Amazing article, I think many modern patients want to be seen, heard, and related to by doctors. Doctors are our new nobility. They don't want the doctor to just poke their head to see them every few hours, or even just once a day. They want more care, there should be more doctors that are trained. Even if they are AI robots.
I don't think an AI robot fills this void. Obviously scientific rigor is still paramount, but there aren't any shortcuts to building interpersonal trust. And I believe the consequences for public health when that trust is lost are dire, as we're seeing now.
A lot of people don't trust human doctors, this trend is not new. Doctors don't do much to build trust. Claude and Chatgpt are both widely used by doctors now and people regularly ask Claude and Chatgpt medical questions. Some people even say it has done wonders for their health! The real issue isn't AI.. It's that humans are not stepping up to the plate when it matters.
Excellent article--and interesting how Chillingsworth is both the measured, well-trained physician and the vengeful dabbler in the occult--especially considering the fascination Hawthorne had with witchcraft.
Yes, I find it curious that Hawthorne took such pains to reference more reputable influences on Chillingworth while undermining those bona fides with his more questionable leanings. Maybe it has something to do with his idea of romance commingling the "actual" and the "imaginary"?
I think that's exactly right. Having just finished writing a Hawthorne-inspired novel, I confess to great appreciation for his romantic comminglings--and for your essay. Thanks.
I know folks say, "Are they still teaching The Scarlet Letter?" See Crazy, Stupid Love: great flick, BTW. I still love the novel as clearly you do, Josh!
In Hawthorne's time, there may have been such an intense quest for knowledge that patient's felt expendable like guinea pigs; in turn lending toward a perception of doctors being more like mad scientists. However, I feel in our present time, part of the problem is the severe lack of humility that traditional medicine has reigned over patients and other medical specialists for the past 50 or 60 years. Health policy and medical education were formed without adequate research and now those policies and teachings are coming up short and in some cases failing; some examples being the food guide pyramid and education about vaccines. When our doctor's do not have an ability to admit that more information/better research is needed, arrogance creates distrust and pushes people toward more radical ideas. Traditional medicine also touts the quick fix and the barrage of scans and tests as gold standard -- as if there truly is one.
The push toward AI in medicine most likely has efficiency and financial gain in mind, which does take away from compassion and personal care. But then we also read about incredible advances toward symptom reversal or potential cure for diseases that we may never have thought possible. Unfortunately, we don't have the luxury of instant gratification in medicine as we have been led to believe. We won't know if these advances are pragmatic or reckless for years to come.
Our expectations of what modern medicine and doctor's are capable of, especially in our ever-changing and toxic world, need to be more realistic. I think sometimes it can feel just as hard today as it was during the 1800's to define responsible medicine, fortunately it is possible for patients to educate themselves in order to ask better questions of their practioners.
This is exactly right: "When our doctors do not have an ability to admit that more information/better research is needed, arrogance creates distrust and pushes people toward more radical ideas."
Dr. Fauci squandered what remained of public trust by admitting, in interviews (God knows why), that much of what he pushed from his authoritative perch was not based on sound empirical evidence. When people realize that a figurehead is using a power structure to demand respect for science without actually practicing science, that damage is long-lasting. But it's really not good for any of us to be unable to trust what the CDC is saying. Where do we get our information, then? How do I, as a non-expert, know which sources to trust? I'm not always sure that self-education in that way is possible anymore.
The SMELL test that I've favored in the past doesn't work any longer. And the evidence-based alternative wellness models are being peddled right alongside the bogus ones.
When politics take precedent over science, the health of American's suffer (I'm sure you are familiar with my distaste of the AHAs promotion of oatmeal and whole grains). I'm not sure why Fauci acted or answered the way he did; he will be historically remembered as hero to the AIDS crisis and possibly faux to COVID. Unfortunately, when working for the government, one isn't always able to make decisions independent of policy or the current administration.
As far as where to get good health information? That is a difficult question to answer right now as there is a major fracture between traditional/conventional medicine and new emerging research that negates health policy and insurance administration that have been in place for decades. (That doesn't even account for the current crazy that is happening with the current administration. There is plenty to fear there as well.) I agree the SMELL test is difficult in today's information overload of Dr Google and trust of social media influencer's. I may be biased as a healthcare professional, but self-education and treatment can have many spinning their tires or led down a rabbit hole when a qualified professional could have gotten right to the heart of the problem. It also means that we need to care about our health before we have to get too deep into our current sick care system.
I believe the best we can do is to understand that our bodies are amazing and not as broken as the pharma ads want us to believe. It is pretty incredible that our body can maintain a high level of function in our toxic world with at least a credit card worth of plastic in our gut.
We need to take responsibility for our own health. Why does anyone think they can live a high quality of life and avoid disease without adequate nutrition, stress management, sleep, water, exercise... the basics! These aren't "sexy" or marketable but time and again have come out on top as reliable and successful.
In our current world, we need to find a team of professionals whom we trust with our care. Since we don't have adequate time with our general medicine doctor, we need to seek out other reputable professionals like certified nurse practitioners, functional medicine providers, counselors, physical/massage therapists, chiropractors. These professionals are team players and have expertise in health and wellness. Our doctor's also need to respect the knowledge and professionalism of these provider's as partners in healthcare; there are many who do, but because of the strain on our healthcare system, this is a must for everyone.
I have been re-reading several classics along with my 16 year old - they certainly read different with a few decades of life experience! I’ll report back :)
Thank you, David! It's not fashionable to say so, but other than some overwritten description and a penchant for didactic finishes, I think Hawthorne is just stunning as a stylist.
Amazing article, I think many modern patients want to be seen, heard, and related to by doctors. Doctors are our new nobility. They don't want the doctor to just poke their head to see them every few hours, or even just once a day. They want more care, there should be more doctors that are trained. Even if they are AI robots.
