‘Clearly Medicine Is As Much Art As Science’

Our expatriate daughter called in a panic from New York. Something was wrong with her foot.

“I got up in the morning, and it hurt so much I almost couldn’t stand on it.”

“Have you seen a doctor?”

“Yes. He says he can fix it. He wants to break the bones in both my feet.”

“He what? Who is this guy? Does he wear jackboots and speak with a Teutonic accent?”

“Somebody gave me his name,” she said.

“Listen very carefully,” I told her. “Stay calm, but get out of there any way you can. Tell him you need to use the restroom. When you get down to the street, take a cab or flag a police car - anything. You may be in great danger.”

“It’s all right,” she said. “I’m at home.”

“That’s a relief. Don’t go near that creep again.”

“I won’t. I have the name of another doctor. I’m seeing him on Wednesday.”

When we heard from her after that second appointment, her voice was bright.

“He’s good,” she said. “Some of his patients are dancers. He knows a lot about feet.”

“So what was it?”

“A problem in the joint of my little toe,” she said.

“And?”

“He gave me a shot of cortisone. When I walked out it was fine.”

“That’s all?”

“It’s over. It doesn’t hurt a bit. He said he would give me some exercises to strengthen the joint.”

It’s an alarming little story. Two unknown doctors in a distant city containing millions of people, some of them reasonably weird. One wants to cure the patient by breaking bones, with weeks on crutches and follow-up visits that could last a year. The other corrects the problem in 15 minutes with a shot.

Clearly medicine is as much art as science. And it’s fair to say there’s risk in every field. Fall in with the wrong kind of journalist, for example, and he’ll do worse than break your feet. He’ll break your reputation and trash your life.

So whom do you trust? That’s the question always, but especially when you’re in some place far from your support system of known people.

Ten years ago, in Africa, I got a worm in my foot. The Lebanese doctor I saw put some tablets in a small, unmarked envelope. “Take these,” he said. “You’ll feel terrible, but they won’t kill you. They’ll only kill the worm.”

I looked in his eyes, and saw there the assurance of a man who knew his business.

The worm perished. I did not.

Another time, years before that, the salad nicoise in a Moscow hotel restaurant smote me with stomach cramps of such violence as to make death seem almost attractive. A Russian doctor treated me, without effect, and in that condition I had to fly off to Samarkand.

“Take this,” said an Uzbek taxi driver, and gave me a dusty brown lozenge larger than a nickel. He seemed a man of good will. I chewed and swallowed the thing, and the next day was fully restored.

When you’re out there on your own - in some Third World backwater or, as in my daughter’s case, in the wilderness of New York - you have to depend on hunches and intuition to get you through.

But if you have a hurting toe, and the good doctor proposes to fix it by breaking both your feet, there’s reason to suspect it’s time for a second opinion.

Exactly.

xxxx