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Palliative Medicine: Farr Curlin
29 Plays2 months ago
Dr. Farr Curlin is a palliative medicine physician and Josiah Trent Professor of Medical Humanities in the Trent Center for Bioethics, Humanities, & History of Medicine at Duke University. Listen to Farr discuss health in the context of palliative medicine, medical aid in dying and the interaction of patient and physician values.
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Transcript
Introduction to 'The Wound Dresser'
00:00:09
Speaker
You're listening to The Wound Dresser, a podcast that uncovers the human side of healthcare. I'm your host, John Neery.
Meet Dr. Far Kerlin
00:00:21
Speaker
My yesterday is Dr. Far Kerlin. Dr. Kerlin is a palliative medicine physician at Duke University Hospital. He is also the Josiah Trent Professor of Medical Humanities in the Trent Center for Bioethics, Humanities, and History of Medicine, as well as co-director of the Theology, Medicine, and Culture Initiative at Duke University.
Medicine and Religion Programs
00:00:40
Speaker
In 2012, Dr. Curlin helped found both the University of Chicago's program on medicine and religion and the annual conference on medicine and religion. Dr. Far Curlin, welcome to the wound dresser. Thank you, glad to be with you.
What is Health?
00:00:55
Speaker
um So I think a good place to start ah is just this idea of health medicine, but I think particularly palliative medicine, it's important to kind of like define you know, what your philosophy is, what you're really trying to do. So I guess my first question to you ah would be, how do you define health? I find the philosopher or physician Leon Cass's definition um as clear as I have seen. And Cass defines health as the well-working of the organism as a whole, or put differently, an activity
00:01:33
Speaker
of the body in accordance with its specific excellences, by which he means that the particular type of living organism ah to some extent defines what health looks like. um We all as living organisms have health, but human health is different in certain respects from that of other organisms. So that those are definitions that are not dropping from the sky, CAS is developing a long tradition of thought on what health is, but I think they they capture the essence of health as well as any.
Patient Health Prioritization
00:02:14
Speaker
When you're thinking about your patients and your work in healthcare, care do you feel um that kind of under that umbrella of that definition you get that everybody kind of has it a different ah experience of what health is?
00:02:27
Speaker
Well, I don't think everybody has a different experience of what health is, although everyone has their own specific experience of being healthy or not in the particular ways that are possible to them, given their makeup and their context and their environment and so on. There is quite a bit of variation among patients in terms of what features of health are important to them and to what extent they're important to them. So one person may really be determined to minimize their risk of and some adverse event in the future, say a heart attack or a stroke. Another may just wanna get back to playing tennis and so they wanna focus on their knee pain and not really interested in dealing with their cholesterol. um So people's interest in different features of health
00:03:20
Speaker
will depend on the particularities of their situation and their own dispositions, their own vocations, their own contacts, um and the resources that are available to them to pursue different features of health. But I think that health is such a thing, namely being an objective characteristic of living things,
00:03:48
Speaker
that we do, to a real extent, even if we may protest on the margins, we do share, we human beings, a recognition of what health is and of what it requires. And it's that shared recognition, I think, that helps to make sense of the profession of medicine.
Palliative Medicine's Focus
00:04:07
Speaker
So what do you do as a palliative medicine physician in your day to day to kind of pursue health um for a lot of the patients you're working with?
00:04:16
Speaker
It's a good question because often people think, well, palliative medicine is what you focus on when you can no longer achieve health, when your health is gone and won't be coming back. And of course, in some sense, that's true. People don't generally see palliative medicine doctors until they have a serious advanced illness that cannot be solved. And so in that respect, these people generally will never be called healthy again.
00:04:46
Speaker
But in another sense, that way of thinking, I believe, is understandable but mistaken insofar as as long as a patient is living, he or she has some measure of health. And very frequently, the very thing that palliative medicine clinicians can do for patients and ought to do for patients is attend to those features of health that still are achievable and that we can help to bring about and to um pursue those in a way that fits the patient's particular vocation. So for example, when I see patients in the outpatient clinic,
00:05:32
Speaker
I am generally doing two things. One, helping them discern among the medical options that they're being offered by other specialists. Which of those options is all things considered a good option for them? And that has to do with thinking about their vocation, thinking what goods that option offers, what kinds of harms or side effects the option brings, and asking whether for them the option being offered offers benefits proportionate to the burdens And that actually takes up probably most of our time in palliative medicine or at least um my experience of palliative medicine. The second thing we do is try to focus on the difficult symptoms they're experiencing with pain being the most obvious and use the tools available um to try to bring some relief.
