Robert Watson offers his perspective on humanism in medicine

Dr. Robert T. Watson, former senior associate dean for educational affairs and a 1969 graduate of the College of Medicine, provides an excerpt of his speech during the first annual Hugh Walters, M.D., Humanism in Medicine Distinguished Speaker and Humanitarian Award held June 10. Dr. Watson currently is executive associate dean for administrative affairs at Florida State University College of Medicine.

It was very special to me to have been selected as the Hugh Walters, M.D., Humanism in Medicine Distinguished Speaker. I feel honored to have known Hugh as his teacher, adviser, colleague and friend, to foster his career and to see how he helped others.  Hugh was one of the first Florida A&M students accepted into the UF College of Medicine’s junior honors program, and he set the standard.  I was pleased to help Hugh receive a year at the Howard Hughes Medical Institute, a very competitive appointment.

All who love to teach have an inner fondness for those we help learn.  On occasion one of those learners is special, someone we come to love as one of our own children. Having the opportunity to positively influence someone like Hugh Walters is more valuable than any marketplace reward. It validates fulfillment of meaning and purpose in life. It was a tragedy to have lost such a promising physician and good friend so early in his life. I hope by honoring him, as we do today, we keep alive his commitment to compassionate care.

As guest lecturer, I was asked to offer my perspective on humanism, which I believe is one of the most important aspects of taking care of patients and their families. This importance is not limited to individual caregivers, but to the institutions, environments and culture in which we work.

What is humanism? I think humanism is making life better for everyone, and leaving the world a better place for those who come after. Humanism offers a basis for moral values, an inspiring set of ideals, a rationale for living life joyously and an overall sense of purpose and meaning. In medicine it means compassionately caring for patients, families and all health-care providers.

I actually found it encouraging that I was asked to speak on humanism, rather than on professionalism. What worries me is that I think many believe that professionalism and humanism are the same. I think they are different, although intertwined. Professionalism is a set of behaviors; humanism a set of beliefs. One can learn to act professionally, if only on the surface. Jean Giraudoux said, “The most important thing for a politician to remember is to act sincere; if he can fake that, he has it made.”

But good, superficial, behaviors are too often not sustainable in our chaotic world of health-care delivery. Professional behaviors are necessary, but not sufficient for the humane practice of medicine. Patients want to be treated by physicians who are not only masters of their craft, but also deeply care for them as people.

But is professionalism all there is to being a physician? Is it enough to go through the motions without the virtues that should form their foundation?

To me this is vitally important. Doing the appropriate acts that define a professional might be easy during a routine day, but less so when under stress.  The daily chaos of medical practice provides many opportunities to forget to act professionally. Being reminded to do the appropriate things might be easy when in the presence of patients, but just as easily forgotten when not in their presence, whether in the hallway, elevator, cafeteria or when the patient is asleep in the OR. Doing the appropriate things directed towards a medical student or resident might be easy, but easily forgotten when dealing with a less-than-helpful ward clerk, even when a medical student might be watching. How we react at these times underscores our fundamental values, and we need to be aware of this and model appropriate reactions as well as we can. We need to draw on our humanistic values to sustain us during times of stress.

Our greatest impact is in the informal and hidden curricula. The informal curriculum is learning that arises out of sporadic, happenstance, and idiosyncratic interactions between students and teachers. It can happen anywhere and at anytime. The hidden curriculum is the difference between what an organization says is its mission and what happens in the trenches. Medical education is experiential, and students learn by experience. We are the role models. The value of humanistic care is largely conveyed to students and residents when observing faculty during their daily activities.

When we teach the formal curriculum in learning environments that are not always conducive to our message, we help create non-receptive, cynical, and even hostile reactions. Hearing a formal curriculum, and regurgitating it on tests, is not the same as learning.  Teaching the formal curriculum is not the sum total, or even the most important aspect, of a medical education.

Some say that being in the presence of bad role models is good, that it helps the student learn how they don’t want to act.  What students really learn is that they exist in a culture that tolerates bad behavior. It is the difference between what we say and what we do that leads to cynicism, and begins the transition of many of our students from being a caring member of the broader community to a professional member of the guild. We want them to remain a caring member of the larger community while becoming a member of our profession. At the least, those students who were admitted who are both smart and humanistic can only be reinforced by a culture that stresses the importance of altruism, integrity, respect for others, and compassion. We must tap into the emotional dimension of caring for patients, because only then can we validate what it means to be a humanistic professional, not just how to act like one. Without true empathy and respect for the human condition, a commitment to professionalism becomes largely an intellectual exercise.

I think being a good physician is possible by being a good professional, but being a great physician requires both behaving and believing.

In many ways the ancient philosophers were right when saying that true humanism is reflected in a consistent set of values that we all should have; values of wisdom, justice, courage and moderation. As physicians we have the incredible honor of being able to make a positive difference in the lives of others, to live values of wisdom, justice, courage, and moderation; to provide hope to those around us. No matter what the environment, no matter how onerous might be the marketplace, no matter how oppressive the bureaucracy, we can’t let these dim our days, darken our zeal, or diminish our profession.

Dr. Hugh Walters had wisdom, justice, courage and moderation. He lived the values that reflect true humanism. He is the role model for all of us.