In this blog post, I’d like to explore how the laughter- and empathy-centered therapeutic philosophy depicted in the movie ‘Patch Adams’ aligns with my own dream of a “calling to be a doctor,” as well as the possibilities and limitations of putting it into practice in the real world of medicine.
The Story of the Movie ‘Patch Adams’
The film begins with Patch Adams voluntarily admitting himself to a psychiatric ward. Although he did not originally suffer from mental illness, the cumulative effects of his father’s early death and an unhappy childhood devoid of love or comfort left him exhausted by life, ultimately leading him to check himself into the hospital.
In the psychiatric ward, Patch meets a variety of patients—those with autism, depression, in a vegetative state, or suffering from obsessive-compulsive disorder—and ponders what he can share with them. He soon realizes that simply listening to the patients’ stories and sharing joy with them is a great help in itself.
Realizing that conversation and laughter can be even more powerful treatments than medication or conventional hospital services, he eventually enrolls in medical school. While studying at the University of Virginia School of Medicine and spending time at the hospital, he learned how to treat patients as human beings and made a conscious effort to get to know their names and lives before even considering treatment.
Patch sought to heal illness through laughter and joy, and eventually realized his dream by founding Gezundheit Hospital to treat people for free. However, it is also important to note that he faced expulsion from medical school after clashing with traditional methods.
The school cited several issues: that he was not yet in the appropriate year to treat patients, his violations of hospital protocols, and his tendency to challenge authority. However, in court, Patch passionately appealed to the judges, expressing his sincere desire to become a doctor and improve patients’ quality of life. His speech moved many people and ultimately led to his being allowed to complete his medical studies.
Why Do I Want to Become a Doctor?
My answer to the common question, “What do you want to be when you grow up?” has remained unchanged for a long time. I wanted to be a “doctor.” Although I’ve heard advice from those around me and considered practical concerns—such as the hardships and income involved—I know clearly that my reason for wanting to become a doctor does not lie in such worldly motivations.
This conviction was the result of deep reflection during my middle school years. I asked myself, “Is my dream of becoming a doctor driven by status or wealth?” That thought made me uncomfortable, and I even felt disappointed in myself. However, after much deliberation, I concluded that being a doctor is a profession that suits my personality and aptitudes.
I have a knack for science and engineering, and I enjoy meeting people and helping them. I felt that the process of becoming a doctor and the work involved suited me better than other professions. That is why I decided it was okay to hold onto my dream of becoming a doctor.
Another important motivation came from the realization that I have received so much. Thinking about my loving family, my supportive environment, and the various privileges that made my dreams possible, I developed a desire to give back and share more. That is why I was willing to choose the profession of a doctor—a career filled with hard work, grueling hours, and, at times, the reality of blood and pain.
Furthermore, the question of “Why must I be a doctor?” does not end the moment I decide to become one. I believe it is a question I must continue to ask and answer myself, both before becoming a doctor and after becoming one. Through clinical rotations, theoretical classes, club activities, and conversations with others, I will constantly seek out that reason.
My View on the Art of Medicine
The art of medicine should, by its very nature, be the skill of saving lives. However, looking at the reality of the medical field, there are many shortcomings in medical practice. Different characteristics emerge when viewed by specialty.
Internal medicine has seen relatively extensive research and is closer to a field of “knowing and treating.” It has a well-established system for understanding and applying the causes and treatments of diseases.
On the other hand, surgery is a field where research is difficult and data is often insufficient, making it a subject that even doctors handle with caution. Consequently, it sometimes takes on the nature of “treating even when we don’t fully understand.”
Psychiatry appears to be a field where it is still difficult to firmly establish treatment methods. Since the process of discovering treatments is ongoing, doctors often remain at the stage of exploring approaches.
Nevertheless, regardless of the specialty, the most important thing when a doctor treats a patient is the commitment to do their utmost to save the patient and take responsibility for them until the very end. Whether we know it or not, a sense of responsibility toward the patient and the best possible effort must be at the core of medical practice.
