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Is Hope 'the Most Potent Medicine of All'?

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The "gods in white coats" era is over.

And many physicians would be the first to say "amen" to that.

As family practitioner Dr. Andrew D. Saal has put it: "We as doctors are essentially powerless over the unknown, just as we are powerless over everyday events. No gods walk in white coats. For physicians, the deepest unspeakable fear is inadequacy. Despite our best efforts, we may not be good enough".

The way doctor-patient relationships have evolved was pinpointed recently in the House of Lords by Lord Walton, an experienced neurologist and physician.

The crossbench peer pointed out that all medical bodies, including the British Medical Association and General Medical Council, "now agree that the days of doctor's orders are long past."

He further explained: "The practice of medicine is a partnership in which it is up to the doctor to recommend to the patient what course of action is most appropriate in the patient's best interests; what it is appropriate to do in order to reach a diagnosis; what tests are appropriate in order to achieve that diagnosis; and what course of treatment would then be necessary. However, it is up to the patient to decide whether or not to accept that advice and it is not possible for a doctor to carry out a test without the informed consent of the patient."

Clearly it takes more than a mandate from on high to bring about such a course correction in medical care. A change of heart is required on the part of both patient and doctor.

Patients needs to find the self-confidence to trust their own judgment without over-compensating and becoming overbearing.

And according to Boston-based surgeon and writer Dr Atul Gawande clinicians need to find more humility.

"It is not possible for an individual to know everything," Dr Gawande pointed out at a recent TED talk, and so "each doctor is a specialist now, even primary physicians". He said that has been a disaster because as medicine becomes too specialised mistakes multiply.

"We have amazing clinicians, and access to incredible technologies, but our experience is that it rarely comes together successfully". To "admit humility" was a key factor in improving outcomes for the patients.

Specifically he gave the example of a need for surgeons to have the humility to use a "checklist" on each operation.

To road-test this approach Dr Gawande implemented a 19-point plan in eight hospitals from Western Africa to the West Coast of the United States.

The results? Post-surgical complications dropped by 30% and the death rate fell by 47%.

This illustrates something relevant in all walks of life - humility is needed as a helpful safeguard against making mistakes.

In times of need, though - especially when one's health is on the line - the heart cries out for more than just a "less bad" prospect. It demands a real and reliable hope.

Where can one look for that?

In attending to the needs of a Navajo patient Dr Saal watched as his charge's relatives added prayer and natural remedies to the Western medicine he was administering. As they waited together for progress, he noted: "...far beyond the realm of antibiotics and technology, both the family and the medical staff are trying to grasp the most potent medicine of all -- hope. Because if disease may occur on the spiritual plane as well as the physical, then so must healing."

In my own practice, centred on identifying that spiritual plane as the solid substance of the patient's individuality - rather than a wispy echo of it - I, too, have found hope and humility to be powerful healing agents. Like ladders connecting consciousness to an unseen divine source they facilitate the inner appearing of insightful ideas which in turn facilitate outer recovery.

Those noble men and women "in white coats" can gratefully and gracefully relinquish the burden of bearing a deific label that can never be earned by even the best of human efforts.

And as the name returns to the exclusive domain of the One who wears it with eternal grace, hope will have a more potent object to gaze upon in the heart that yearns for healing.