00:06:26
Speaker
that relief which restores to them some measure of health like being able to sleep, being able to talk to people, being able to rest, ah being able to move about without being in pain or without vomiting or without being very out of breath and so on.
Understanding Patient Vocation
00:06:45
Speaker
So you mentioned a couple of times like a patient's vocation. How do you work with a patient to kind of define that in your clinical relationship?
00:06:54
Speaker
I start by asking them, ah tell me about yourself. By the time people see me, they usually know that they have some life-threatening and life-limiting illness. So I'll ask them, in light of the reality of the illness you have, what's most important to you in the time that you have left?
00:07:18
Speaker
And then I'll ask follow-up questions to understand to whom do they belong, what is the kind of work that they've been about, um what are the convictions they have about how they should live in the in the face of their own dying, and so on. And then that information will help me ah present to them what I take to be the reasonable options that medicine could offer them.
00:07:48
Speaker
that ah fit their vocation. And by that, I don't mean that I hide anything from them, but the clinical communication is, I think, rightly understood by its nature. um when When it's done well, it's directed at discerning how to achieve the goods available to that patient related to health um while avoiding undue side effects.
00:08:18
Speaker
taking into account all that's important to that patient and all that's at stake in that situation and offering those or recommending those to the patient and then of course respecting the patient's authority to either consent to or refuse to consent to any of those proposals.
00:08:37
Speaker
Do you feel like when you explore that question of vocation with ah a patient with life-threatening illness that you get a pretty wide range of responses or um do you feel like they're generally pretty narrow in the sense of I want to kind of be with my family, and my loved ones, I want to be comfortable, et cetera? Is it kind of like a wide range or do you feel like 95% of your people kind of fall in this bell curve pattern? and I would say it this way there, there is a wide range, but there are some pretty consistent themes that recur in most patients, including I want to be with my family. I want to be home. I don't want to be going back and forth to the hospital. I want to be able to be in my right mind and communicate with those who love me.
00:09:30
Speaker
And then depending on the person, there's often some specific goal they have in mind. Like I want to be there at my daughter's wedding next spring, or I've been working on a book for 10 years and I really hope to finish it. Um, or I want to go out and be on my boat and not be bothered. Um, there, there,
00:09:58
Speaker
there is a So in that sense, there's a wide array, but within that wide array, this these themes recur.
Palliative Medicine vs. Care
00:10:06
Speaker
I've heard you make this distinction between like palliative medicine and palliative care. Can you kind of elaborate on ah what that distinction is for our listeners?
00:10:15
Speaker
Yeah, I use those terms not so much to say that the specific words mean two clearly different things, but to highlight two clearly different understandings of what palliative clinicians focus on. And so the first, palliative medicine, I think, is a focus on palliation that operates under the traditional norms and boundaries of medicine when medicine is properly understood and properly practiced. And the specific thing there is that the patient's health provides a governing standard against which our practices are held. And so practically that would mean that if someone's practicing palliative medicine,
00:11:09
Speaker
under that understanding, they will not do to patients things that the clinician believes contradict a commitment to the patient's health. They won't intentionally hasten the patient's death, for example, much less kill the patient. Those would be the two obvious boundaries. But they also will not relieve suffering willy-nilly without
00:11:36
Speaker
considering whether that suffering is connected to um and the relief of it is consistent with the patient's health. And so that's how I see palliative medicine. Palliative care, by contrast, insofar as I use that term to draw the contrast, is reflects a second understanding of palliative care or palliative medicine in which the goal of palliative medicine professionals or palliative care professionals is broader than the goals of medicine. And it's more to maximize quality of life as the language is often used and to minimize suffering as the language is used according to the values and goals of the patient. And when people practice palliative care so defined, the problem it seems to me is that they,
00:12:32
Speaker
ah set aside their clinical judgment regarding what is consistent with the patient's health and can even come to act in ways that are directly contradictory to patient's health. And so thereby, I think, undermine the trust that the practice of palliative medicine needs in order for patients to submit themselves to our care when they're um Health is diminished and their lives are threatened.
00:13:01
Speaker
So those are mine. Those are how I use those terms to to highlight that important distinction within our field because the field is very much, as it seems to me, ah divided about these two different ways of understanding, palliation, and is often weaving back and forth into the two different understandings in a way that I think confuses the practitioners and the patients alike. So would you say there's a lot of tension in the palliative medicine community regarding like where to draw those boundaries in terms of comfort versus hastening death versus, you know like you said, flat out killing the patient?
