The Miracle In Front of You Jamie Lynnn Schuster's recent article titled “Miracle In Front Of You” interviews pediatric oncologist and Duke University Professor Raymond Barfield on the intersection of medicine, philosophy and theology and his views on integrating palliative care for children and adults alike. In this interview, Barfield speaks of his personal background, history and underlying philosophy that guides his research and work with pediatric cancer patients. He also speaks on his current medical research which examines immune therapies and quality of life issues for children with terminal illness. He also speaks on how his doctoral work in the history of philosophy and in particular ethics informs his values and personal approach towards redefining the doctor-patient relationship and the psychological approach to medicine doctors should take in view of their work today.
As current director of Pediatric Palliative Care for Duke University, Dr. Barfield leads The Healing Arts Institute, which brings together students from the Duke University School of Medicine, School of Nursing and School of Divinity to explore innovative and compassionate treatment modalities to care for patients dealing with issues of suffering, illness and death. In the interview, Dr. Barfield makes several points about the nature of patient care and the status of the doctor – patient relationship model that dominates contemporary medical practice. Barfield laments the depersonalization and overemphasis on dry, scientific rationality that has taken over the interpersonal dimension of medical practice, a practice for which medicine is a claim to both an art and a science. In his interview therefore, Barfield argues for a new standard of practice for doctors which involves a more attuned, focused attention of doctors on their patients. In order to provide the best kind of medical care, doctors should orient themselves towards understanding their patients.
Barfield weighs this interpersonal dimension so heavily in the delivery of practice standards that he even suggests it would be reasonable to replace a portion of rote memorization that is required in medical school for those subjects that can be easily referenced by means of a smart phone. The time saved by not focusing on memorization and replacing this with training doctos to understand their patients, he argues, would make a much greater impact on the development of young doctors and would elevate treatment standards in revolutionary ways. "If, due to poor communication, we make a decision that does not fit a patient's goals, then
it doesn't matter how good our medicines and techniques are; we are not serving the
patient. It's like taking a left turn when you should have turned right. Even if your car is a
wonder of mechanical engineering, you are going in the wrong direction."(Schuster
2016).Barfield's vision of medical care reorients the relationship back on human terms, emphasizing the need for partnership and collaborating for two people in order expedite a healing process. In this sense Barfield weighs soft skills and the interpersonal dimension in relationships almost over that of technical ability and talent with medical knowledge. He suggests that even the most prodigious of doctors will fail in some areas of their treatment practice if they fail to fully incorporate this respect and reverence for the patient whom they serve. In today's contemporary situation of health care, where doctor's are given little more than 15 – 20 minutes on average with a patient, and where their work is now commonly reimbursed in large hospital and insurance systems based on a factory, piece meal system that calculates each clinical patient visit as a tally of work-units, it seems that the dominant mindset has strayed more than ever from traditional focus on the human dimension in health care. Barfield's insights call for internal reform in medicine, not by HMOs and administrators, but by doctors themselves.
References
Schuster, Jamie Lynn (2016, January). The miracle in front of you: Raymond Barfield
on practicing medicine with compassion. The Sun 481(1). Retrieved from
http://thesunmagazine.org/issues/481/the_miracle_in_front_of_you.
