Intensive Units

Dissecting issues related to healthcare

Dr Farokh Erach Udwadias book is timely in many ways. Health reform and policy are taking centrestage in every society and on every governments agenda. But there is a dearth of literature,of books like this that discusses the issue of healthcare,its delivery and future.

The Forgotten Art of Healing has nine essays that Udwadia has written over a period of a very distinguished career in Mumbai. They cover an array of issues,including euthanasia,doctor-patient relationship,ethics,the need for empathy on the part of doctors to rebuild the lost trust of patients,breakthroughs in medicine and the future of medicine. While the essays cover a wide canvas,the narrative is bound by the authors love for his profession and all that it should encompass the art of medicine,psychology,technology and humanism.

In the opening essay,from which the book gets its title,Udwadia puts forth his central argument that specialised medicine has dehumanised patients and on the need for sympathetic communication with the patients spirit and for considering the patient as a whole rather than as a compilation of diseased organs.

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Udwadias second essay,drawn from a convocation address at the Benaras Hindu University,underlines the importance of these basics to fresh graduates in order to create a new breed of physicians who are empathetic to the needs of their patients.

Of special interest in the book are Udwadias views towards modern medicine. The debate he has begun is relevant but it must be assessed against a stocktaking of the brave new world of medical technology,and the many ways in which it has enhanced and saved lives. However,as he cautions,there are limits to medicine despite claims to the contrary. And it is the unrealistic expectation,as he points out,that eventually leads to disappointment with and distrust of doctors and hospitals. I completely agree with him that this crisis has been accentuated by lack of internal audits and controls in many organisations. The only way forward is to institutionalise systems ensuring quality and accountability.

In the chapter on euthanasia,Udwadia provides a brief history of this litigious topic. He asks tough questions on the subject,including some on the ethical dilemmas involved. In many ways,the issues discussed here remind me of Bernard Shaws classic The Doctors Dilemma,the dark comedy which captures the moral dilemmas of who should get treatment and who decides when to stop it. This essay serves as a good starting point for health professionals on the subject and is a must-read.

The essay Art and Medicine is absolutely inspirational: he talks about the great works of art that depict doctors and diseases and further discusses how diseases unleashed or impeded creativity in many great men and women.

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The last two essays discuss at length topical issues that plague health systems across the world such as the cost of healthcare,organ transplants,rural healthcare,preventive medicine and human embryonic cloning. He also gives space to the under-discussed connection between global warming and the disease burden,a reality that governments and healthcare providers are just beginning to take notice of.

Put together,through these essays,Udwadia gives a valuable impetus to a discussion on the values of humanism and selflessness that make medicine a noble profession to begin with. While it is a must-read for doctors,healthcare professionals and scholars,this will appeal even to the lay reader.