: And the clearest place to begin is with the words themselves.
• 1:53
  SPEAKER_00: What is a doctor?
• 1:55
  SPEAKER_00: Let's start with the word doctor.
• 1:57
  SPEAKER_00: It comes from the Latin docere, to teach.
• 2:01
  SPEAKER_00: A doctor at the root is a teacher.
• 2:05
  SPEAKER_00: And for a long time, the title had nothing to do with medicine.
• 2:08
  SPEAKER_00: Medieval universities granted doctors in theology and law.
• 2:13
  SPEAKER_00: If you read the King James Bible, you've seen it.
• 2:16
  SPEAKER_00: In Luke, the 12-year-old Jesus is found in the temple, sitting in the midst of the doctors, both hearing them and asking them questions.
• 2:26
  SPEAKER_00: Those were doctors of the law, teachers of Torah.
• 2:30
  SPEAKER_00: I love that picture.
• 2:32
  SPEAKER_00: The doctors are teachers, and the one sitting with them is listening and asking questions.
• 2:38
  SPEAKER_00: That's the posture I want in my treatment room.
• 2:42
  SPEAKER_00: So I believe a doctor is meant to teach, to help you understand your body, what's happening to you, what you can expect, and what you can do about it.
• 2:52
  SPEAKER_00: Now, physician.
• 2:55
  SPEAKER_00: Physician comes from the Greek Greek phesis, meaning nature.
• 3:00
  SPEAKER_00: In older English, medicine itself was called physic, knowledge of the natural world applied to the body.
• 3:08
  SPEAKER_00: A physician was someone who understood nature.
• 3:12
  SPEAKER_00: In Wisconsin, physician is a protected title reserved for medical doctors and doctors of osteopathy.
• 3:20
  SPEAKER_00: I hold a clinical doctorate, so I am a doctor.
• 3:24
  SPEAKER_00: I am not a physician.
• 3:26
  SPEAKER_00: That isn't greater or lesser, it's just a different scope.
• 3:30
  SPEAKER_00: And given where the word doctor comes from, I'm glad to carry the one I have.
• 3:34
  SPEAKER_00: I believe telling the truth about where things are headed is still part of the job.
• 3:39
  SPEAKER_00: But we're no longer limited to predicting.
• 3:42
  SPEAKER_00: Name what's happening, tell the truth about where it's going, then teach what can be done.
• 3:48
  SPEAKER_00: So that's the doctor side.
• 3:50
  SPEAKER_00: But there's always another person in the room, the one who walks in carrying something.
• 3:55
  SPEAKER_00: That is a patient.
• 3:57
  SPEAKER_00: Now the patient, the word comes from the Latin patins, one who suffers, one who endures.
• 4:05
  SPEAKER_00: It's the same root as patients.
• 4:08
  SPEAKER_00: A patient is someone who is bearing something.
• 4:11
  SPEAKER_00: Over time that came to mean more.
• 4:13
  SPEAKER_00: A good patient was a compliant patient.
• 4:16
  SPEAKER_00: You did what the doctor said, you didn't question, the doctor was the authority, your life was in their hands, and in many ways they carried an almost godlike status, the one who held life and death.
• 4:30
  SPEAKER_00: That model has a name, medical paternalism.
• 4:34
  SPEAKER_00: It held for a very long time, and only in roughly the last 50 years have informed consent and patient autonomy become the standard.
• 4:44
  SPEAKER_00: The idea that you have the right to understand and the right to choose.
• 4:49
  SPEAKER_00: So here's the shift I want you to hear.
• 4:51
  SPEAKER_00: Patient does mean one who suffers.
• 4:54
  SPEAKER_00: It doesn't have to mean one who is passive.
• 4:57
  SPEAKER_00: You can be carrying something heavy and still be fully awake, fully participating in your own care.
• 5:04
  SPEAKER_00: So how do these two people, one trained, one carrying something, actually meet?
• 5:10
  SPEAKER_00: For me, that question goes back to a promise I made out loud.
• 5:15
  SPEAKER_00: When I completed my doctorate, I took an oath.
• 5:18
  SPEAKER_00: And I want to read you parts of it because it says what I believe about this better than I could on my own.
• 5:25
  SPEAKER_00: It opens with, I swear to fulfill to the best of my ability and judgment this oath.
• 5:31
  SPEAKER_00: And here's a line I come back to often.
• 5:34
  SPEAKER_00: I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the therapist's hands or the herbalist's formula.
• 5:47
  SPEAKER_00: Art, not only science.
• 5:51
  SPEAKER_00: In 1956, Eric Fromm wrote a small book called The Art of Loving.
• 5:57
  SPEAKER_00: He begins by asking whether love is an art, something that takes knowledge and effort, or just something that happens to you.
• 6:05
  SPEAKER_00: And he says that learning any art follows the same path, whether it's music, painting, carpentry, or he names it specifically, the art of medicine.
• 6:17
  SPEAKER_00: And then he does something I love.
• 6:19
  SPEAKER_00: He uses medicine as his own example.
• 6:22
  SPEAKER_00: He says that to learn the art of medicine, you first have to know the facts, the human body, the diseases.
• 6:30
  SPEAKER_00: But even with all of that theory, he says you are by no means competent in the art of medicine.
• 6:36
  SPEAKER_00: That only comes through practice.
• 6:38
  SPEAKER_00: Then he adds a third piece.
