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Role of Suffering and Illness in Medical Education

 , August 03, 2013

Francisco Goya Self-Portrait with Dr Arrieta

Self-Portrait with Dr. Arrieta, the last of Goya's many self-portraits, was executed late in his life. In 1819, Goya had fallen seriously ill and his doctor, Eugenio José García Arrieta, nursed him back to health. On recovering, he presented Arrieta with this painting which shows the physician ministering to his patient.

The poem “for an intern on call in Houston” by Rachel Pearson is the first of a three poem series on the role of suffering and illness in medical education. “for an intern” is a crisp and dream-like poem that highlights parts of this theme. With the lines “where you in a windowless / I imagine room are waiting / for something to be born / so you can palpate / and percuss it”, she draws on the necessary truth that medical education is based on suffering. To learn to heal, we must learn on the ill and broken.

Throughout a life in medicine, our patients provide us with the gift of suffering, a difficult irony that is offset by the reward of healing that we are able to offer some of our patients. When interacting with sick patients, we often wish we could do more, that we could offer more than our limited tools and knowledge. This poem shares our wish to send sick children to “maybe a boy kingdom / where it rains insulin / and hails pancreases.” 

What we cannot provide for patients with our medicine, we must provide with our spirit and our intentions. Some of the most important tools in medicine are not medical tools.

Bryan Sisk
Deputy Editor, The Living Hand

The image above is a photographic reproduction of a work of art that is in the Public Domain and was downloaded from WikiMedia Commons and is available at