Treatment from the Heart

By Felix Unger
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Medicine has always stood in the center of all our endeavors and interests and is driven by the wish to live as long and healthily as possible. The role of doctors is to help patients realize this desire through the treatment they offer. Another task of doctors, however, is to guide the patient.

Medicine of course deals with a very large spectrum of maladies, from mild disturbances such as headaches, stomach upsets and so on, through to serious diseases. Because the range of diseases is so large, it is sometimes very difficult for doctors to ascertain the real severity and extent of the symptoms.

In our modern, mechanistic society, people generally do not expect that the onset of an illness might alter their lives. Most people believe that a disease can be evaluated clearly in a mechanistic way and controlled much as one would control a machine. The expectation is simply that a proper diagnosis will be made, followed by the proper therapy. But in fact illness is as much a part of our life as night is complementary to day. And all days find an end, as we will too.

The simplest contribution to leading a healthy life is to correct our lifestyle. This is particularly so with our aging population. Effective medicine can help people be healthy, but lifestyle plays a major role.

Our society, which includes patients and doctors, shares the same time paradigm. In consequence it is how we deal with man. Today we have a mechanistic, materialistic view of the world, a paradigm of constant change known as "progress." We believe, as a result, that we can control nature too. A disease is seen as nothing more than a temporary disturbance to be managed immediately by doctors. After finding the disturbance and cure, people often believe they can continue an excessive lifestyle as they have done before.

Another problem for medicine is misleading information. There are constant reports of how medicine fights cancer and cardiac arrest successfully. We read in the newspapers that medicine can manage all. In reality, while our medicine is very effective, it has certain limits. This causes disappointment for patients and their relatives. Ultimately, death cannot be avoided.

Europe has a very efficient health care system. Most people are cared for very rapidly. Because of the advancements in medicine, medical care has become very expensive. In terms of how we deal with people, health care is seen as a market, and the health-care system thus creates a new financial burden. Medicine cannot be evaluated in terms of costs and benefits. In fact the benefit is the quality of life of a patient. Highly efficient patient care makes the system costly. The recent debate in the United States over health-care reform is a prime example of how controversial the health system has become.

Despite all this, a doctor has to set life at the highest value. When life itself is perceived as the highest value, then doctors have the right basis for a doctor-patient relationship. The doctor cares for his or her patients and tries to return them to health and back into society, or to accompany them on their final journey.

In my professional life as doctor and cardiac surgeon over the past 40 years, it is my experience that good patient care is based on an honest doctor-patient relationship. This bond begins with looking into the eyes of the patients when you tell them you will care for them, and what therapy you propose will help them regain their health, with a specific course of treatment to follow. The patients are immediately ready to follow the proposed treatment when they feel this trust. I experience this consent in the eyes, like a spark between patient and doctor. After finding the proper trust you can treat a patient successfully. This relationship of trust and honesty makes the life of a medical doctor wonderful.

All patients are fearful, especially when they have heart operations. I tell them they can overcome their fear with trust and belief in their own future. Then I experience this spark, which is a basic consent for big operations with, one hopes, a successful outcome.

In our modern society we detect a lack of a real doctor-patient bond, due to many influences in society. I believe we have an enormous deficit in terms of the way doctors are educated in our medical schools.

We have to consider man as an entity of body, soul and spirit and not as a machine. Health is a balance of these three entities. My criticism of medical schools is the strong focus placed on the body to the exclusion of the soul and spirit. My recommendation would be to design a new curriculum for medicine. Students need to be trained to respect life and consider proper therapy aimed at the benefit of the patient in the broadest sense. Doctors are now also placed under a terrible burden by awful administration systems that are a result of poor financing and overreliance on information technology.

A doctor dedicated to his patients sees them only for a short period in their life. While treating the patients, he also has to respect life at its highest value. The doctor is not only treating the patient; through his findings, he is serving life as an ultimate goal.

Felix Unger M.D. is director of the University Clinic of Heart Surgery at the Paracelsus Private Medical University of Salzburg in Austria. He is a cardiac surgeon and has published over 400 papers and 17 books. He implanted the first artificial heart in Europe in 1986, and in 1990 he founded with Cardinal Franz König and Prof. Nikolaus Lobkowicz the European Academy of Sciences and Arts, which today has 1,300 members (