Healing: A Journey, Not a Destination

January 8, 2024 – by Lindsay Paulsen, Media Logic

Much of the practice of medicine emphasizes the importance of finding a cure for a condition or disease, or as the Cambridge Dictionary says, making someone with an illness healthy again.

Unfortunately, we also know that curing a patient isn’t always possible. What then? How can we still make a positive impact on patient lives, even when we can’t relieve them of their ailment? How can we find meaning and purpose in our roles as clinicians when restoring health isn’t possible? We believe the answer lies in concentrating on healing, rather than curing.

Although healing and curing are often used interchangeably, we think of these two terms in different ways and believe the distinction is important when it comes to our outlook on patient care and bedside medicine.

According to Cambridge Dictionary, healing refers to the process of becoming or making someone well again, but also refers to “the process in which a bad situation or painful emotion ends or improves.” There are many times when we may not be able to cure a patient’s disease, but with extra care and attention, we can certainly improve an individual's emotions, state of mind and spirit.

Stanford Medicine 25’s own Abraham Verghese, MD, was forced to reckon with this idea when he worked on the frontlines of the AIDS epidemic in Tennessee in the 1980s. During this time, he learned that he had been consumed by the “conceit of cure” and decided to refocus: “One can be healed even when there is no cure, by which I mean a coming to terms with the illness, finding some level of peace and acceptance in such a terrible setting; this is something a physician can, if they are lucky, help facilitate.”

In the article “Finding Hope and Healing When Cure Is Not Possible," featured in the April 2019 issue of Mayo Clinic Proceedings, Brad Stuart, MD, and colleagues wrote about how physicians can support healing. The team’s research examined how clinicians could help patients and families through difficult times using a variety of tactics, including:

• shifting from “focused hope” (which is oriented towards finding a cure) towards a more holistic “intrinsic hope,” which the team says provides a “more resilient emotional foundation”;
• emphasizing the importance of the present moment;
• creating new memories that can be cherished beyond the patient’s journey with illness;
• and avoiding the mindset that “nothing more can be done.”

As Stuart and colleagues explain, “There is plenty to do in providing physical, emotional and spiritual comfort.”

Those who work in palliative care and hospice are well acquainted with this focus. As Montefiore New Rochelle Hospital’s Daniel Pomerantz, MD, describes in a CLOSLER article, his goal is to improve a patient’s journey, regardless of the destination. “Many years ago, a rabbi taught me that we can’t confuse seeking healing with seeking a cure,” he writes. “Sometimes, we are able to cure; however, many times, particularly in palliative care, I help with healing by making a rough road smoother, or by helping someone find a new destination (goal), or a new path to an old destination.”

We take his words to heart and hope that, whether it’s through major or minor illnesses, we can gently guide patients on their journeys, regardless of the path or the destination.