Towards regeneration: the evolution of medicine from fighting to building

The practice of medicine and the art of caring for patients are evolving, driven in part by the new epidemiology of chronic disease and the technological advances made to tackle it. Medicine is increasingly shifting its focus from combating disease to helping to build or rebuild human life.

The shift is adaptation more than inspiration. When infection was the major threat to survival, medicine responded with better sanitation and nutrition, antibiotics, surgical debridement, and supportive care. Some patients succumbed “after a long battle”; others recovered, often with battle scars.

In an era of chronic non-communicable conditions, the long criticised fighting metaphor feels antiquated.12 Now we live, and eventually die, with diabetes, heart failure, rheumatoid arthritis, chronic obstructive pulmonary disease, or as a survivor from a battle against cancer or against sepsis in the intensive care unit. When no enemy remains, or when defeat of the enemy is not achievable, fighting and thinking of medicine as a fighting force is often cruel, counterproductive, and futile.

The specialty of regenerative medicine has contributed remarkable technological achievements at the fringes of medicine, but the term and practice have a broader significance. We propose recognising that regenerative approaches in medicine extend from the need to combat illness and injury to the rebuilding and regeneration of lives affected by chronic disease.