Brain or Heart

It's a given that physicians are smart. However if given a choice what should be the number one trait that a physician must have. Should a physician be so intelligent and wise hence have a well-developed brain? Or should a physician have the drive, the passion and the empathy for patients hence have a big heart?

Well according to Neuroscience, we live and feel with our brains. Our feelings and emotions are found in the limbic system of the brain. Our hypothalamus releases chemicals that influences the rest of the limbic system. For instance, you have an exam and you need to get a very high grade. The limbic system gives the necessary drive for you to study all-night. In addition, the hypothalamus releases a signal to the pituitary gland. The pituitary gland, in turn, releases a chemical signal to your adrenal cortex. The endpoint of which is a release of cortisol. Cortisol now gives you the energy to study all-night albeit for a short while.

So really, the graphic representation of our feelings into a heart is a mistake. The better representation would be our brains with all its gyri and sulci. But it is not completely wrong to represent our feelings and emotions with a heart. The brain influences the heart rate through the autonomic nervous system. The heart makes manifest what we feel in our brains. That increased heart rate and sweaty palms when your crush passes by that's your autonomic nervous system making its effects on the body. However, I highly doubt that people will shift to representing emotions with a brain.

At this point, it was all a long-winded explanation to get to the point that the brain and heart are interconnected. In terms of what should a physician have, it's not far off from the truth. A physician must have both Brain and Heart. One cannot become a physician if one aspect is deficient or not in synergy.

Because a physician with only a Brain will only see the patient in terms of his/her organ systems. If said patient is suffering from a cancer then that doctor will only see the cancer and how it is disrupting the organ systems of the patient. The brainy physician will ignore the signs of distress evident on the patient's face. How his/her family members are holding back tears. And if said patient is a parent, how his/her child is suffering in school. The patient becomes Homo sapiens but not anymore a human being.

Conversely a physician with only a Heart will see the patient as a human being but will ignore the disruption in the organ system brought about by the cancer. The physician will then forget about making differential diagnoses and cry with the patient. The hearty physician will not know which drugs to prescribe or when to refer to a surgeon. Or if the physician is a surgeon, he/she may not be able to perform surgery on the patient. So in this situation, the patient is a human being but the physician is helpless.

The Brain now refers to the physician's arsenal against disease and disability. The Brain supplies the medical knowledge and pharmacology of drugs. The Brain is a reservoir of many specialties enabling the physician to make a scientific and economical choice for treatment. And if the disease is beyond the physician, the Brain enables the physician to know when to refer to another physician. The Heart is the physician's drive and motivation. It is his/her humanity. The Heart enables the physician to remain motivated to keep updated with the latest medical advances. Medicine, after all, is an ever-changing Science. The Heart keeps the physician grounded with his/her patients. The Heart motivates the physician to serve his/her patients because service to others is the ultimate manifestation of the Heart.

So Brain or Heart? The answer is Brain and Heart, in synergy, together.