Physician Aid in Dying Tension
00:13:41
Speaker
Yeah, yeah there clearly is. It matters that the American um Hospice and Palliative Medicine Association
00:13:53
Speaker
is ah ambivalent about or ambiguous about physician aid in dying, for example. It has a policy of neutrality, which is effectively a policy of support. um Within the field, a lot of palliative medicine clinicians still oppose intentionally hasing hastening patients' death and will tell patients we don't um We won't hasten your death, but we will stick by you to the end as best we can and using our best lights. But the there is not at all um uniform conviction about that across the field. And as we see with the growing number of states that offer medical aid in dying, um a large proportion of Americans and a large proportion of palliative medicine clinicians
00:14:48
Speaker
believe that if the patient defines being alive as a condition that for them brings suffering out of proportion to benefits, then our commitment to relieve their suffering and to maximize their quality of life according to their judgments gives us a reason to help them kill themselves if we're asked and if the law permits it in that context.
00:15:14
Speaker
So this tension that is present in the broader public is very much equally present among palliative medicine clinicians.
00:15:26
Speaker
How do you see that kind of playing out in the near future? ah do um my My sense is I reside in a state where ah medical aid in dying is legal, New Jersey. um and you know how do you see that plan Do you see more states are probably going to allow that? More states aren't going to allow that. How do you see that playing out in the near future?
00:15:49
Speaker
Well, I'm not great at prediction, but my hunch would be that we will see more states approve medical aid in dying, so called. And we'll see growth in the numbers of people dying by being killed by their physicians or being given deadly remedies that they can take themselves to kill themselves um in the near future.
00:16:10
Speaker
In the long term, I think at some point people will wake up and say, you know this this has created a dystopian medicine and it's created a world in which those who are ill and diminished are no longer safe um and are um given not subtle messages that they also should consider whether medical aid in dying may be right for them. And the most sobering sign of that I think is what Canada has been doing in recent years um with, as I understand it, um as many as 9% in some provinces or areas of deaths being through euthanasia and the rapidly increasing criteria that are by which people can can choose medical aid in dying, including now in Quebec, You can specify that you can be euthanized in the future if you develop a certain amount of dementia or other cognitive disability. So I think the signs are that ah there is a cultural um appetite for killing ah people with diminished capacities and and particularly for, as people put it, dying on one's own terms when one
00:17:36
Speaker
is afflicted with some illness that's going to take away your capacities. And that I think is also seen, I just ah just saw that some movie, I forget the name of it, just won some big festivals award. And it's a movie that's pro euthanasia. It's coming out of Europe. um So I think that the signs are not good for this turning around anytime soon.
00:18:03
Speaker
but it will, I hope, eventually turn around.
Euthanasia Debate
00:18:09
Speaker
Yeah, I guess it's interesting to think about a question when I've been in discussions about euthanasia. It's just like, at what point do you deem a life is not worth living? um And kind of like where do you draw that line? Is it based on an objective outside third party kind of deciding that? Or is it a person who's ah perhaps in a you know uh, a negative psychiatric state. So it's like, it's like, how do you, it's, it's it's like, it's a very like hard thing to consider. I i kind of like as a, as a young medical trainee, I guess I'm, I'm just like grappling with it and trying to have conversations like this to learn more. So, yeah. Well, I think John, that there are two questions basically. One is, is it ever reasonable, uh, to kill another human being as a, as a,
00:19:00
Speaker
um You know, an innocent human being, which is what pertains in these cases. And that I i don't, in my own judgment, that that's not ever fully reasonable. It's often, and I shouldn't say often, it's sometimes understandable, um but not fully reasonable. The second question that seems to me even more clear is whether if we're going to kill people who have advanced illness or who want to die,
00:19:31
Speaker
um physicians should be the ones to carry it out. And it seems pretty obvious to me, and this I think is part of the the deception of medical aid in dying, um that it's pretty obvious to me that people can be killed in equally efficient, equally painless, um less costly ways, a number of different ways.
00:19:58
Speaker
um if our goal is to to kill, ah and to draw physicians into it, um notwithstanding the fact that that makes those physicians less trustworthy in the eyes of all those who oppose medical aid in dying and introduces this fracture in the medical profession that has not been there for now 2,000 years until the last generation um is
00:20:29
Speaker
seems to show that medical involvement is more to give the patina, ah the facade of this being medical care. um Because medical care, people know, is a good thing. And so if this is medical care, well, then it has the the cover of being good.
