The Quiet Art

David Weatherall's book, 'Science and the Quiet Art', is subtitled 'Medical Research & Patient Care'. The cover of the book is of 'The Doctor' by Sir Luke Fildes. Fildes was born in 1843 in Liverpool, and was brought up by his grandmother Mary Fildes, a political activist. He trained at the Warrington School of Art, going on to become the most successful and well-paid portait painter of his day. 'The Doctor' was a £3000 commission from Henry Tate which, although he grumbled about the fee, prompted Fildes to paint more on social matters. The painting is in Tate Britain.

I've been thinking about the 'Quiet Art' as I prepare a talk. I am loosely involved in what has become known as 'molecular medicine'. There is strength to this reductionist approach, indeed most drug discovery proceeds in this way, but there is a risk of hubris: the notion that disease is an undesirable state and the state should be 'fixed' seems too simple, and 'Western' if I may put it that way. You see it in corporate advertising ('Disease has no greater enemy'), and in the press ('fighting disease'). Yet we spend little on palliative care, and in today's FT I read that the UK has over 100 unfilled vacancies for palliative care consultants. Perhaps the work is unattractive, but the end of life is surely as important as the beginning.

There is only so much you can see in a scanned image, so last week I went to the Tate to see it. I had not noticed the child's parents in the pale dawn light from the window, the man with his hand on his the shoulder of his exhausted wife. The first Noble Truth.

It is said that doctors like this picture, and I can why. The seated doctor lit by the shaded lamp could probably do little but give witness to the pain and suffering and see the night through with them. The pale dawn suggests that the child might have made it through the worst.

So, I work on the talk, trying to suggest the 'Quiet Art' is more than molecular medicine. We are more than cellular machines to be "fixed" when broken.

Today was my 59th birthday and so I am perhaps mindful of these things.