I don't think an AI robot fills this void. Obviously scientific rigor is still paramount, but there aren't any shortcuts to building interpersonal trust. And I believe the consequences for public health when that trust is lost are dire, as we're seeing now.
A lot of people don't trust human doctors, this trend is not new. Doctors don't do much to build trust. Claude and Chatgpt are both widely used by doctors now and people regularly ask Claude and Chatgpt medical questions. Some people even say it has done wonders for their health! The real issue isn't AI.. It's that humans are not stepping up to the plate when it matters.
Excellent article--and interesting how Chillingsworth is both the measured, well-trained physician and the vengeful dabbler in the occult--especially considering the fascination Hawthorne had with witchcraft.
Yes, I find it curious that Hawthorne took such pains to reference more reputable influences on Chillingworth while undermining those bona fides with his more questionable leanings. Maybe it has something to do with his idea of romance commingling the "actual" and the "imaginary"?
I think that's exactly right. Having just finished writing a Hawthorne-inspired novel, I confess to great appreciation for his romantic comminglings--and for your essay. Thanks.
I know folks say, "Are they still teaching The Scarlet Letter?" See Crazy, Stupid Love: great flick, BTW. I still love the novel as clearly you do, Josh!
Thanks Mary — the book holds up!
In Hawthorne's time, there may have been such an intense quest for knowledge that patient's felt expendable like guinea pigs; in turn lending toward a perception of doctors being more like mad scientists. However, I feel in our present time, part of the problem is the severe lack of humility that traditional medicine has reigned over patients and other medical specialists for the past 50 or 60 years. Health policy and medical education were formed without adequate research and now those policies and teachings are coming up short and in some cases failing; some examples being the food guide pyramid and education about vaccines. When our doctor's do not have an ability to admit that more information/better research is needed, arrogance creates distrust and pushes people toward more radical ideas. Traditional medicine also touts the quick fix and the barrage of scans and tests as gold standard -- as if there truly is one.
The push toward AI in medicine most likely has efficiency and financial gain in mind, which does take away from compassion and personal care. But then we also read about incredible advances toward symptom reversal or potential cure for diseases that we may never have thought possible. Unfortunately, we don't have the luxury of instant gratification in medicine as we have been led to believe. We won't know if these advances are pragmatic or reckless for years to come.
Our expectations of what modern medicine and doctor's are capable of, especially in our ever-changing and toxic world, need to be more realistic. I think sometimes it can feel just as hard today as it was during the 1800's to define responsible medicine, fortunately it is possible for patients to educate themselves in order to ask better questions of their practioners.
This is exactly right: "When our doctors do not have an ability to admit that more information/better research is needed, arrogance creates distrust and pushes people toward more radical ideas."
Dr. Fauci squandered what remained of public trust by admitting, in interviews (God knows why), that much of what he pushed from his authoritative perch was not based on sound empirical evidence. When people realize that a figurehead is using a power structure to demand respect for science without actually practicing science, that damage is long-lasting. But it's really not good for any of us to be unable to trust what the CDC is saying. Where do we get our information, then? How do I, as a non-expert, know which sources to trust? I'm not always sure that self-education in that way is possible anymore.
The SMELL test that I've favored in the past doesn't work any longer. And the evidence-based alternative wellness models are being peddled right alongside the bogus ones.
When politics take precedent over science, the health of American's suffer (I'm sure you are familiar with my distaste of the AHAs promotion of oatmeal and whole grains). I'm not sure why Fauci acted or answered the way he did; he will be historically remembered as hero to the AIDS crisis and possibly faux to COVID. Unfortunately, when working for the government, one isn't always able to make decisions independent of policy or the current administration.
As far as where to get good health information? That is a difficult question to answer right now as there is a major fracture between traditional/conventional medicine and new emerging research that negates health policy and insurance administration that have been in place for decades. (That doesn't even account for the current crazy that is happening with the current administration. There is plenty to fear there as well.) I agree the SMELL test is difficult in today's information overload of Dr Google and trust of social media influencer's. I may be biased as a healthcare professional, but self-education and treatment can have many spinning their tires or led down a rabbit hole when a qualified professional could have gotten right to the heart of the problem. It also means that we need to care about our health before we have to get too deep into our current sick care system.
I believe the best we can do is to understand that our bodies are amazing and not as broken as the pharma ads want us to believe. It is pretty incredible that our body can maintain a high level of function in our toxic world with at least a credit card worth of plastic in our gut.
We need to take responsibility for our own health. Why does anyone think they can live a high quality of life and avoid disease without adequate nutrition, stress management, sleep, water, exercise... the basics! These aren't "sexy" or marketable but time and again have come out on top as reliable and successful.
In our current world, we need to find a team of professionals whom we trust with our care. Since we don't have adequate time with our general medicine doctor, we need to seek out other reputable professionals like certified nurse practitioners, functional medicine providers, counselors, physical/massage therapists, chiropractors. These professionals are team players and have expertise in health and wellness. Our doctor's also need to respect the knowledge and professionalism of these provider's as partners in healthcare; there are many who do, but because of the strain on our healthcare system, this is a must for everyone.
Time to re-read The Scarlett Letter, it’s only been 30 or so years….
It will hold up! I’d love to hear what you see/hear in it now.
I have been re-reading several classics along with my 16 year old - they certainly read different with a few decades of life experience! I’ll report back :)
A great analysis. Hawthorne's skilled use of literary techniques has made him a particular inspiration to me.
Thank you, David! It's not fashionable to say so, but other than some overwritten description and a penchant for didactic finishes, I think Hawthorne is just stunning as a stylist.