Hiredesai: Russian Literature and Medicine

Annika Hiredesai, Columnist

In the opening lecture of my Introduction to Russian Literature class, Professor Gary Saul Morson declared the texts were unique in the authors’ quest to get at the very heart of our existence. Great novels, Morson said, were born to answer the great questions of life. And though I’ve only read the course’s first novel, Dostoevksy’s “The Brothers Karamazov,” Morson was right. My understanding of human nature has been utterly transformed.

I chose the course in part as an intellectual respite from my pre-med coursework and yet, these very questions of humanism are those that are intrinsic to medicine itself. Finding faith and meaning in our existence is something that I’ve always seen in the practice of medicine. Reading Dostoevsky’s words has given me a new perspective to reflect upon.

One of my favorite passages from the book connects the two beautifully. A townswoman visits Father Zossima, a saint-like character, to confess a dilemma she is facing. She desires to become a nurse and devote herself to the service of others. However, she reveals that if a patient were rude and ungrateful to her, she couldn’t help but feel resentful. She is deeply ashamed of this feeling as she knows conditional love is neither authentic nor selfless, the qualities she aspires to. Father Zossima counsels her with an anecdote of a doctor who loved humanity yet found himself increasingly disenchanted by his patients.

How can someone love humanity but not the people that comprise it? The answer lies in how one views their service of others. Those in the medical profession believe in bettering humanity. On principle, it’s something to aspire to, something to strive towards. These lofty ideals, however, can be incongruous with the day-to-day realities of practicing medicine, especially in the modern era.

I’m no stranger to the trends of growing physician dissatisfaction. Doctors are showing staggering levels of stress, with 42 percent of respondents in a national physician survey reporting burnout. Under the increasing burden of electronic health records, complicated reimbursements and general bureaucratization, modern healthcare has made it much harder for doctors to do what they set out to do: help their patients.

Even then, there’s no such thing as the perfect patient. Everyday people aren’t equipped to deal with their mortality on a daily basis. Even an ailment as innocuous as a stuffy nose can lead to emotions running high. While a provider has the training to step back and consider treatment options, expecting a patient to do the same is unfair and unrealistic.

Patients are people. They can be skeptical, scared and paralyzed by the magnitude of decisions. They may forget prescriptions that took copious amounts of paperwork to secure. They might skip the appointments that are critical to their long-term care. It is perfectly understandable as a provider to feel frustrated by these setbacks.

It is not, however, an excuse to treat patients with moral superiority. The doctor in Father Zossima’s story places his profession on a pedestal, elevating himself as a savior of the peasants. Having to care for imperfect people feels less satisfying to him than the perfect belief that he cares about the world. His dislike of his patients stems from the reminder of his own faults. Rather than embracing this shared humanity, he uses the white coat to distance himself.

While it may sound bleak at first, when I reflect on this passage, I begin to see opportunities to do better. This story shows that it’s futile to feel fulfilled in medicine by retreating into a position of intellectual superiority. Treatments and prescriptions are no substitute for connecting with patients on a human level. Throughout the novel, Father Zossima preaches the idea of committing to small actions of everyday love. Maybe that’s taking a few minutes to chat with a patient about life or getting an expensive procedure covered for a patient.

I’ve yet to experience the day-to-day life of a physician. I don’t claim to have a solution to the increasingly complex challenges doctors, and medicine as a whole, face. Yet, I can’t help but feel hopeful for the future of the profession. The joy of taking measured steps to improve patient lives serves as an opportunity to infuse the mundane and bureaucratic with renewed purpose. It’s a chance for health care to refocus on its guiding principle of serving humanity. “The Brothers Karamazov” has taught me that it is the small acts of active love that sustain us. As I move forward, in medicine and life, it’s a lesson I’m in no hurry to forget.

Annika Hiredesai is a Weinberg sophomore. She can be contacted at [email protected]. If you would like to respond publicly to this op-ed, send a Letter to the Editor to [email protected]. The views expressed in this piece do not necessarily reflect the views of all staff members of The Daily Northwestern.