30 April 1974 / Magnus Estate

I was recently given a copy of Oliver Sack's book, Awakenings by a former employee who now works with Dr. Sacks in New York. To say I enjoyed it would be an understatement. Its appeal to the lay audience is unprecedented, and I hear that it is going to be made into a movie that will feature the voice of Johnathan Winters as the animated protagonist of the story, the chemical L-dopa.*

It is, simply put, the most engaging work about catatonic people that I have ever read. As impressed as I was by Dr. Sacks intellectual bravery, I was more taken by the way his story humanizes both the patient and the caregiver, which was one of my primary goals when I began to practice medicine, and continued to be one after I eventually went to medical school. Yes, experimentation and technology drive medicine forward, but the basic relationship between healer and patient is paramount.

For years, I made sure that any patient in my hospital was hugged for a full 15 minutes before any questioning or examination began. While concerns about effective use of time and a few mean-spirited lawsuits lead me to terminate this policy, I still believe it was sound. It was certainly better than the austere culture of medicine that existed in my youth. Back then it was not uncommon for patients to be examined through a hole in a sheet or be forced to confide in doctors who insisted in speaking with the affected "robot voice" that was favored by technology obsessed MDs (some of the most extreme "futurist doctors" refused to speak at all, and communicated only with "beep" noises).

I am not advocating that doctors coddle their patients. It can do more harm than good. Do we fuss over babies because they are weak, or do we make them weak by fussing over them? It is a question only a clinical trial can answer. In addition to sounding creepy, overly "touchy-feely" doctors are worthless. They form relationships with their patients that interfere with objective treatment. Cold, hard science will always be needed in medicine. I only suggest that a balance must be struck for maximal healing.

I applaud Dr. Sacks for showing that rigorous human experimentation and compassion can exist side by side.

*Robin Williams, who starred in the eventual adaptation of the book, said that he actually based his portrayal of Oliver Sacks, and later, Patch Adams on Bent Magnus, having seen two very different sides of his personality: before and after a large lunch - Ed.