The "art" in pain management

I enjoy art. To experience art, and especially to experience art in the making, is timeless. Why talk about art in a pain blog?

When I was in dental school and then in grad school, echoes of phrases such as  “the art and science in medicine…the art and science in dentistry” would be heard throughout the course of many lectures and talk. The art in medicine and dentistry was predominantly meant as the skill-set that required expertise in technique. However, to me, the “art” in health care is the openness and creativity that underlies every doctor-patient interaction.

Every patient, new or previously known to the doctor is a new experience. Each time the doctor interacts with a patient, the space is open. It is magical if both the participants walk in with an open-mind. Although, It is quite something to watch the pre-conceptions color a conversation, it makes it more exciting as the space opens up in that conversation to allow for a healing interaction – both ways.

The technique in health care- both medicine and dentistry is imperative. Without it there is no core. It is the very skeleton to that trusting bond between the doctor and patient. But the art is the life of that interaction. Art lies where the doctor uses his or her intellectual, emotional and technical skill sets in a creative, patient-centered manner. It lies in steering the conversation as it un-folds. It lies in being open from moment to moment to receive what the patient has to say and then guide appropriately, in terms of the treatment.

In my clinical practice, when I present treatment options, often times I use the analogy of an empty room with multiple doors. The patients choose the treatment that suites their belief, their needs and personal goals. The technical expertise lies in defining those treatment choices for the patient, but it is indeed an art, in exploring the patient’s needs in their own terms and then watch it all unfold in front of you.  Art give that interaction a certain element of timelessness. Already, for a lot of chronic pain patients, time is irrelevant, as they have tried so many “interventions” and treatments over so many years. Hence, sometimes, a patient conversation lasts 60 minutes and sometimes its 10 or even 5 minutes, but the time is only guided by the patient’s goals. It can also be influenced by the doctors intentions, but I have found it best to be a receiver and then a guide than first the guide and then the receiver.

So, this is something I emphasize to visiting students here…allow your expertise to be your core strength, but develop an openness to your patients, and a certain awareness…develop a compassion to listen to your patients and a certain readiness to be in the moment of those three important words…clinical decision making…because there in lies the he-“art “ of medicine.