00:20:51
Speaker
um and it To me, it shows a ah a disingenuous, um I'm not saying everybody's involved is disingenuous, but a disingenuousness about whether the goal um is really just to honor people's choices to die or to relieve suffering, both of which can be much more easily accomplished in other ways than by having physicians carry it out.
00:21:17
Speaker
I want to switch gears and just ask you, I guess more broadly about healthcare.
Learning from Palliative Medicine
00:21:22
Speaker
Do you feel like healthcare, care broadly speaking, can learn a lot from the palliative medicine profession that ah in a sense we should kind of have an understanding that life's finite and sort of like all care, all care is in theory palliative. Well, the way I'd put it is I think the heart of palliative medicine is the heart of medicine, which is to attend to those who are sick or injured.
00:21:47
Speaker
ah seeking humbly, without the premise of solving the problem, um to preserve and restore their health insofar as one reasonably can. um But this sort of fundamental practice of being present to and attending, sticking with, even when you don't have things that solve the problem, um that seems to me the heart of medicine.
00:22:13
Speaker
So in that respect, I think palliative medicine is a witness to this heart of medicine that a lot of people in medical practice and training feel like is being lost. And I think the enthusiasm among so many trainees about palliative medicine, I suspect is because it's one context in which they they feel like they have the margin and the invitation to actually be humanly present to someone without the anxiety of getting all the techniques right now.
00:22:44
Speaker
um And at the same time, I think medicine is an important witness to palliative medicine. And so far as medicine properly practiced reminds palliatricians that um Our profession is not to deliver a good death, much less to get people dead according to their own terms. um Our profession is to heal, and palliation is an important aspect of seeking the healing that's available when people have advanced illness. But when it gives up the profession to heal and instead substitutes a
00:23:28
Speaker
um an effort to basically satisfy people's longings to end life on their own terms, then I think it it becomes a corruption of medicine that then filters back in and has bad influence on the rest of the profession.
Navigating Value Differences
00:23:45
Speaker
we've ah We've talked a lot about ah goals and values, right? When you're in a clinical situation, you know, you have a patient in front of you, they have values, they have things that are really important to them. And, you know, physicians and members of the healthcare team also have values and things that are really important to them. So how, um you know, when you're kind of dealing with two sets of values, two sets of beliefs, how do you um you know you You kind of want to respect the patient's values, but you want to respect your own value. So how do you as a physician kind of move forward in clinical situations in light of that? Yeah, well, first I'll say how we don't do it or how we shouldn't do it. And that is by either presuming that we are value neutral,
00:24:32
Speaker
um which none of us is or can be, especially medical practitioners, cannot be value neutral. i'm Nor should we approach this by trying to separate um ourselves into two cells, a professional self and a personal self, who operate according to different norms, um which I think just introduces a fracture ah and of integrity for medical practitioners.
00:25:00
Speaker
and teaches us, when we do that, it teaches us to demoralize our work and detach ourselves morally from our work because we're, insofar as people buy this way of thinking, they basically approach their work as if it's just supposed to follow some rules that they don't even necessarily think are good, but that they've agreed to follow and they they kind of ah set aside their own judgment.
00:25:28
Speaker
So how should we do it more if we if we're seeing clearly and being fully reasonable? It seems to me we we set out to be medical practitioners, not because we learned that it's a good place to set aside your personal values, but on the contrary, it's because we all personally value healing.
00:25:48
Speaker
And we recognize it's a very good thing to heal. And we recognize that if you were to spend your life focused on pursuing healing for the people that come into your care, that's a worthy way to spend a life that's intrinsically worthwhile. And so we personally elevate the normal human valuation of and commitment to health to the level that we make it a career defining profession and we discipline ourselves to to learn about health, to show up when people are sick, to follow through and so on.
00:26:26
Speaker
And when we do that, we know that if we're thinking fully reasonably, we know that the pursuit of a particular person's health is not the only thing, even if it's the thing that we are professionally committed to and and that gives us our professional identity.
00:26:43
Speaker
It's not the only thing that's at stake for that patient. There are a lot of other goods that may be important to them. And so we have, we should not presume that our commitment to health as medical practitioners, which is right and just and reasonable, implies that the patient has to take that as the most important thing for them and has to follow all of our instructions. On the contrary, patients reasonably decide which of the proposals that medical practitioners offer them for the pursuit of different aspects of their health, um which of those they're going to consent to, or if if there's more than one reasonable proposal a physician offers, which one they're going to choose. And in that respect, patient values, patient vocation, patient judgment, and ultimately patient authority um is critical for clinical decision-making, and doctors have to respect that.
