Filial Gaze at Our Noble Profession

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Chandrakanth Are, MBBS, MBA, FRCS, FACS

Despite all the complex changes of the turbulent, extremely uncertain health-care environment, the sheer joy of possessing the privilege to mend and extend life as a physician is what drives us to our desk or operating room every day.

—Chandrakanth Are, MBBS, MBA, FRCS, FACS

As we stood outside patient X’s room going over the vitals, from a distance, I saw the father of the patient by the side of her bed. I saw him standing there and looking down at his child conveying what I guess were words of reassurance and reinforcing the pillars of strength needed for her recovery. It appeared like he was not saying much, but his silence, punctuated by a few words and combined with that affectionate and elegiac gaze, was enough to make her look comfortable.

It is difficult for patient X to do anything on her own due to the severity of her illness. Even a smile can be an enormous feat to accomplish due to her extreme weakness and the hindrance from all the tubes and drains. A machine has to breathe for her, and several tubes take care of her nutritional and other needs necessary for survival.

The Man Standing Beside Her

Despite the predicament of her illness, for the first time, she somehow looked capable of fighting the battle—and only because of the man standing beside her. What made it touching was to watch the entire spectrum of feelings, emotions, and love that is associated with a father and child relationship play out in front of us. Even more touching is to know that patient X is in her mid-40s with teenage children of her own, and the father standing by her side is in his 80s.

A robust man is his day, I am sure by looking at his build, he is now stooped and has to hold on to the railing of his daughter’s bed to stand for long periods. An honorable man, without any doubt as he is of the great generation, he did not miss greeting all of us in the group, despite the enormity of the problem facing his child. A hard-working man—yes—they did not come in any other form. An affectionate and loving father—they all were. He did not complain—not many did in his days. He was thankful for all the care we were delivering—the honorable generation.

He must have held her in his arms when she was born, fed her through the bottle, put her to sleep, read her tales, carried her on his back into this world. He watched her go to school to learn the ways of the world, gain her independence, and make something productive of her life. He probably gave her away at her wedding and was around for the arrival of her children. It was to come that he would enter the twilight of his life surrounded by his children and her children.

Unfortunately, sickness has snatched her away from feeding the fruits of filial affection to her aging father, when he would need it most. As we left the room after examining patient X, I saw him go back to her bedside in measured steps. Here they were, in the same father-daughter world again, reassuring each other.

A Noble and Selfless Profession

This is what we physicians witness on a regular basis at work—the human and humane aspects of our wonderful profession—and fortunately not all outcomes are in the same league as patient X. And it is far away from the medicolegal aspects, the Affordable Care Act, health maintenance organizations, concerns about health-care expenditures, pay for performance, Medicare cuts, big-industry influence, health-care reform, medical school debts, and the legions of uninsured. Buried underneath all this lies the true profession, which still at its core is one of the most noble and selfless professions. But to get to the core, one has to peel away so many layers of unwanted paraphernalia. It is not that there are not enough people who ponder entering this profession. The crux of the problem lies in the fact that how many people are willing to spend a better part of their youth trying to get to the core of this noble profession and enjoy the benefits that it offers? The benefits cannot be measured in monetary terms, or on a performance scale, or on the U.S. News & World Report ranking list of the best hospitals in the country.

The best benefits derived from this profession are measured in the number of lives saved, the smiles on the patients going home, the thank-you notes of family members, the trust of the patient in the doctor, the ability to share intimate moments with patients and families, and the shrinking but still present respect for the profession accorded by some. Not many professions give you the pride of waking up every day to say that you will save someone’s life today. Fewer give you the satisfaction on the drive back home that you indeed had an indelible impact on someone’s life that day. It is not uncommon to be out shopping or at the gym with your family and have someone approach you and mention to your children “your father saved my life.” Such is the joy of this profession that it is probably one of those few professions that is actively working to ensure that they are not forced to work fewer hours.

Despite all the complex changes of the turbulent, extremely uncertain health-care environment, the sheer joy of possessing the privilege to mend and extend life as a physician is what drives us to our desk or operating room every day. There are few professions that can demand so much of you and take so much of your life away from you. At the same time, there is no other profession that rewards you with so much in return. These rewards are tangible and intangible, short term and long term, and finally can only be measured on a yardstick of “silent but bountiful” gratification, which none other than a physician can appreciate.

I dare say it is the best profession in the world. We knew it coming into it and still abide by those feelings and principles. So for all that we selfishly took away from this profession, it is time for each one of us to do our part to maintain the viability, glory, and sanctity of our noble profession. So for generations to come, scores of physicians can continue to reap the innumerable benefits and joy derived from following its simple but strong guiding principle: “to nurture life.” ■

Disclosure: Dr. Are reported no potential conflicts of interest.


Dr. Are is Jerald L & Carolynn J Varner Professor of Surgical Oncology & Global Health; Vice Chair of Education; and Program Director, General Surgery Residency, University of Nebraska Medical Center, Omaha.

Disclaimer: This commentary represents the views of the author and may not necessarily reflect the views of ASCO.