“The Doctor” is a 1991 film on one surgeon’s life and relationships with his family, friend, colleagues and patients. Dr Jack MacKee, played by Willian Hurt was a surgeon with great skills but arrogant, egocentrinc person who didn’t take care of patients as individual humans rather just as mechanics. But he one day diagnosed as malignant throat cancer and becomes a ‘patient’ from ‘doctor’ and first time experiences a bureaucratic system in his hospital and how cold are manner of doctors on patients, meet fellow patients who have each one’s name, feeling and story, and knows how his wife think about him. His cancer is treated and cured, and his thoughts and manners completely change.
The core messages of the movie, “every doctor can be a patient,” and “every patient has their own name and feeling” are still meaningful to medical practitioners. But when we watch the movie standing on today, 21st century, we can learn more complicated lesson for our life and health care.
Most of today’s major diseases in industrialized societies are chronic, such as cancers, mental illnesses, obesities, and debilitating physical and mental functions accompanying the aging. Since these are closely related to each person’s daily behaviors, social relationships and built environment, in most of the cases, care for chronic diseases cannot be completed only in hospitals or by medical practitioners. Social supports from various persons around patients such as friends, parents, partners, children, colleagues at worksites, local community members, social workers and religious workers are crucial so patients can preserve their dignity and maintain decent and capable lives as much as possible. More important, patients themselves know much about their behaviors and feelings. Therefore, surgeons are no longer the strongest “judgments,” as described once in the movie, to decide what is the best way to treat patients. Rather, hospital workers including surgeons are required to communicate and collaborate with outside actors and patients to understand patients’ feelings and needs, and seek for better treatments for each one.
On the other hand, a relatively weakened power of doctors does not necessarily lead to good results for our health systems and healthcare. It might lead to, in turn, an excessively stronger influence of patients on medical practices. The more information spread out our society, the more lay people tend to think they know much about medicine and be likely to order a lot of things on doctors. Increasing elder population leads to shortage of medical resources such as beds, doctors, nurses and time, while every patient wants to get better and therefore wants to be treated first in the best way. As a result, nowadays overwork of medical practitioners and increasing risks and burdens of court cases that blames for malpractices are serious problems (today in Japan, there is a term “monster patients” which describes selfish and immoral patients who require too much on medical practitioners). However, no one doctor can be perfect, same as no patient can be, especially in today’s highly specialized and segmented medical practice fields. Same as patients should be treated as individual humans, each medical practitioner has their own name, life, feelings, strengths and weaknesses, and limited physical and mental capacity. To realize a good healthcare, we also need to understand and support medical practitioners. Going beyond the message from the movie “every doctor can be a patient,” we need to consider a reality of today’s fragile and interdependent society. Given the nature of life-style related chronic diseases as I mentioned above, every actor in society, not exclusively for ‘patients’ and ‘doctors,’ can be a supporter one time, and can be a player who fight against diseases receiving supports other time. What is important manner in today’s healthcare may be an inclusive collaboration across diverse, interchangeable actors, understanding each individual’s limitation and potential.