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The Art of Living...The Art of Medicine the Wit and Wisdom of Life and Medicine: a Physician's Perspective

by Edward C. Rosenow III, MD MS

170 pages; quality trade paperback (softcover); catalogue #03-0631; ISBN 1-4120-0262-1; US$16.95, C$19.49, EUR13.92, £9.75

Life is your career, not your work. If you aren't enjoying life, you can't effectively practice the art of medicine or any other occupation.

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about the book      about the author      sample excerpts      catalogue info

About the Book During my nearly 50 years in medicine (closer to 60 years if you count the many years I visited patients in the hospital or their home with my physician father), I slowly realized that we physicians are losing, or never had, good bedside manner like my father and my role models did. As a result, and for many other reasons, we have lost the trust of the public. Practicing medicine has become a contract rather than a covenant with the patient. Our professionalism is being eroded. This is a 'how-to' book for young physicians who may not otherwise learn what the Art of Medicine is supposed to be from their role models. Many (most?) people have lost control in maintaining a balance in their lives, resulting in stress, huge debts and unhappiness. As a result, they cannot perform any job as well as their potential. We need to relearn the Art of Living. I can summarize why I wrote the book by saying, "I wish I had known all this when I was younger!"

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About the Author Dr. Rosenow spent his whole professional career at the Mayo Clinic, retiring after 31 years on the staff. Prior to his retirement he was the Arthur M and Gladys D Gray Professor of Medicine. He has achieved numerous awards and honors, including the Mayo Fellows Hall of Fame Outstanding Teachers, president of the Mayo staff, president of the American College of Chest Physicians, Distinguished Mayo Clinician Award, and the Mayo Foundation Distinguished Alumnus Award. He was chairman of the Mayo Pulmonary and Critical Care Medicine Division. He is a Master Fellow of the American College of Physicians and the American College of Chest Physicians. he considers the Karis ("caring") Award from the Mayo Medical Center as one of his most cherished awards, because he learned over the years that many times the gift of caring and compassion are more effective in healing than the power of modern medicine.

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Sample Excerpts

Table of Contents

Forward

The Art of Living
        The Most Important Person in Your Life - You!
        Your Most Important Asset - Your Health!
        Happiness
        Volunteer

The Art of Working
        Time Management

Mindfulness

Emotional/Social Intelligence

Think

The Art of Medicine

Qualities of the Respected Person

Communication
        Body Language
        Verbal
        Listening

The Patient-Physician Interaction
        A Partnership
                How to Be a Physician: The Importance of the Little Things
                How to Be a Patient
        The Difficult Patient
        Covering for Another Physician
        The Cancer Patient in Remission
        Avoiding a Malpractice Suit

Physician-Physician Relationships/Collegiality

Your Relationship to People You Work With
        Service

Stress*Burnout*Depression
        Simplify Your Life
        Write-Therapy

End of Life Issues
        Hope
        Spirituality

Conclusion

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FORWARD

Before I begin speaking I'd like to say a few things!

Dan Quayle
Vice President
1990

For the last 15 to 20 years I have been collecting Pearls of Wisdom and humorous quotes that have a message, primarily to someday share with my grandchildren. But several years ago, after 40 years in medicine, I realized that we physicians are losing the ability or desire to practice the Art of Medicine, and as a result, the public's trust, a personal sacred trust, that we have been entrusted and empowered with. In my younger days we referred to the practice of the Art of Medicine as bedside manner. Dr. Bernard Lown, in his excellent book, refers to the absence of it as The Lost Art of Healing. At this point I realized that many of the quotes I saved for my grandchildren fit in with the messages I wish to pass along.

I began to put my thoughts together on what I might tell young physicians about their obligation to the patient, the very reason we are in medicine. Every day we physicians are given a gift by being invited into a patient's life to make a difference in their life, because they think we care. When they come to us we are their hosts. By doing this I would urge them to protect the profession and remind them that the covenant of the patient-physician relationship should be their highest priority - they can't do this without practicing the Art of Medicine, every day with every patient. But it isn't just the patient-physician relationship, it is the person-to-person relationships that decide whether we are living a fulfilling life.

The Art of Medicine isn't just the perfection of interpersonal trust between the patient and the physician, it involves a caring relationship with the people we work with, our families and our friends, and especially with ourselves. This is respect, mutual respect!

I take the golden rule of life one step further in the trust/bonding relationship between the patient and the physician in practicing medicine including the art as well as the science of medicine, and that is:

The Platinum Rule of Medicine:

Treat every patient like you'd want a
Member of your family treated!

If this were done, we wouldn't have nearly as many problems in the practice of medicine as we do. We would restore our lost trust. Our patients deserve to be treated like family. We are all in this together. We must treat all people with respect and dignity, even if we don't agree with them. We know, as physicians, that a calcified solitary pulmonary nodule on a chest x-ray is not cancer, that a blood sugar a few milligrams above normal doesn't mean we're going to get diabetes, or a slight elevation in your cholesterol doesn't mean a heart attack is imminent. But to the non physician patient, your family, they frequently think the worst, that their physician might not be telling them everything. Or, the minor abnormality isn't fully explained. They may leave the office feeling worse than when they came in! Thus, treat every patient as you would want your family treated. I am adamant on the Mayo Way which is

The needs of the patient come first!

WJ Mayo

When I came across Anne Quinlan's statement to the effect that your life is your career, not your work, I realized that unless the physician has a balanced life and not truly enjoying life, then he or she can't effectively practice medicine, the science as well as the art of medicine. Thus, my emphasis on happiness, the art of living.

