Intended for healthcare professionals

Observations Ethics Man

The essence of medicine

BMJ 2008; 336 doi: (Published 22 May 2008) Cite this as: BMJ 2008;336:1163
  1. Daniel K Sokol, lecturer in medical ethics and law
  1. 1St George’s, University of London
  1. daniel.sokol{at}

    Writers may tell us their theories on what the essence of medicine is, but it takes actual contact with patients to bring it home to us

    I do not know whether she expected this: a crowd of 10 curious students in this small, overlit room deep in the bowels of the hospital. She seemed so exposed and frightened in her wheelchair, like a hapless musician unwittingly pushed on stage. The neurologist, standing by her side, was hitting a tendon hammer against his palm.

    “Please gather around,” he ordered, “and get as close as you can to the patient.” We encircled her. A student in the front row took a history.

    Anastasia Hayes (who wishes to have her name published) was in her 60s, with golden hair and thick glasses that magnified her eyes. Her voice was soft, close to a whisper. She explained how, months ago, her left leg became weak. Then the weakness spread to her right hand. “I thought it was just one of those things,” she said. Today Anastasia cannot get changed or wash herself unassisted. …

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