NOTES FROM AN ISLAND Day 24 Telemedicine 4/16/20

Now there are many humans struggling for want of human interaction. With typical bias, I believe those in healthcare are feeling the absence more keenly than most.

Medicine is founded on the principle of the laying on of hands. In fact, the actual practice of medicine has not changed since the days of druids and shamans. The practitioner would view the patient, would ask pertinent questions and then would touch the patient in order to feel what negative spirits were at play to create the disease (nowadays we call this the physical exam and the negative spirits pathologies, but they amount to the same thing). The actual treatment is almost an afterthought. The creation of the bond between healer and healed is arguably the most important step in the process. The patient must trust that the healer is bound to help, and the healer must have confidence that help will be offered.

Contagion is a scary thing. The COVID virus is both very contagious and very virulent and without knowing who may carry the virus, practitioners must take precautions across the board. This may include everything from masks and gowns to the physical closing of their clinics and using only telemedicine for the evaluation and care. And I know from experience that it hurts every time a practitioner cannot establish some form of meaningful contact.

I am no Luddite. I have wanted to see telemedicine in effect for a long time, ever since the capacity for visual contact remotely was first developed. But I firmly believe that telemedicine is a tool and not the treatment in and of itself. There is so much information that a good healthcare agent can get from personal observation. Much of that is lost in the two-dimensional world of a video screen.

But more important is the loss of connection between healer and healed. I have always said that there is a substantive difference between healthcare and medicine – the latter is only one tool in the former. There is room, if not the necessity, for other tools, be they massage, oil dispersal or psychological therapy. These may not be hard sciences as pharmacology or surgery are. But they are part of the component whole of the wellness not just of the patient but also of the caregiver.

Telemedicine is probably here to stay. But I hope that it is never seen as a replacement for in-person care (except when necessary) or for the human touch.

[This Post was adapted from a essay originally published on Facebook the day listed above]