The Most Powerful Tool in Medicine:


National Chairman, Biological Psychiatry Senior Consultant Psychiatrist, Cochin

Michael Angelo’s ‘hands’

The good Lord allocated quarter of the motor cortex to the Human-Hand. Hand does not act alone, it works in coherence with the Frontal Lobe, and the Mind which is generated by the Brain. It is therefore the perfect ‘functional’ tool that we have, a tool accomplishing ne tasks impossible even for advanced robots. Delivering the most powerful function of a Healer – the HUMAN TOUCH. Touch that connects to the patient to make him Trust. Touch that Talks volumes to him. Touch to Diagnose the disease, touch to Reassure the patient, and the touch that Heals.

In spite of the exponential technology today, the Human Hand remains the most powerful tool in the Doctors’ arsenal. We have to restore the place of the Human Hand in our practice of Medicine, in order to restore the place of Modern Medicine in the hearts of people. To Diagnose, to comfort, and to heal.

The Human Touch determines the quality of ‘Patient-Doctor’ Interaction. The ‘Clinical Touch’ that ‘examines’ undergoes transformation during the all- important Physical Examination, to the ‘Reassuring Touch’, thus generating the unique ‘Interpersonal Trust’ that helps the patient to instantly con de his secrets or even to disrobe himself, for the Healing Touch. Hands make the Heart of the ‘Patient-Doctor Relationship’. Our next generation seems to ignore this truth, in the backdrop of available technology for instant diagnosis and often refrain from Physical Examination. For the current generation, therefore, there is less scope for a ‘connect’ between Doctor and Patient! Old

days, Physical Examination spontaneously connected the Doctor and Patient, as part of our clinical ‘RITUAL’, but sadly no more so!

‘Physical Examination’ and ‘Clinical Diagnosis’ which kindle the passion of medical practice is a ‘dying art’ today. Physical Examination skills are about to atrophy and die. And so may be the ‘Patient-Doctor’ relationship. This we need to resist. The Human Hand is the most powerful Tool, not just for Diagnosis but for Relationship.

Medical gizmos have sunk the ‘Art of Medicine’ and the ‘Trust of Patient’. Some current trends indicate that the practice of medicine is losing its ‘human face’, care is sometimes without ‘caring’. The NGOism sweeping our country these days is likely to persist in making ‘targets’ of doctors for every ill in
healthcare. Some of our west-thinking colleagues add to this woe with fads like

‘evidence-based medicine’, in the background of technology heralding the ‘Victory of Technology over Wisdom’. But, Medicine has always been, and will be the tricky ‘Art of Conclusions on Insu cient Evidence’. William Osler called Medicine ‘the Science of Uncertainty, and the Art of Probability’. Medicine is this balance between Art and Science – the art of the Right Brain, and the science of the Left Brain. The successful delivery tool of their balance is the Clinician’s Hand- to touch and to heal.


On this Doctors’ Day, let us resolve to restore Clinical Diagnosis. An MRI cannot detect Cerebral Palsy. Computer- generated questionnaires cannot diagnose Autism. Only the Clinician’s Hand can determine costochondritic pain, and reassure the patient – to heal. Thus, no technology can replace Physical Examination or the Human Touch, nor the resultant ‘Patient-Doctor Relationship’.

Our Profession should also begin to advocate rewarding Physicians not merely for Procedures and Interventions; ‘Clinical’ Diagnosis, Physical Examination and a Medical Outcome also must be advocated to be remunerated and rewarded equally; such a step can e ectively eliminate the need for investigations with vested interest.

Trousseau, the French Physician implored, ‘For mercy’s sake, Gentlemen, let us have a little less Science, and a little more Art’.

Philip John

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