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| EDITORIAL |
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| Year : 2023 | Volume
: 38
| Issue : 1 | Page : 1-2 |
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Ethics, spirituality, and the surgeon/physician
Vijendra Devisingh Chauhan
Department of Orthopaedics, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| Date of Submission | 16-Mar-2023 |
| Date of Acceptance | 19-Mar-2023 |
| Date of Web Publication | 20-Apr-2023 |
Correspondence Address:
Vijendra Devisingh Chauhan
Department of Orthopaedics, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, Doiwala, Dehradun, Uttarakhand
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jbjd.jbjd_16_23
How to cite this article:
Chauhan VD. Ethics, spirituality, and the surgeon/physician. J Bone Joint Dis 2023;38:1-2 |
The medical profession is as old as human civilization. It is said that the day “Adam and Eve” ate the forbidden apple they were surrounded by miseries and illnesses. In the process of human civilization, somebody must have treated the sick patients with whatever treatment tools they had at that time. The treating physician may have been called by different names but the purpose of each was “Healing & Caring” for the sick.
The modern medical education curriculum worldwide is based on three basic pillars:
- Knowledge (cognitive domain)
- Skills (psychomotor domain)
- Ethics (affective domain)
A very important component “Spirituality” is missing. My spiritual teacher H.H. Swami Rama, one of the great yogis of twentieth century used to say “Unless spiritual learning is included in the education system, we can never overcome our inner poverty. Happiness within and without is the real goal of education.” Our Gurukuls had a beautiful parampara; the Gurukul education commenced with the initiation ceremony which comprised a beautiful prayer from Upnishads:
O Supreme Brahman!
May we learn together;
May we progress together;
May we eat together;
May our combined energies, be rich in gaining knowledge;
May we be never, Jealous of each other.
This prayer formed the foundation and essence of Gurukul’s education. The Gurukul education received a setback and has been completely wiped off and replaced by modern English culture during the Britisher’s rule in India. The current scenario in education where values and ethics are at crossroads is compelling us to re-think about the value-based education being imparted during the Gurukul days.
Once I was sitting in my outpatient department (OPD), a young boy was wheeled into my OPD, and the father was very much disturbed and in distress with the reports he was carrying. I asked him what is the problem? He tells me that his son is suffering from cancer in the leg and started weeping. I asked him since when he has this problem? He said since One week. I asked him did he have fever? He said yes. I told him that it cannot be a cancer. He said, “No Sir, please see the MRI reports I am carrying.” I told him to let me examine the patient first; he had swelling in the lower end of the left leg on the lateral side and it showed all signs of inflammation. I immediately asked my resident doctor to take this patient to the minor operation theater (OT) and with all aseptic precaution tried to aspirate the swelling-frank pus came out. It was a simple abscess. We finally drained it under anesthesia and it healed. On the contrary, the magnetic resonance imaging (MRI) report that he was carrying, the radiologist reported “Osteosarcoma of the lower end fibula, please correlate it clinically.” Even the orthopedic surgeon, who examined the patient and got the X-ray done, mentions in his case records, the periosteal reaction of lower end fibula and advised MRI of the ankle. It appears that the orthopedic surgeon had no time to clinically evaluate this patient. Had he taken a good history and conducted a good clinical examination, the patient and his family would not have to undergo a mental trauma and agony.
Yes, investigations are an important component of a diagnostic strategy. Even the most sophisticated test cannot replace the thinking physician. We have become more like a human car mechanic; find it and fix it. We have forgotten the art of touching and examining the patient. Yes, benefits of advances in medical technology cannot be denied; however, technology has made our vision so hazy that it has started casting its evil shadow in the conduct of practicing the modern medicine.
There is vulgar commercialization of medical care. I am sure some of you might have heard Dow Corning’s story. This company came out with silicon breast implants. They had to find a disease where silicon breast implant could be used. The American Plastic Surgeons coined a new term “Micromastia.” Anatomically and physiologically these are normal breasts, however, cosmetically they look small. Thousands of dollars were spent on the campaign by the concerned business houses to allure women to get their breasts bigger. More than 2 million women received breast implants. After few years, some of these patients developed breast malignancy but could not be detected early on mammography because of the silicon implant in situ. The final outcome was a harmless procedure became a health hazard. This company was sued and we know that “Dow Corning went into bankruptcy.”
Unethical practices like “giving cuts” are growing signs of commercialization. It appears as if the health profession has developed a vested interest in human suffering. Both monetary benefits and machines are driving the medical profession into a materialistic pursuit. In fact, the medical profession has been reduced to the level of a trade. We always need to remember that a practicing physician/surgeon is walking on an edge of a sword. His earnings for his livelihood are derived from the services he is rendering to a person who suffers from pain/disease or in agony. Hence, our earnings have to be very pure. Charka the great Ayurvedic Physician once said, “Not for self, not for the fulfillment of any earthly desire of gain, but solely for the good of suffering humanity will I practice my art and so excel all. Those who sell the treatment of diseases as merchandise gather the dust and neglect the gold.”
High-tech surgeries like knee and hip replacements using robots are acclaimed more for their glamour and surgical heroism than for their true therapeutical content; so much so, that the conventional surgical techniques like high tibial osteotomies for osteoarthritis knee are still relevant but are forgotten altogether. We need to understand that sophisticated high-cost diagnostic and therapeutic facilities caters to the needs of those who are financially sound. What about the people who cannot afford the high-end surgeries and costly treatments?
My concept of spirituality changed when I came in contact with H.H. Swami Rama. He was an accomplished yogi, scientist, philosopher, musician, singer, painter, and prolific author who had full control over his autonomic nervous system. He used to tell me, son, “Science helps us meet our physical needs and Spirituality helps us meet the needs of the mind & soul; in isolation from spirituality, science shrinks into a cold life denying mechanism.” Hence, we need a beautiful amalgamation of science and spirituality. Further a human being is neither body alone, nor mind nor soul alone. Human needs are not just physical, they are also mental and spiritual. If we use our intelligence only for gathering worldly means and to satisfy our biological urges (food, sleep, sex, and self-preservation) then we are no different than animals. We need to think differently. The moment you start thinking about others selflessly, become compassionate, and start loving your fellow beings you become divine.
Once I asked my Spiritual teacher, I am a doctor, I don’t have time to do my sadhana and spiritual practices. He said, “If you are a doctor, transform your medical practice into worship; treat your patients selflessly and lovingly. It’s a privilege that the Divine has chosen you for this job. It is the Divine within you serving the Divine that dwells in the patients. This awareness will infuse your action with a spiritual consciousness. Your simple actions will thus turn into Karma yoga.” When I contemplated on this philosophy, I realized that when we do any surgical procedure, we do not remember our families and our dear and near ones; we do not feel hungry nor have an urge to go to the toilet for hours together. Even our feelings are very pure and selfless at that time. I call this state of a surgeon/physician “a state of spirituality.” In fact you are practicing spirituality in true sense.
My spiritual teacher used to tell me “If I cannot serve the God within you and others then going to temples, mosques and churches is hypocrisy.” The health profession is the only profession that has a privilege of serving others 24 x 7. To me a health professional is a biggest meditator. Let us bring dignity, not a shame to this noble profession.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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