Plato’s physician: the ideal doctor

“That doctor was just perfect, a proper real doctor.” Wait, what.. really?!

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Learning objectives

1. Explore the qualities of a doctor

2. Utilise Plato’s theory of Forms in a healthcare scenario

3. Let no one ignorant of geometry enter

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Most people reading this will know what a doctor looks like and if you don’t, it’s likely that it’s only a matter of time before you will. But what do we really mean by the word “doctor”? Throughout my posts I have often used the word doctor synonymously with physician or surgeon or indeed any individual with a medical degree who is involved in the care of patients. The use of the term doctor in this respect is colloquial and I’ve used it to be inclusive. Dictionary definitions are of course different:

Doctor (https://en.oxforddictionaries.com/definition/doctor)
Clinician (https://en.oxforddictionaries.com/definition/clinician)
Physician (https://en.oxforddictionaries.com/definition/physician)
Surgeon (https://en.oxforddictionaries.com/definition/surgeon)
Medic (https://en.oxforddictionaries.com/definition/medic)
Healer (https://en.oxforddictionaries.com/definition/healer)

All doctors are different. For example, some doctors are physically tall, others are short. Some doctors only undertake scheduled clinic work while others only work in an emergency setting. A previous exploration into online images of doctors provided an insight into how we see doctors. There can be considerable variation in visual appearance. But a doctor is more than what we can see. When we use the word doctor there must be qualities that all doctors share for this word to have any real meaning.

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Questions

What are the qualities of a doctor?

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Well, you may have thought of a few possibilities. Understandably, you may have considered having a medical qualification as being an essential quality for a doctor. But if that were the case, would there be no more doctors if all the medical schools closed down? Did doctors exist prior to the advent of the university degree? Alternatively, another possibility is the quality of having specialist knowledge. But what specialist knowledge is essential? Although very elegant, do you absolutely need that biochemistry lecture on the Kreb’s cycle to be a doctor?

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Questions

What specialist knowledge is absolutely essential for a doctor?

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Of course, medical knowledge changes. The doctors of the past didn’t know many of the things doctors of the present now utilise routinely. Most of us partake in continuing professional development to keep up-to-date with advancements in our specialities. Knowledge is now so specialist that doctors in one speciality are incompetent in another. The doctor you are today will be different from the doctor you are in the future. But that’s enough Heraclitus for now. To be universal, the qualities we are looking must be timeless; they must apply to all doctors of the past, future and present. They have to be eternal.

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Questions

What are the eternal qualities of a doctor?

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You may have considered qualities such as compassion or empathy. Yet, many of us working in healthcare have encountered doctors who at times show a lack of compassion and empathy. These universal and eternal qualities are hard to clarify and may not always be evident yet have the potential to do so.

‘…if someone’s clever at keeping people safe from sickness, he’ll also be cleverest at making them sick and getting away with it?’

The quote above is from Plato’s Republic, perhaps one of the most famous explorations of Plato’s theory of Forms. This theory proposes that the physical things we see around us are not as true as the non-physical essence they partake in. The things we do see are imitations of the timeless and unchangeable Forms. The Forms aren’t visible to the eye but instead, as Plato puts it: ‘the things we’re calling “forms” are grasped by intellect and not seen.’ With the allegory of the cave, Plato is encouraging us to make a distinction between appearance and reality and the theory of Forms can be further illustrated with the analogy of the divided line:

Image from https://commons.wikimedia.org/wiki/File:DividedLine

Imagine a line cut into two unequal segments and then cut each of these again in the same proportion. The cuts represent difference in relative clarity and obscurity.

AC the visible world

AB shadow images and reflections of physical things (imagination)

BC visible physical things (belief)

CE the intelligible world

CD mathematical reasoning (thought)

DE philosophical Forms (understanding)

BC represents the doctors you see on the ward round, in theatre or behind the desk in clinic. AC would be the shadow of these doctors, or perhaps that mysterious doctor that no-one knows or has ever seen but is still on the on-call rota.

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Questions

What is the Form of a doctor?

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Using the theory of Forms, it would have all particular doctors (like you and me) only partaking in the nature of the Doctor.

The concept of a Form may seem far-fetched to many (let alone the concept of a Doctor as a Form). Indeed, you aren’t the first. Plato himself explores the pitfalls of his theory of forms, notably in the dialogue Parmenides which Bertrand describes as containing “one of the most remarkable cases in history of self-criticism by a philosopher”. We’ll be looking at this further in the next post.

So why have I asked you to think about doctors using the theory of Forms? Philosophy isn’t usually on the medical curriculum, yet we are expected to be professional, reflective and autonomous in our work. Engaging in the process of trying to understand the universal qualities of a doctor can be a useful exercise in understanding ourselves and where we are as a profession.

One such contemporary example would be the use of telemedicine or artificial intelligence in medical decision making. Do doctors even have to be human? Will the AI doctors of the future be mere shadows on the wall of the cave or be closer to the real deal than you or I could ever be?

Personally I feel an understanding of philosophical ideas will become an increasingly important part of training the doctors of the future, not only in helping our patients but in helping ourselves.

Plato’s Academy mosaic from Pompeii.
Image from https://en.wikipedia.org/wiki/The_School_of_Athens#/media/File:MANNapoli_124545_plato’s_academy_mosaic

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Summary

Doctors in everyday life aren’t perfect, yet may still aspire to the best doctor they can be. Plato’s theory of Forms can be used as a framework to help us reflect upon the qualities of a timeless unchanging exemplar doctor. These Forms are are paradigms from which other things can participle with. The doctors you see around you are images of the Form. All doctors, in all time will participate with the nature of the Form.

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Further resources