00:27:40
Speaker
But the other corollary is that physician values, particularly as respected as with respect to valuing the patient's health and the pursuit of their health and the maintaining of the the the norms and standards that that guide our profession.
00:27:59
Speaker
in pursuit of that health. Those are things that the physician bring, ah physicians bring, and those are not values that are to be set aside. They are they are values that are in service to, frankly, um patient healing. um So physicians make judgments about what they're going to offer, and they do that if they're doing it well in conversation with the patient, and patients ultimately have authority to accept or decline any physician proposal.
00:28:30
Speaker
So to give a little more, uh, you know, like a concrete example, have you had a situation where your, your own values, your own faith, your own beliefs, um, it's really become maybe more visible in the clinical setting and like, how how did you navigate a situation where you, you feel like you really had to stand up for your, what you believe in?
00:28:52
Speaker
Well, in in palliative medicine, the places where I find my own convictions, which I hope are reasonable, but I recognize can be scrutinized and challenged,
00:29:08
Speaker
sometimes are at odds with what patients want, or even with what some colleagues are willing to do for patients. And specifically, I have experienced that when a patient is dying and is in an inpatient hospice unit and the patient's family is experiencing distress at watching their loved one die and anticipating their death. And the family asks me to um increase the medications um or says, this is taking so long. Is there anything you can do?
00:29:47
Speaker
I tend to be, I think as I perceive myself, um more strict in making sure that um the dosing of the medications that I give is ah fits my judgment of what is needed to relieve the symptoms that the patient is experiencing and not more.
00:30:16
Speaker
And I think for some families, that has been frustrating. um And for some colleagues, I think that may seem too abstemious or moralistic. I should say to ah to avoid one misunderstanding here, I do not mean that I watch people in pain or out of breath and very carefully and slowly increase meds out of a fear of going too high. That's that's not the case at all. in fact as i As I see it, I treat symptoms quite aggressively, but I am looking to treat them in ways that's proportionate to the symptom out of that baseline desire to act in a way that's consistent with health and um and to not base the dosing as straightforwardly on what a family member says they think is needed, for example.
00:31:11
Speaker
um Can you speak more about like the motivations for not just like upping the medications like a family would want? like is it just um Is it more or less so in your eyes as to like let nature take its course is that kind of and and kind of to have more of a ah like a ah good death? ah No, it's it's not in pursuit of a good death. um Again, i I think the idea of pursuing a good death is a mistaken idea. um I think the the proper goal for physicians is to help patients live um with the health that is available to them in the face of their dying. And that includes relieving their symptoms that are disabling and health diminishing. And so um it's honestly, it's a fundamental concern that um that I not,
00:32:10
Speaker
give into the temptation that is ever present within medicine and the very temptation that leads to New Jersey and other states believing it's a good thing to authorize physicians to help patients kill themselves, um which is to communicate to patients or their families that um when someone has come to a certain level of diminishment and illness,
00:32:39
Speaker
that it is better that they're better off dead. And that is part of our ambit as medical professionals to bring that about. um I think that creates a world that is not hospitable to people who are diminished and people who are dying and people who have suffering that won't go away. And um it seems to me that those people who far outnumber those who are availing themselves of assisted suicide in euthanasia um should count on should be able to count on physicians to have a resolute commitment to not intentionally hasten or cause their death.
Diversity in Healthcare Values
00:33:20
Speaker
Do you feel like healthcare systems work better if like kind of like the patient both the patients and, uh, you know, physicians and and and the whole healthcare care team are all have like similar values. Is that perhaps like something we should move towards where, where healthcare is kind of given in, or there's kind of like this idea of pluralism where they can like kind of ah coexist within a healthcare care setting. How do you, how do you see like, uh, a diversity of values playing out within like a healthcare system?
00:33:50
Speaker
No, i don't I don't think, generally speaking, we should try to bring out about a balkanization, if you will, and into various value groups.
00:34:01
Speaker
um on Although there's nothing intrinsically wrong with um medical professionals And or patients setting about to create institutions in which certain standards and norms are upheld that they may see are not upheld in other institutions. um So i I'm not ah I'm not opposed to that but I don't think that's a thing that we all need to um try to bring about. You know the very idea of authority.
