Love and the Physician: A Reply to Thomas Irons

Abstract

In ‘Loving the Chronically 111 Child: A Pediatrician’s Perspective’ [4], Thomas Irons exhorts his fellow physicians to rededicate themselves to the traditional but endangered values of service and love for their patients. These values are symbolized by and embodied in the house call, the healing touch, the soothing voice, and the listening ear, activities and skills central to the practice of an earlier generation of physicians. Irons identifies a number of major obstacles preventing today’s physicians from achieving the ideals of service and love, including fragmentation in health care, limited access to care, paternalism, defensive medicine, retreat into science, and over-reliance on consultation. The latter four of these — paternalism, defensive medicine, retreat into science, and over-reliance on consultation — are described as attempts by the physician to avoid the vulnerability and pain which accompany identification with the patient and his suffering. I believe that physicians would do well to dedicate themselves to the ideals Irons has presented, and I agree that the obstacles he discusses seriously threaten the provision of compassionate care for chronically ill children.