Also, I'm a strong believer in the importance of a sense of humor. This, and not taking ourselves too seriously, makes us less likely to judge people, to moralize. I think this is mandatory as a stress reliever. By using quotes with a message, many being humorous, I think that I can get my point across easier and hopefully my message will last longer. A quote of wisdom or humor says something in a few words or sentences much better in what I and many others would take paragraphs or pages to say. They add to the messages I want to make.

• Too many people suffer from terminal seriousness!
• The doctor must have at his command a ready wit as dourness is repulsive both to the healthy and the sick! (Hippocrates)

I've tried to credit the source of my quotes but frequently by the time they are passed down through a few authors, the name of the originator of the quote is deleted. Most have become anonymous by virtue of this lineage.

Even though I speak as a physician, and although most, but by no means all of my messages, are directed to physicians and other health care workers, the points I try to make are pertinent to everyone.

There is very little in this book that is directed to 'physicians only'. My hope is that by the public (the patient) reading this, they will get a feeling for what I think they should expect from their physicians as to what the practice of the Art of Medicine should be, and expect this of their physicians. Then, hopefully, we can ultimately begin to restore the mutual trust we need to improve healing and the health of society.

I summarize the points in my book by saying, "How can I be a better, happier, more productive person?" "How can I leave this world a little bit better?" And, I wish someone had told me all this when I was younger!

What you do today,
Doesn't end today!

Nothing would be the same if you
Did not exist!


David Niven

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CONCLUSION

I didn't initially plan a summary but I've learned so much from my reading of numerous books and articles as well as gelling my thoughts on rereading and rewriting this book, that I feel it is important to briefly summarize what I think are the important features that I would like you to remember. As you recall, the initial premise was to tell young physicians that they aren't as effective a physician if they aren't happy, aren't enjoying life, the Art of Living. As Brown said, I finally figured out that the reason to be alive is to enjoy it.

Balance in your life is absolutely critical, beginning now. You have no promise for tomorrow, no one does. Don't postpone joy. Your life is your career, your work is part of your life. Your priorities must be family, friends, fun, ....and work.

The respect for you - yourself - as well as your health takes parallel high priority to family, friends and fun. You can't take your wellness for granted. Depression, if it occurs, comes insidiously and affects everything you do and everyone around you. It almost always can be effectively treated. Maintain a heightened awareness for this in yourself as well as those around you. Deal with it.

We are creatures of habit. We rely on 'assumptive thinking' without actually and truly reflecting on the data before us, or the potential consequences of what we are about to do. We live on automatic pilot. This can result in stupid actions. It takes work to become mindful of everything you are doing now, but with time mindfulness will become more automatic. This applies also to negative thinking - stop it! You have total control over this. A positive attitude will get you almost every where you want to be.

It wasn't until I was over half way through writing this book that I realized that I hadn't once mentioned the word happiness. It turned out to be one of my longest sections. Happiness should be the sine quo non of enjoying life, but it must come from within - you alone are responsible for this. But you must work at it. An attitudinal intent to be happy is imperative. It should be a fairly constant mind-think. It can't be done without smiling, without a sense of gratitude and appreciation. The value of a smile is incalculable. The best way to be happy is to make others happy. You can't expect your children and grandchildren to be happy if you aren't.

A sense of humor is absolutely essential as is adopting a positive attitude.

Delvina Dalhumer (from Minnesota, no less) was interviewed on her 113th birthday shortly before she died of natural causes and was asked what she attributed her long life to. She said, "Nothing ever bothered me." For those of us who are bothered by everything, it'll just seem like we are 113!

I've become even more impressed with the importance of calling people by their name; you connect with them and they feel good about this.

Lowering your expectations of people won't lead to disappointment. Authors writing on happiness, wisdom, equanimity, maturity, mindfulness, and emotional intelligence all allude to this. This allows you to be less reliant on others for your happiness.

I've listed so many 'imperatives' in what I think are important in the Art of Living, but effective communication is critical, especially the art of listening. Be aware that your body language can reveal your attitude, your level of unhappiness, your anger (outright or suppressed), your self-esteem.

Finally, if I have to pick what I think is the most important thing I've learned, I would select the value of the practice of kindness, not only to the people you work with and your patients, I mean everyone around you that you interact with or just coincidentally encounter in the street or the other end of the phone. And also to yourself. Make being kind a philosophy of your life. One act of kindness leaves the world a little bit better. Remember, it's fun to be kind!

All human beings experience guilt, frustration, fear, shame. We need to accept this in ourselves and others and help each other. We are all in this together. An act of kindness is infectious; the more you do the better you feel, and the kinder you get. It builds. It contributes to equanimity and a good self-esteem. Be a little kinder than necessary. The Dalai Lama says that his religion is kindness.

In order to develop more kindness begin each day with a positive attitude. Then add a smile. Kindness and respect will follow automatically, as will equanimity and happiness, leading to an even more positive attitude. I describe this as the Circle of Happiness.

Be the best you can be, but without striving for perfection. Be a role model to everyone and a mentor to at least someone besides your children. And don't be afraid to be yourself.

I close with Ralph Waldo Emerson's poem that so beautifully portrays what I have been trying to say in this book:

To laugh often and much;
To win respect
Of intelligent people
And the affection
Of children;
To earn the appreciation
Of honest critics
And endure the betrayal of false friends.
To appreciate beauty;
To find the best in others;
To leave the world
A bit better
Whether by a healthy child.
A garden patch or
A redeemed social condition;
To know that even one life has breathed easier
This is to have succeeded.
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Catalogue Information

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