Introduction

This is a European Charcot Foundation Symposium on the diseased human being, on the person whose health is in danger or destroyed, who suffers (patient) and who may become incapacitated, disabled (EDSS), debilitated.

Modern medicine is mostly disease oriented and with success: separating Devic's Neuromyelitis Optica from multiple sclerosis by demonstrating NMO's singular relation to aquaporin, made a better NMO treatment possible. Such seems to confirm the disease paradigm.

The development of epidemiology and genetics however, confirming the disease paradigm by HLA relations, also demonstrated the strong person by person differences caused by environment, nutrition, life events (see monozygotic twins).

That personal aspect of disease, be it formulated in Hippocratic lines, in holistic, psychosomatic or psychoanalytic words, does not change the fact that "man is the main actor in a constant triangle of patient, doctor and disease”. ¹

And this fact becomes more and more clouded by technical repair, replacement, hygienic assumptions, statistical significance, odds ratio's and production figures.

Every doctor knows that the principle of medicine is basic compassion, sym-pathy, in the face of the human (and animal) suffering. Therefore the General Medical Council 2008 Guidance for Doctors was timely and strongly needed: the ethics of medical behaviour.²

But how to turn the doctor from facing the computer screen to facing - face to face – the patient suffering, to provide comfort and hope, without shielding from the human predicament: being a partner?

Could we increase the doctors specificity and sensitivity as a diagnostic and therapeutic partner in such a way that she (he) smells the relapse coming, feels progression, recognizes MS before it is there, that she (he) sees the differential diagnosis?

Can rational-technical medicine have its counterface in doctors diagnostic and healing skills far beyond rational explanation: by the same basic experience as compassion?

Let us call it healing power – a gift like musicality, like writing, building; the gift of an artist.³ There is no musician without an instrument. In this way modern medicine is an excellent instrument to develop the art of medicine.

¹ The dream of Unity of Psyche and Body; has it passed us by? (Interview with Prof. Thore von Uexküll)Psychother.Psychosom 1988 50:117-124
² Guidance for Doctors. Consent: patients and doctors making decisions together. General medical Council 2 June 2008
³ Iain McGilchrist. Paying attention to the bipartite brain. Lancet 377:1068-69 2011