By Dr. Attia Anwar
As a physician, we always deal with the diseases. Some diseases happen and then go completely and we say the patient or disease is cured. But in actual practice, we can cure very few diseases completely. Like if you have a urinary tract infection you get a three-day course of antibiotics and you are cured completely although there are chances you may get it again. Or your bone gets fractured in a minor accident it is fixed and your condition is cured forever. Your small skin cancer is diagnosed in the very early stage it is removed, and you are free of the disease forever.
There are many diseases especially non-communicable diseases which are managed lifetime but the patient is never completely free of disease. Examples of these diseases are very common ailments like high blood pressure, diabetes, migraine, and epilepsy to very serious diseases like muscular disorders. Your blood pressure can be managed by one to three pills a day but it will never be cured. It is very painful when we cannot get the eradication or cure of the disease that we are trying to find. But if we can find healing in the midst of our illness we will continue to find hope for our future, and we will be able to help others find healing. Healing is strengthening your mind, spirit, and body to improve your quality of life.
The lesson I learned from my life as a physician is that healing is not the same as curing. Very little attention is paid to healing in medical training. The focus is entirely on curing and eradication of disease. But the problem is that we cannot eradicate many diseases. We deal daily with people with diseases, we know will never go away. We cannot eliminate all evidence of disease. We as clinicians try to offer some hope to these patients. This model accepts that a state of wellness does not always mean that you are strong, disease-free, successful, and young. In contrast, someone who is well might at the same time be physically disabled, aged, in pain, and imperfect. The difference is in which direction a person is going. Are they growing in their awareness, knowledge, and consciousness of self or are they shrinking and, withdrawing or limiting themselves? Someone with a progressively debilitating and perhaps terminal illness may be optimally well in their capacity to grow and heal from experience. And someone with optimal physical health may be in denial. It involves spiritual and emotional aspects of care. Intrinsic hope can bring inner peace in your life. That will make you able to deal with disease in a better way. The people who are on the real level of acceptance will physically be better. their physical parameter of improvement are better and they usually have better quality of life and more life expectancy. An extreme example of living with a disease and disability and a productive life is Stephen Hawking. After accepting his diagnosis and limitations by healing, he did wonders.
False hopes can harm patients. So what we can do is spend some time with the patient to give accurate information. Then we should set realistic goals and expectations and add a human touch to them.
If the disease has not so much impact on life the patient can live with medication as normal as other people. It should be explained to the patient. Roadblocks for lifestyle modification should be discovered and hope for the best life should be given. And people will find their condition more under their control and manage it more efficiently. Examples of these diseases are high blood pressure and diabetes. Studies have proven that patient who knows about their disease well and has a positive outlook on the disease can get better control of the disease. Their quality of life improves and adverse outcomes are significantly reduced. In more serious and debilitating conditions we should offer small hopes like going from the hospital with family, seeing a grandchild, and attending the graduation ceremony of a son. That will have a positive impact on disease and sometimes miracles happen.
Sometimes you even become free of disease but you are not able to heal completely. There are examples of people who had major accidents. They are cured completely, and their bones and muscles are physically completely healed. But they are not able to heal . For people who have had physical pain for a long time, certain areas of their brains change in such a way that they keep on feeling real physical pain without the presence of injury. And that has been proven by scientific research and testing. This pain is so debilitating that it is not relieved by any medication. So this aspect should be kept in mind while dealing with patients of extreme injuries.
Healing requires mental, spiritual work accepting the situation and then wonders can happen. It depends on both the patient and the doctor. How they deal with the situation, will have a longer impact on life. I already gave the example of Stephen Hawking. He did not let that extreme physical dependency get in the way of his life. Then he achieved what an able person can usually dream of. So we can either respond to our situation with bitterness or transform it into a creative force and help ourselves and others.
The author Dr. Attia Anwar is a consultant family physician with a postgraduate degree from the Royal College of GP UK. She is a strong advocate of health and well-being and wants patient participation in decision-making regarding health.