Virtual Mentor. May 2002, Volume 4, Number 5.
From the Editor
Peking Duck Soup
The journal editor acknowledges the many skills that mothers have as caregivers and healers that are parallel to those needed to be a competent and compassionate physician.
Audiey Kao, MD, PhD
I know more than doctors," my mother confidently claimed. Despite practicing medicine for nearly 10 years, I still occasionally hear from my mom that my education and training as a physician do not compare to her years of experiential knowledge and expertise as a caregiver. In some ways, my mom cannot be serious—she is not licensed by the state to practice medicine, nor can she sort through a grocery list of differential diagnoses to determine the appropriate course of action. But in other ways, she and other mothers like her, armed with the healing powers of chicken soup, can teach their physician-children a thing or two about caring and common sense.
According to the World Health Organization's Action Programme on Essential Drugs , a drug is considered essential if it is "as relevant today as it was 20 years ago," and satisfies 4 criteria. It must be (1) evidence-based, (2) efficient, (3) flexible, and (4) forward looking. To many, the chicken soup that our mothers made for us when we were sick can be classified as an essential drug . But maybe more importantly, these criteria also characterize our mothers' abilities in their roles as caregivers that are as applicable and relevant for medical professionals today as they were more than 20 times 20 years ago.
While there has never been a randomized control trial on the therapeutic efficacy of chicken soup, mothers have long used observational, anecdotal, and intuitive evidence in their roles as caregivers and healers. In an era of increased understanding about the biology and pathophysiology of disease, the emergence of scientifically driven, evidence-based medicine is critical to the advancement of medical care. But, as physicians, we should never loose sight that other information and evidence, oftentimes gleaned from careful observation, remains an important part of the therapeutic relationship.
Mothers are famous for their ability to juggle a seemingly infinite number of tasks in any given day. Time management, prioritization, and peer support are skills and resources that mothers draw on and that physicians increasingly need in the hectic environment of contemporary medical practice. Unfortunately, while these "efficiency" skills seem innate to mothers, they seem lacking in, and are not taught to, medical students, residents, and new physicians during their education and training. For example, physicians should to take advantage of the competencies of other professionals such as nurses, social workers, and chaplains in providing efficient care to their patients. While it is true that physicians need to manage their time better, it must also be noted that physicians do not have as much control over the conditions of their work environment as mothers, and thus true efforts towards efficiency, must address the "hassle factor" that distracts physicians from caring for patients.
There is no "basic" formula for the preparation of chicken soup. Some mothers add carrots, others may not; there seem to be an infinite number of variations. The fowl of preference in Chinese culture may be duck (of the Peking variety) rather than chicken—but, frankly, both birds will probably be equal in therapeutic value.
"Flexibility" also describes the different ways mothers relate to their children whom they love equally. Some mother-children relationships are easy while others are more difficult. One child will almost always obey, another will need closer observation and more coaxing. From the physician's perspective, the ability to interact differently with patients who have exactly the same illness is critical to establishing a therapeutic relationship. Thus physicians, no less than mothers, must be flexible and treat each person they care for as an individual.
Mothers are, by their nature, forward looking, devoted to and constantly protecting their children's futures. This longitudinal perspective that mothers have in the care of their children is a worthy of reminder for physicians. Physicians, too, look out for their patient's best interest, but sometimes our view gets myopic. Frequently physicians get swept up by the intensity of managing and treating an acute illness, and can lose sight of patients' long term well-being. There are few relationships outside those of the blood variety that are as important and intimate as the patient-physician relationship. Therefore, in many ways, our mothers remind us as physicians to balance our desire to cure at all costs and the need to care for our patients.
In the month of May when mothers are honored and motherhood celebrated, I want to say, "Mom, thanks for all of your support through the years. Love, your son.
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