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“Knowledge is power.” The words of Sir Francis Bacon still ring true almost 400 years later. For the most part, knowledge can provide the power to change lives, change communities and change the world. People born in adverse conditions can potentially improve their circumstances with a degree from higher education, and it is why the first college degree in a family is celebrated so much since it symbolizes the potential of a child to go farther than his parents did. It is why in so many families, hard work in school is emphasized, since the knowledge we gain from that hard work can give us the power to control our future destiny. And in some instances, that knowledge can give us the power to save the lives of people that we encounter, or so I learned as a student in medical school.
From the beginning of medical school almost 10 years ago, each day was full of lectures that we had to follow up with hours of reading. At times, it was grueling, but it was a necessary exercise to go through in order to develop as a future doctor. In the hours spent in the library, I learned about how different diseases presented, how certain drugs worked, and how to apply all that knowledge to treat the patients that I would soon encounter in my training. We focused on symptoms and how they progressed over time in certain conditions. The occasional problem with that knowledge, however, was the potential of self-diagnosis. If my fellow classmates and I had a particular symptom, we would immediately go to the most terrifying disease and worry ourselves unnecessarily. It would always turn out to be nothing, but in those brief moments of fear, I started to realize that maybe medical knowledge might not be as great as I thought it was.
However silly those moments may seem to me now, I realized how important they were in terms of helping me figure out how to assess symptoms in a way that can lead to more refined diagnoses using the knowledge that I learned in medical school. Applying that knowledge is a particular art, I was told, and that it is all part of the “art of medicine,” an art that allows you to look beyond the textbooks to treat the person in front of you. It is an art that also takes into account the social, emotional and spiritual aspects of the individual, aspects that many of my medical textbooks did not choose to explore too often. Over the years, I have had the honor of treating thousands of patients while refining this particular art in the process.
Eventually, I encountered those “terrifying diseases” that scared me and my classmates during our training, such as the progression of cancer or the rapid spread of a rare infection. Many of the patients with these conditions have either died or had significant complications that have forever altered their lives. Throughout the course of their illness, many of the symptoms they had and the side effects of the medications they received were all according to the textbook. Many times, the focus would be on promoting comfort instead of active treatment given the mostly poor prognosis, and thankfully, the knowledge available with regards to medications used for symptomatic relief gave me and my colleagues the power to provide comfort for these patients in their last days. However, when someone you love gets diagnosed with one of these diseases, the feeling of being powerful through knowledge suddenly changes.
Over the years, I have learned about some of my friends who have had to deal with particular illnesses that have altered the course of their lives. For the rest of their lives, they have to undergo certain treatments or take certain medications to stabilize their illnesses. It is one thing to make sure one of your cancer patients receives chemotherapy while they are in the hospital; it is another to sit across from your friend in an outpatient cancer center while she is receiving treatment. It is one thing to write an order for insulin to be given to a diabetic patient; it is another to watch your friend give himself insulin prior to eating lunch with you. The challenge with having this medical knowledge is that you know ahead of time the potential possibilities of how a disease may progress or how a medication can affect a person’s body. The problem with this is that you cannot stop how your loved one may feel after a particular treatment or after a progression of their illness. Those are the times when there are exceptions to Sir Bacon’s words; even with this medical knowledge I obtained, I felt powerless in those moments.
For those who choose to go into medicine as a profession, one must be prepared to encounter this paradox, that the medical knowledge we learn over the years to help others can also be what causes us the most anxiety when we walk alongside the ones we love during their periods of illness. It is a profession that gives us the most potential to significantly change the life of someone else for the better if we use that knowledge the way we are supposed to, but in a way, it makes us see into the future with regards to certain illnesses. Sometimes, the writing on the wall does not look that great, and it is all the more difficult when our loved one is involved. At times, the medical knowledge we have can be a blessing when used to improve our patients’ lives for the better, but it can also be a curse if we have a loved one dealing with an illness that we know does not have a good prognosis ahead of time. In those times, perhaps we can put aside our medical caps and instead be a friend, a child or a parent, and use the knowledge we have gained from caring for others in a way that can give us the power to provide friendship and comfort for those who need it during their most vulnerable times in their illness.
Chiduzie Madubata is a cardiology fellow.