The first major science fiction novel was written 203 years ago by Mary Shelley, called Frankenstein. The story follows an obsessive student named Victor Frankenstein, who aims to create life using the, then, fairly new idea of galvanism. However, when he finally succeeds, he is repulsed by the sight of his creation, referring to it as “hideous”¹. When examining the story of Frankenstein, many acknowledge that it was the first to examine ethics when it came to scientific experimentation, yet, there is a lot to learn about physician-patient relationships as well².  

The practice of medicine, from a literal perspective, is to diagnose, treat and prevent diseases, however there is an arm of medicine that is continually overlooked. Patients seek medical assistance when their personal narratives are broken and they wish to restore it³. Like Victor Frankenstein, who aimed to manipulate life, physicians, too, have the power to manipulate the life of the patient.

In Mary Shelley’s novel, Victor Frankenstein attempts to follow the ideal standards of beauty but when the Creature he creates fails to follow the standards of perfection, he immediately abandons it. He further failed to acknowledge the feelings of his Creature, neglecting to even name it⁴. With this, it is important to include the idea of aesthetics in the context of perfection and the perception of society. When the image of perfection is spoiled, for the physician or the patient alike, negative feelings like shame, anger, and fear may arise and blame is placed. As a physician, neglecting such emotions, and worse, blaming the patient for these negative emotions, may result in the patient abandoning to seek care all together⁴. Patients not only require physicians who are able to treat their medical illnesses, but ones that can join and guide them in their journey facing the illness⁵. 

This can further be elucidated when Victor Frankenstein fails to prepare his Creature for life in society, increasing the stigma the Creature felt for itself and by society⁴. Physicians have a paralleled ethical commitment to not forsaking their patient, whether that means physically or emotionally. Understanding the perspective of Victor Frankenstein allows one to see the causes and consequences of apathy and disregard⁴. Although physicians allow the lengthening of patient lives through scientific innovation, it often causes dramatic changes to body images making it difficult to reenter society². For example, one common change many diabetic patients go through are those required to give themselves an insulin shot in the abdomen, in some cases, multiple times a day. If patient’s saw doctors as allies to help navigate a judgement-filled society, instead of the all to common view of the doctor mirroring the stigma seen in society surrounding non-conformity and death. Therefore, an important responsibility physicians need to learn from the beginning is the responsibility of courage, to ally themselves with patients to help restore the narrative that has been broken⁴. Failing to do this can often lead a patient to feel rejected², which can lead to dire consequences, as exemplified in the story of Victor Frankenstein.

To view medicine as more than evidence-based is important. The medical community must incorporate the concept of narrative based medicine, which highlights physician-patient communications. Narratives about the patient’s illness and caring for the ill can provide new understanding to physicians, creating an opportunity for openness towards patients. This can increase empathy, individualize a diagnosis and subsequent treatment, and provide room for self reflection³. When narrative based medicine is coupled with evidence based medicine, a more holistic approach is formed for patient care.  

References

1. Shafer, A. (2018). Why Frankenstein matters. Stanford Medicine. https://stanmed.stanford.edu/2018winter/why-issues-raised-in-Frankenstein-still-matter-200-years-later.html
2. Childress, A. (2018). What Frankenstein Can Teach Clinicians About Patient Care. Texas Medical Center. https://www.tmc.edu/news/2018/10/what-frankenstein-can-teach-clinicians-about-patient-care/
3. Kalitzkus, V., & Matthiessen, P. F. (2009). Narrative-based medicine: potential, pitfalls, and practice. The Permanente journal, 13(1), 80–86. https://doi.org/10.7812/tpp/08-043 
4. Lewis J & Shapiro J. (2020). Speaking with Frankenstein. J Med Humanit. 1-16. doi:10.1007/s10912-020-09653-3
5. Charon, R. (2001). Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust. Journal of the American Medical Association: The Patient-Physician Relationship. 286(15):1897-1902. doi:10.1001/jama.286.15.1897