00:34:36
Speaker
And the way that's been respected in medicine for a very long time, I think carries with it the resources we need to live with real disagreement. And that is that the physicians have authority over what they're going to offer.
00:34:54
Speaker
um It has doesn't mean they can do that again willy-nilly and without accountability. But within you know within pretty generous boundaries, they have authority to make judgments about which proposals are they they're going to offer to patients, which proposals are consistent with their profession. And then patients don't have to do that. They can give consent to that or or they can refuse consent.
00:35:21
Speaker
And if they want something the physician cannot in good conscience provide, they of course can look for someone different. um I certainly hope that in the long run, the profession will recover it's in a more uniform way, its commitment to not killing. um So I do look forward to the day when we can say to doctors, ah obviously we we don't kill and If you're going to be a part of the profession, you can't do that. That was our reality for more than 2,000 years, uniformly across the West. um And I hope that day will return. In the meantime, I hope that the witness of medical practitioners who will not submit to that regime will remind people that there's a better way. But I realize that may be generations before people remember that important insight
00:36:21
Speaker
The last ah kind of big topic I want to think about is just generally bioethics, right?
Religion and Spirituality in Bioethics
00:36:26
Speaker
Every hospital and organization kind of has a ah bioethics committee. And oftentimes, you know, chaplains or other other folks are ah represented on those um those coalition. So, you know, what can spirituality and religion, you know,
00:36:43
Speaker
looking at bioethical issues through that lens, what can what can those things bring ah in an effort to resolve some of those dilemmas? I don't know that what religious traditions bring is resources to resolve dilemmas, um but they certainly bring resources to highlight the character of dilemmas and to um offer um stories that make sense of the dilemmas and of reasonable responses to them. So if I speak, for example, from a Christian tradition, a Christian tradition is not necessary for making sense of medicine, but it and does have a pretty rich story and a pretty rich history to make sense of medicine as a practice of hospitality toward those who are sick and injured.
00:37:43
Speaker
and otherwise broken down in body. um It has a pretty rich story and exemplars um to appeal to ah for making sense of why we owe our patients a fundamental respect, a kind of reverence, insofar as Christian tradition teaches us to think of all human beings as bearing what Christians call the image of God,
00:38:13
Speaker
bearing a kind of dignity that commands respect and care, um even charity or love. um And that ah even when patients show up to see someone as a healer, the the patient is is bringing Christ, bringing Jesus in some mysterious way so that the healer in responding well to someone who is sick is, according to Jesus's teaching, is responding well to Jesus himself. So those are examples of how a tradition can animate the practice of medicine. And then a tradition like Christianity um has norms that have developed in its community over the the years.
00:39:06
Speaker
For example, the norm against suicide and the norm against killing our neighbors, even when they want us to help them kill themselves. um Those norms are not specific to Christianity. Same norms are present in Judaism, present in Islam, president and present in other traditions, and I think are um the reasonableness of those norms can be seen by people outside of those religious traditions, but certainly the traditions make the norms easier to see and ah give ah formation that trains people to take those norms seriously um rather than seeing them as just a kind of arbitrary personal value that someone might hold.
Quick Personal Insights
00:39:51
Speaker
With that, it's time for a lightning round a series of fast-paced questions that tell us more about you. ah Who is your favorite philosopher?
00:40:00
Speaker
I guess it's a tie between Aristotle and Aquinas. ah What is your vice or guilty pleasure? Watching football.
00:40:13
Speaker
ah What's your go to work day lunch? Skipping lunch. What ah is a hobby you'd like to try?
00:40:25
Speaker
Well, I used to play the guitar and I would like to play it again better than I played it before. And lastly, what's one change you'd like to see in healthcare?
Introduction to the Hippocratic Society
00:40:35
Speaker
care I'd like to see a visible community nationwide and then worldwide of medical practitioners who recover a commitment to medicine as a strictly healing practice. And I'll just say as we're finishing up, we're I and other colleagues have formed an incipient little association called the Hippocratic Society that may be coming to a school near you if you're listening to this and you can check us out online. But we'd like to see doctors meeting with doctors to grow together in the virtues that characterize good medicine and to discern good medicine from not good medicine.
00:41:22
Speaker
um And to do that out of intrinsic motivations, not because ah some external authority is bearing down on them, ah telling them what to do. Dr. Farkerlin, thanks so much for joining the show. My pleasure.
00:41:47
Speaker
Thanks for listening to The Wound Dresser. Until next time, I'm your host John Neery. Be well.