“Wabi is a mindset that appreciates humility, simplicity, and frugality as routes to tranquility and contentment. The spirit of wabi is deeply connected to the idea of accepting that our true needs are simple, and of being humble and grateful for the beauty that already exists right where we are.
Sabi is a condition created by time, not the human hand. Sabi is concerned with how the passage of time manifests itself physically in objects… the way all things evolve and perish ….”
- Beth Kempton
As a lapsed vascular surgeon, long retired from clinical practice, I watch as the ways I practice fall to the wayside. House calls gave way to hospital care which gave way to outpatient care which has fractionated into so many specialists staying in “their lane,” leaving the patient with the responsibility of integrating their care. A cottage industry of physician-entrepreneurs, emphasizing physician, has given way to workforces, full-time equivalents, and corporate care. It is hard for me to see these changes as a physician; it is even more challenging to cope with them as a patient. As I worked through my grief over the loss of a profession I so dearly loved, I found acceptance, that last stage of grief in recognizing how healthcare differs from medicine or how I believe I practice that art.
- Healthcare is based on a logical, rational view of the world; Medicine is intuitive
- Healthcare looks for universal solutions; Medicine seeks personal, idiosyncratic solutions
- Healthcare believes in control and is future-oriented; Medicine recognizes that our present health, like nature, is uncontrollable but can be influenced
- Healthcare is intolerant of ambiguity; it requires metrics and categories; Medicine is more comfortable with ambiguity and fuzziness
- Healthcare seeks to maintain; Medicine seeks to accommodate
- Healthcare recognizes the commonality; Medicine identifies the “forms of attrition” that are our individual histories.
- Healthcare has guidelines and standards for providing care; Medicine inspires relationships within ourselves and with our caregivers
- Healthcare stands apart; Medicine coexists with the environment
- Healthcare is expertise; Medicine in quiet authority
- Healthcare is excess; Medicine is restraint
- Healthcare is resistance; Medicine is resilience
It is a sacrifice to sit and wait to see your physician, but when we exchange that relationship for convenience, we move from the wabi-sabi of medicine to the consumption of healthcare. Convenience is a Faustian bargain; the price only becomes apparent when you are older and need the wisdom that springs from relationship rather than consumption.
Chuck Dinerstein, MD, MBA
Director of Medicine
Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.
