MODERN medicine owes much to philosopher Rene Descartes, who centuries ago separated the mind from the body.
This allowed science to study the body as a machine that could be fixed when broken. The model has brought extraordinary progress, but it has also created a blind spot. Bodies do not suffer – people do.
In hospitals, I see this blind spot daily. Too often, medicine focuses on curing disease at any cost, while overlooking what matters most to patients: their independence, their relationships, their ability to live as themselves. I used to think older people were simply like me, only older.
But the longer I work with them, the clearer it becomes that independence is treasured even more than life itself.
While death can be met with quiet acceptance, the loss of independence is rarely endured without distress.
Frailty, now recognised as its own medical condition, lies at the heart of this challenge. Frail patients are more likely to suffer chronic illness, more likely to depend on others, and less likely to survive serious disease.
For them, aggressive treatments often bring heavy burdens – sometimes greater than the illness itself. The risks of death or permanent disability loom large.
Medicine rightly demands informed consent, yet our ability to predict outcomes is limited. Even estimating whether a patient will live, or how treatment will affect their independence, is an inexact science.
Within the body-as-machine model, these uncertainties become even harder to confront. The hospital’s pace, younger doctors’ lack of life experience, and a culture that resists talking about death all add to the problem.
But the truth is simple. Older people do not want miracle-workers. They want to be seen, acknowledged, and spoken to honestly. They want doctors to recognise their humanity, not just their failing bodies.
For me, the deepest satisfaction in medicine comes not from fixing machines, but from guiding people through choices that reflect their values and lives.
Extracts from an article by Bill Lukin, published in Theconversation.com.au –2017
