When Medicine and Science Reach Their Limits

by Peter Liu

Published Sept. 12, 2018, last updated Dec. 2, 2018, 10:14 p.m.

“If today was your last day to live, what would you do?” Doreen asked me this question on my sixth visit. I immediately froze and didn’t know how to respond to her, an elderly patient with advanced malignant brain tumour. Still we reminisced, exercised, and laughed as we watched the sunset through the giant window on the fourth floor of the Foothills Medical Centre in Calgary, Canada. I wheelchaired Doreen back to her bed and tucked her into a warm blanket before saying goodbye. I returned to check on her before finishing volunteering, and she was sound asleep with a gentle smile on her face. I left her a note with my answer beside her bed, and that was the last time we met.

The Tom Baker Cancer Center at Foothills Hospital in Calgary, Alberta, Canada

As a young and curious undergraduate seven years ago searching for a meaningful pursuit, patients like Doreen were mentors who have helped to shape my interest in academic medicine. Back then, I did the best I could to provide support to cancer patients but felt powerless against fatal diseases. I believed training in clinical medicine could empower me so that I can empower patients. However, the further along I went into my medical training, the more I begin to recognize the limitations of medicine against diseases, summed up beautifully by Hippocrates: “cure sometimes, treat often, comfort always.” In this sense, medicine becomes an art where physicians use the resources and knowledge available to maximize comfort for patients. Although this is a reasonable answer, it nonetheless highlights the need to improve current paradigms in medicine so that we can do more for patients and their families.

I searched for a solution and discovered science as the answer to advance medicine. With science as the foundation guiding clinical practice, I believed a training in medical research will help bring novel discoveries from bench to bedside and help patients who need them most. Scientific research requires tremendous persistence and dedicated effort to answer a specific question. Medicine requires a broader understanding of many possible symptoms, diagnosis strategies, and treatment algorithms for effective disease management. As a result, a scientist could have a promising discovery without realizing its potential to improve disease management; a physician could understand the limitations in treatment without realizing the existence of potential solutions. Even for clinician-scientist trainees like myself, who will be working both as a physician and researcher, bringing new discoveries to patients can be further complicated by relevant policy, public resources, and business frameworks that are required to effectively implement innovation. As a result, it often takes 15 to 20 years for research to become clinical practice, delaying the actualization of critical lifesaving discoveries.

For scientists, physicians, policy makers, business professionals, and anyone who want to bring scientific innovation to people, we need to understand the holistic process involved and be able to actively connect and collaborate with like-minded people from different sectors. This is precisely the reason for the creation of BRIGHT International.

As a platform, BRIGHT acts as a bridge to bring together multidisciplinary professionals aiming to bring innovation to patients; as a think tank, BRIGHT conducts research on how to improve health innovation implementation through knowledge exchange and policy comparison across different regions; as a global network, BRIGHT aims to accelerate health innovation implementation through evidence based advocacy, so that patients like Doreen can access the most cutting-edge care possible.

Doreen was moved to palliative care a few days after our visit and received the best care possible at the time. On her note, I wrote: “I hope myself and colleagues can dedicate our lives to bring the most cutting-edge health innovation to patients like you. Thank you for inspiring me.” Medicine and science alone might have their limits, but combined together with active multidisciplinary collaboration, we can more effectively bring the fruits of health innovation to those who need them most.

Peter is currently reading for a D.Phil. in Clinical Medicine at the University of Oxford co-supervised by Profs. Jane McKeating and Sir Peter Ratcliffe. He will be completing the final two years of the M.D. Program at the University of Toronto thereafter as a part of his training as a physician-scientist.