Modern medicine includes many experiences that are similar to primitive healing rituals. Traditional healers often have required the patient to confess misdeeds, wear special garments, and perform certain tasks, while the healer might touch the patient with stylized gestures or interpret various physical signs. In modern medicine, the doctor takes the patient's history, or "confession." During an examination, the patient wears a paper drape, and the doctor often touches the patient's body with a stethoscope and other instruments. Later, the doctor interprets the results of laboratory tests and requires the patient to take certain actions, such as exercising, dieting, or swallowing pills.

Often unconsciously, we doctors use these ritual aspects of medical practice to distance ourselves from the emotions of our patients, to keep ourselves from being overwhelmed by their traumas. We wear "power clothes" while the patient is nearly naked, covered only by the drape. When we keep patients waiting, we send the message that we are more important than they are. We often use technical language that patients cannot understand, in an attempt to deflect their likely emotional reactions to diagnoses of serious illness.

Physicians and other health professionals may not admit that these common practices constitute rituals that relay psychological messages. But many of our patients — especially when they are afraid or in pain — detect ritual messages, as well as logical rationales, in medical procedures such as drawing blood for laboratory tests, in harrowing encounters in the darkness of the radiology department, and in other complex treatments for disease. Instead of allowing the ritual aspects of medicine to intimidate patients, we need to acknowledge the rituals and make deliberate use of them as part of our treatment.

M.L. Elks is a physician on the faculty of the Morehouse School of Medicine in Atlanta. From The Chronicle of Higher Education, November 21, 1997.