The Purpose of Medicine: Healing Illness and Caring for Life
When practicing medicine, we usually face a crossroads with two choices. One is to prioritize resolving the physical problems in the patient’s body as much as possible, and the other is to prioritize maintaining the patient’s current condition as well as possible while resolving the problems to a reasonable extent.
I believe the latter of these two options is more important. Of course, there are individual differences among patients, but those who visit a hospital generally have the desire to transform a life of suffering caused by illness into a better, more comfortable one. However, if a patient comes to be cured but the treatment process itself is too painful—or if there is even a possibility that the treatment could shorten their lifespan—that is not only an outcome the patient does not want but also a reversal of the purpose and means of medicine.
To be precise, the patient’s better life and happiness must be the goal, and curing the illness must be the means to achieve that goal. However, if we become fixated solely on curing the illness without considering the patient’s quality of life, medicine becomes the goal, and the patient is reduced to a mere means. I place greater importance on an approach that maintains the patient’s current condition and enhances their quality of life. This perspective aligns with the message conveyed in the movie ‘Patch Adams’.
The Ideal Physician the World Needs and My Resolution
Objectively speaking, doctors can be broadly divided into two categories: the “reckless doctor” who puts the patient first, and the “cowardly doctor” who prioritizes rules, stability, and reality. These two types are clearly illustrated in the film ‘Patch Adams’ through the contrast between the protagonist, Patch Adams (Robin Williams), and his adversary, Mitch (Philip Seymour Hoffman).
Patch Adams lives alongside patients in a psychiatric ward, striving to build close relationships with them, and goes out of his way—even if it means breaking official regulations—to bring laughter and joy to his patients. While his actions sometimes irritate the professors and cause problems, to the patients, he becomes the sole source of comfort in their hospital life and a reason to keep living.
On the other hand, Mitch is the type who strictly adheres to rules and schedules and is devoted solely to his studies. He represents the realistic, efficiency-driven doctor who, upon opening a patient’s chart, looks at the diagnosis and symptoms before the patient’s name.
Running a hospital organization and managing emergencies requires a “pragmatic doctor” who is down-to-earth and follows the rules. However, a “reckless doctor” who cares for patients’ actual lives, clarifies the purpose of treatment, and practices compassionate care is also absolutely essential. The two types are mutually complementary.
Patch Adams’ speech resonated deeply with me. He strongly asserts that the relationship between doctor and patient, and the doctor’s mission, is to improve the quality of life. Several passages from his speech were particularly memorable.
“Is death wrong? What is so frightening about it? Why can’t we treat death humanely and with dignity, with courtesy and a sense of humor? Death is not the enemy. Ladies and gentlemen, if we are to fight a disease, let us fight the most vicious one: ‘indifference.’”
“I’ve heard many lectures on transference and professional detachment. Transference is inevitable. Every human being influences others. Why wouldn’t you want that in the patient-doctor relationship? I’ve heard your teachings, and that’s why I believe they’re wrong. A doctor’s mission is not to prevent death, but to improve the quality of life.”
“When you treat people, I guarantee you, no matter the outcome, you win. … Don’t let these things numb you. Don’t let yourself become insensitive to the miracles of life. Live your life always marveling at the amazing workings of the human body. Let that be your focus, rather than good grades. Grades cannot teach you what kind of doctor you will become. Reclaim your humanity before you step into the ward.”
Patch Adams insists that it is crucial to restore human connections with patients—even if it means breaking rules and conventions—and to care for life with humor and compassion, even amidst patients’ suffering. Listening to this speech, I clearly understood the reason and direction for becoming a doctor, and I resolved to emulate that spirit.
Above all, I want to be a doctor who stands by the patient’s side. I intend to put into practice my belief that a doctor’s purpose is to work for the patient’s happiness and a better life. To achieve that purpose, the relationship with the patient is crucial. Therefore, I will consistently communicate one-on-one with patients and strive to understand what they lack and what they need before the nurses do.
I want to be a doctor who makes eye contact with patients and calls them by name with warmth. While there may be times when I must set aside my personal shortcomings or flaws and make sacrifices, I am fully prepared to do so if it is for the sake of the patient. My vision of a doctor is one who shares in the lives of patients and hospital staff, laughing and crying together, and practicing compassionate, human-centered care.
