The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. Medicine’s focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul. Yet — and this is the painful paradox — we have decided that they should be the ones who largely define how we live in our waning days. For more than half a century now, we have treated the trials of sickness, aging, and mortality as medical concerns. It’s been an experiment in social engineering, putting our fates in the hands of people valued more for their technical prowess than for their understanding of human needs. That experiment has failed. If safety and protection were all we sought in life, perhaps we could conclude differently. But because we seek a life of worth and purpose, and yet are routinely denied the conditions that might make it possible, there is no other way to see what modern society has done.

[Medical] science was indeed powerful, but its self-understanding left much to be desired. It knew the human parts in ever-finer detail, but it concerned itself little with the human whole. … The art of healing does not inquire into what health is, or how to get and keep it: The word "health" does not occur in the index of the leading textbooks of medicine. To judge from the way we measure medical progress, largely in terms of mortality ­statistics and defeats of deadly diseases, one gets the unsettling impression that the tacit goal of medicine is not health but rather bodily immortality, with every death today regarded as a tragedy that future medical research will prevent.

in all great civilizations we notice that doctors were always priests and vice-versa. I am convinced that a doctor who is not concerned with reintegrating himself into a dimension in which the spiritual is more important than the physical cannot understand his patient as such. And this is rather the tragedy of medicine today, not to denigrate its authentic value concerning what it has allowed as far as transformation of man, but it nevertheless still leads to a dead end because it refuses to integrate the spiritual man into the physical man, even though the spiritual has conditioned the physical.

The emergence of this high-tech scientific medicine may be a prime example of what William Blake denounced as 'single vision', the kind of myopia which (literally and metaphorically) comes from looking doggedly down a microscope. Single vision has its limitations in explaining the human condition; this is why Coleridge called doctors 'shallow animals', who 'imagine that in the whole system of things there is nothing but Gut and Body'. Hence the ability of medicine to understand and counter pathology has always engendered paradox. Medicine has offered the promise of 'the greatest benefit to mankind', but not always on terms palatable to and compatible with cherished ideals. Nor has it always delivered the goods. The particular powers of medicine, and the paradoxes its rationales generate, are what this book is about.

Being mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits, and the potential value of this power was a central reason I became a doctor. But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite and always will be. We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?

Modern medicine is a negation of health. It isn’t organised to serve human health, but only itself, as an institution. It makes more people sick than it heals.

Modern medicine is a negation of health. It isn't organized to serve human health, but only itself, as an institution. It makes more people sick than it heals.

The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated.

We've been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive.

We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being.

Medicine is for the very ill, never the healthy. In, there is the assertion that there has been practically NOTHING made by humans to "improve" on nature or help with shortcuts that did not end up harming with UNSEEN side effects.

The practical basis of the medical profession rested on psychology. Everyone felt better when self-confident, expensive experts could be called in to handle a vital emergency. Doctors relieved others of the responsibility for deciding what to do. As such, their role was strictly comparable to that of the priesthood, whose ministrations to the soul relieved anxieties parallel to those relieved by medical ministrations to the body.

For, medicine being a compendium of the successive and contradictory mistakes of medical practitioners, when we summon the wisest of them to our aid, the chances are that we may be relying on a scientific truth the error of which will be recognized in a few years’ time. So that to believe in medicine would be the height of folly, if not to believe in it were not greater folly still, for from this mass of errors there have emerged in the course of time many truths.

The essence of Medicine is story-- finding the right story, understanding the true story, being unsatisfied with a story that does not make sense. Healthcare, on the other hand, deconstructs story into thousands of tiny pieces-- pages of boxes and check marks for which no one is responsible.