• 6:40
  SPEAKER_00: Beyond theory and practice, the mastery of the art has to be a matter of ultimate concern.
• 6:47
  SPEAKER_00: Nothing else in the world can matter more.
• 6:50
  SPEAKER_00: Theory, practice, and ultimate concern.
• 6:53
  SPEAKER_00: That's what makes an artist.
• 6:56
  SPEAKER_00: That's why we say a doctor practices medicine.
• 6:59
  SPEAKER_00: It isn't a figure of speech, it's a practice, something you do every day, refine, and never finish.
• 7:06
  SPEAKER_00: Later in the book, From names, what any practice requires, discipline, concentration, and patience.
• 7:16
  SPEAKER_00: Patience.
• 7:17
  SPEAKER_00: That's the word again.
• 7:19
  SPEAKER_00: The practitioner needs patience.
• 7:22
  SPEAKER_00: The patient carries it, it belongs to both of us.
• 7:27
  SPEAKER_00: The oath goes on, I will not be ashamed to say, I quote, I know not, nor will I fail to call on my colleagues when the skills of another are needed for a client or patient's recovery.
• 7:42
  SPEAKER_00: And, quote unquote, I will remember that I do not treat a chart or an illness, but a human being whose illness may affect every aspect of the person's life.
• 7:53
  SPEAKER_00: An artist doesn't paint by number.
• 7:56
  SPEAKER_00: A doctor who practices medicine as an art doesn't treat by protocol alone.
• 8:02
  SPEAKER_00: She sees the person in front of her.
• 8:04
  SPEAKER_00: And seeing the person is where the relationship begins.
• 8:07
  SPEAKER_00: Which brings us to the heart of today's episode.
• 8:11
  SPEAKER_00: The relationship.
• 8:13
  SPEAKER_00: So what is the relationship between doctor and patient supposed to be?
• 8:18
  SPEAKER_00: Chinese medicine has a lot to say here.
• 8:20
  SPEAKER_00: The Wang Di Nijing, the Yellow Emperor's Inner Classic, the foundational text of our medicine, roughly 2,000 years old, contains a line that stops me every time.
• 8:32
  SPEAKER_00: The patient is the root, the practitioner is the branch.
• 8:37
  SPEAKER_00: The patient is the root, the person getting well is the foundation.
• 8:41
  SPEAKER_00: The practitioner comes second.
• 8:44
  SPEAKER_00: The same chapter says, the needle and the stone are a method, but if the patient's spirit doesn't move forward and their will isn't settled, the illness can't be cured.
• 8:57
  SPEAKER_00: Healing needs your participation.
• 9:00
  SPEAKER_00: I can't do it to you.
• 9:02
  SPEAKER_00: The Nai Jing also says, the sages didn't wait for illness to fully form.
• 9:08
  SPEAKER_00: Treating a disease after it has developed, it says, is like digging a well after you're already thirsty.
• 9:15
  SPEAKER_00: Centuries later, the physician Sun Sei Mao described three levels of doctors.
• 9:21
  SPEAKER_00: The superior doctor treats disease before it begins.
• 9:25
  SPEAKER_00: The middle doctor treats disease that's about to begin.
• 9:29
  SPEAKER_00: And the lesser doctor treats disease that has already formed.
• 9:33
  SPEAKER_00: Myoth says it this way: I will prevent disease whenever I can, for prevention is preferable to cure.
• 9:42
  SPEAKER_00: So in this view, the doctor is a teacher and a guide, and the patient is the root, a participant with real work of their own.
• 9:51
  SPEAKER_00: Chinese medicine even has a name for it.
• 9:54
  SPEAKER_00: That work is called Yang Sheng, nourish life.
• 10:00
  SPEAKER_00: The daily things you do between visits.
• 10:03
  SPEAKER_00: That's the relationship I believe in.
• 10:06
  SPEAKER_00: Two people.
• 10:07
  SPEAKER_00: One brings training, tools, and a clear eye.
• 10:10
  SPEAKER_00: The other brings their body, their life, and their will.
• 10:15
  SPEAKER_00: Both responsible, neither one the whole thing.
• 10:19
  SPEAKER_00: We've covered a lot of ground today, so let's bring it together.
• 10:23
  SPEAKER_00: A doctor at the root is a teacher.
• 10:26
  SPEAKER_00: A physician at the root is a student of nature.
• 10:29
  SPEAKER_00: Today they're different legal titles, and I carry the first one.
• 10:33
  SPEAKER_00: A patient is someone bearing something, but not someone who has to be passive.
• 10:39
  SPEAKER_00: Medicine is art and a practice, theory, practice, and a commitment that matters.
• 10:46
  SPEAKER_00: And in the Chinese medicine view, you are the root.
• 10:49
  SPEAKER_00: I'm the branch.
• 10:51
  SPEAKER_00: Join me next time where we get practical.
• 10:54
  SPEAKER_00: We'll look at what the practice of medicine actually means legally, why the word medicine in law really means drugs, and what applied pharmacology is, how that differs from looking for the cause.
• 11:08
  SPEAKER_00: Then we'll talk about what you can reasonably expect from a good doctor and how to be a proactive patient, someone who owns their power and takes responsibility for their own health.
• 11:20
  SPEAKER_00: I'll see you there.
• 11:24
  SPEAKER_00: Keep the conversation going.
• 11:26
  SPEAKER_00: Find your next steps in Notes from a Fellow Traveler, my blog.