Over the years, however, we've kind of lost sight of the fact that this also applies to the medical profession. We have come to regard doctors as miracle workers who can heal us at will, simply by rebuilding our ailing bodies into perfectly functioning ones. Deep down, we know better of course and we are reminded daily that at best, doctors are merely allies as we essentially heal ourselves with their help.

The recent outbreak of SARS, that initially defied the best efforts of the medical community to deal with it brought that home once again. In fact two of the victims were themselves doctors. Combine that with the fact that most of our antibiotics have become ineffective against some of the more virulent strains of bacteria that now abound.

I believe that at the heart of all these problems is the fact that we have forgotten one basic truth. Doctors don't heal us; we heal ourselves. To be sure medical research, especially as it applies to uncovering the mysteries of our genes, has brought us an amazing amount of understanding of our physiology.

That's the point, I suppose. Collectively we now know a great deal about how our bodies function often in amazing detail. With modern diagnostic tools it is possible to pinpoint problems with phenomenal accuracy. This is certainly a far cry from the past when diseases were attributed to some pretty fanciful causes. And yet there are some troubling issues.

With all the high-tech diagnostic procedures there are still an awful lot of cases that are either mis-diagnosed or not diagnosed at all. Even when the diagnosis is accurate and timely, a cure is far from guaranteed. Not only are we still faced with a substantial number of afflictions for which there is no cure, too many people die even today, from diseases for which the cure has become relatively routine.

Shouldn't we be asking why? Obviously, it would be downright silly for me to suggest I have the answers or even that no one else has thought of the questions. But it does seem to me that, given the obscene amounts we pay for medical care including what we pay for prescription drugs, we could expect better results.

Now I'm not unaware of the spectacular medical "miracles" that make it into the press and T.V. But what of the care received by the average person such as you and me. It's easy enough to find scapegoats of course, such as greedy drug companies and incompetent health care providers. Let me suggest a more useful approach. Let's look at our own role in all this.

How realistic are our expectations? What about our responsibility for our own welfare? Our bodies are truly miracles of design and engineering with an amazing capacity to keep itself healthy and sound. Lost in the fog surrounding medical practice, is the role played by our own immune system and its ability to fight off, on a daily basis, any number of disease-causing organisms.

Although sometimes it needs a little help, most of the time it does this without any outside interference. The point is, that ultimately the healing begins and ends within our own bodies. We are dealing here "with natural processes which would continue of their own accord whether we interfere with them or no". Let's follow a mythical patient, John Doe.

John leaves his doctor's office clutching a prescription. Just like the last one, it is embellished with some arcane hieroglyphics. He has only a vague notion of the nature of his affliction and no idea whatsoever of what the magic potion, described on the slip of paper, is supposed to do to cure it.

You see, John is a patient. As such, he understands his role. After all his place in the system was established long before he was born. Oh it didn't happen overnight. As recently as the late 1700's the practice of medicine was somewhat different than it is today. Diagnosis and treatment was largely a hit-and-miss affair.

Disease was generally blamed on an imbalance of "humors" and the influence of "vapors" and each episode was treated as a totally unique case. The social success of any physician of the day, hinged largely on the rapport he managed to form with his usually influential patient. It was often the patient who ultimately determined the nature of his illness and which (or whose) medical treatment he would accept.

All this changed when it became gradually apparent, starting with the research of William Harvey, what the true causes of disease were. Harvey's work on blood circulation showed a new, more rational approach to anatomy. This line of research was pursued, especially by the surgeons who at the time were considered as little more than tradesmen.

Surgeons worked in hospitals and no self respecting pillar of the community or his physician would actually go to such a place. Hospitals were for the poor and for wounded soldiers. In these places of desperation it was the surgeons who brought about much of our understanding of medicine.

Through a detailed study of anatomy, it was they who discovered that diseases and their apparent causes could be categorized which then led to a more systematic approach to the practice of medicine. No longer was disease seen to be a series of unrelated conditions. Medicine was becoming a science.

By the end of the 18th century this change in understanding was largely complete. Building on the work of Philippe Pinel who in 1798 wrote a book which dealt with "the application of analysis to medicine", one Xavier Bichat presented the first systematic view of disease as a localized phenomenon. This "new" view of disease effectively removed the patient from direct involvement with the doctor. Instead of a person, he had now become a repository of symptoms to be assessed, analyzed and treated. Which brings us back to John.

John doesn't take much of an active role in the diagnosis and treatment of his various illnesses. He has been conditioned not to question nor to even try to understand what is happening to him. After all, the man in the white smock with the stethoscope dangling from his neck has already made his determination. In a language that to John might as well be latin (because it probably is), he's been told what the problem is. To him that's just fine. It's not his field you see.

Is John risking his life?
To answer that question, we pay a visit to Doc Hollywood a.k.a Dr. Neil Shulman. Dr. Shulman who, as Dr. Benjamin Stone was portrayed in the movie (Doc Hollywood) by Michael J. Fox, has a rather revolutionary idea. In fact, he has several. One such idea is to take the mystery out of medicine. Dr. Shulman, who teaches medicine in Atlanta, Georgia, believes the science is far too shrouded in mystery and it's time to make Medicine 101 compulsory. He also believes that better communication would be good for both doctor and patient.

His views are in fact far from revolutionary because more and more experts in the field are recognizing the importance of treating the whole person. Enlightened physicians know that the patient should be an active participant in his treatment rather than a passive object. These doctors go out of their way to explain and involve the people in their care.

So let's return to John. He must do his part. But does he? There is a lot of evidence to suggest that he does not. We operate in a culture where the doctor is seen as the ultimate arbiter of our care rather than as a powerful ally. "Ask your doctor" we are told, or "It's the one doctors recommend most". As we enter the brave new world of the third millennium, it is perhaps time to re-examine this notion.

Research has shown that, hypochondria aside, in many instances people themselves have a pretty good idea of the general state of their own health. Time and again when their honest perceptions are compared with medical reality these perceptions are found to be pretty close to the mark. What seems to be lacking is the confidence to trust those instincts and what's even worse, an even rudimentary idea of what it is that makes our bodies tick. Remember, this is our body we are talking about, not the family car. As Dr. Shulman said, it's time for Medicine 101. It's time to make ourselves aware of modern medicine and how it relates to us personally.

More than at any time in our history we now have the tools to do just that. The internet can bring us all sorts of medical information that until recently was only available to the medical community. I am referring to such sites as WebMD®, MedlinePlus and Med Web Plus to name a few. Even a brief search will turn up many more. The idea behind all these sites is to have an informed patient empowered to deal one-on-one with his caregiver, not in an atmosphere of confrontation but rather enlightened co-operation.

John can no longer afford the luxury of leaving his wellness up to his doctor alone. He must realize that the state of his health is first and foremost his own responsibility. Not all medical intervention is necessarily positive. On the other hand, timely intervention can prevent more serious problems.

The key then, is communication which will only occur when you, the patient, and the doctor both know what the other is talking about. There are too many instances, judging from media reports, where poor communications have led to tragic consequences.

If "John" and indeed all of us make the wrong choices there may be no one left to watch the garden grow.

1 The Architecture of Matter - S. Toulmin/J. Goodfield - Penguin Books Ltd

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