By JiJi Russell
Without a doubt, the greatest changes in medicine over the past 25 years have come in our understanding of the molecular biology of human disease. For centuries, the physician’s greatest tools were the medical history, the physical exam, and the stethoscope.
When I first began to practice medicine some 25 years ago, technology began to be added to this equation. The crude and simple X-ray gave way to more improved techniques. First on the scene were CT scans, then MRIs, then PET imaging, and forward we surge. These capabilities have truly revolutionized our ability to view the human body with more precision and accurate detail.
But even though these tools allowed us to visualize human anatomy and see where it was aberrant, the underlying reasons why these anomalies occurred were not answered. These past many decades of basic science research elucidating both normal and abnormal physiology on a molecular level have begun to produce insights and answers into the mystery of human disease. Understanding exactly what the defects are that result in disease states like cancer is now being translated into newer and improved treatments that are highly focused and targeted against what specifically has gone wrong within the DNA of an individual patient.
Recently, the pace of newly published medical information has proceeded, not linearly, but logarithmically. This has produced the need for specialization in medicine because one physician cannot ‘do it all.’ It would be impossible for one primary care doctor to keep pace with all of the new information arising daily in fields of cardiology, oncology, and all of the other ‘ologies.’ This has altered the face of medicine, and it is a rare individual who never requires a referral to a specialist.
It is quite a challenge for both the physician and the patient in today’s world of medicine to maintain that old heartfelt bond that described the doctor-patient relationship for so many centuries. Holding on to this human element describes the art of medicine in today’s world. Not that it is impossible, just more difficult. Although this is the ‘downside’ of the medical information revolution, the very positive ‘upside’ is that more and more individuals are being treated more specifically and more effectively for their underlying disease states than ever before. And the future looks even brighter.
Although medicine has been my passion for the past 30 years since I began training in 1984, I have been fortunate enough to have found yet another passion in life, and that is art. I retired earlier than I had imagined from medical practice last summer to pursue this newer passion.
On the surface the two endeavors could not seem more dissimilar. But both flow from a desire to serve the human family and to share and express meaning in our existence together. I very much miss spending time with patients, but all of the experiences I have been privileged to have over these years are adrift within me and are expressed in every brushstroke.
Kathy Stewart practiced as an oncologist and hematologist for 20 years at Shenandoah Oncology. She attended medical school at the University of Virginia; completed her residency in Internal Medicine at Yale-New Haven Hospital, and her fellowship in oncology and hematology at Duke University Hospital. Currently, Dr. Stewart is enrolled in Studio Incamminati, a full-time art atelier in Philadelphia.