Power to the people: Patient in command

Blog Essay 32*

Bernard Lown, MD

Benedictions to patient-centrism, patient privacy, patient autonomy — everything-for-the-patient rhetoric — flow from the pervasive PR of the health establishment. The more I hear these jingles, the more my heart skips a beat. At my age I can’t afford arrhythmia’s. My experience as a cardiologist murmurs that these extra-systoles may be auguries of the hereafter.

I have learned that in our market culture, whenever a message is oft repeated, you can suspect a sales pitch. Indeed the patient looms large as a commodity to be seduced by medicalization, to be showered with drugs, subjected to endless tests, imaged to expose hidden recesses of anatomy, probed by magical genetic analyses for the Ur-self, and salvaged by so-called life-saving interventions. At the same time the patient has grown ever more Lilliputian. You the patient, with real or imagined dysfunctional biological machinery, is largely present; but you the sentient human being is largely absent. The contradiction is beyond Hegelian dialectics.