Lessons from El Salvador – Humane Medicine 101

I’m presently volunteering at an orphanage for disabled children within the mountains of El Salvador. I’m part of a benevolent Italian-Canadian RC church group from the greater Toronto area. This orphanage has continued to flourish largely to the dedication and leadership by our pastor, Father John Borean.

As I prepared for this experience I thought in terms of offering whatever help I could (child care, maintenance, construction etc) as well as potentially offering my expertise in wound management. Upon arrival, I quickly realized that I could not practice my professional in the classic “high tech” mode that I was accustomed to in North America. However, I  began to see that the absence of “high tech” was more than offset by he enormous levels of “high touch” (love) extended to the over 120 children by their staff caregivers, nuns, volunteers, and healthcare professionals.

As I reflect on the contrasts between healthcare (medical care) in developed countries versus that occuring in developing countries, I must emphatically conclude that a truly humane approach no longer occurs in developed countries. It is a rather de-humanized approach that focuses on the disease rather than focussing on the whole patient. In this system, there is very little interaction between physician and patient as all of the attention relates to the micro aspects of the disease rather than the effect that it is having on the patient as a whole. Moreover, this had led to the development of physicians that are boldly paternalistic and egotistical, while painfully lacking humility and compassion. Thus, physicians from developed countries have lost their skills in the art of medicine which is the essence of a truly humane approach to healthcare (medical care).

I was fortunate to be mentored by a couple of eminent professors from the University of Toronto, Dr. DG Oreopoulos, and Dr. WO McCormick. I regard both as icons and trail-blazers. Both have been pivotal in my own personal and professional development. In 1983, Dr. Oreopoulos published a manuscript in the CMAJ in which he made a passionate plea to restore “Humane Medicine”. In this paper, he quotes M. Balint (1964) who originally stated “the most potent medicine that a physician has to prescribe is “himself”. During the late 1970’s, Dr. McCormick coined the term “Humbility” to desribe the key elements for the synthesis of the ideal physician, namely, humility and ability.

In summary, my experiences in El Salvador have reminded me that we need to not only practice in a manner that espouses the principles of “patient-centered care”, “interprofessional collaboration”, “integrative healthcare”, and “evidence-based medicine”, but, also restore a more HUMANE approach in which we connect with the “whole person”  through the extension of humility, compassion, and love.


About drvincentmaida

Consultant in Palliative Medicine & Wound Management, Assistant Professor, University of Toronto & McMaster University, Researcher & Author.
This entry was posted in Bioethics, Palliative Medicine, Wound Management. Bookmark the permalink.

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