A letter from Mahesh to those who are taking up the healing profession
Dear Doctor, Dear Student,
I am not writing to teach you anything.
I am writing because I think someone, somewhere, told you that you are not enough. That your clinic is not enough. That your system is not enough. That the way you were raised, the way you feel things, the way you instinctively reach toward a suffering human being, is not scientific enough, not structured enough, not Western enough to count as real medicine.
They were wrong.
You already have the most important thing. You had it before you opened your first anatomy textbook. You had it when you were a child and you felt something move inside you when you saw someone in pain. That thing has a name. Manussakama. And no examination, no curriculum, no postgraduate qualification gave it to you. And none of them can take it from you either.
The patient sitting in front of you today is not a case. She is a person. You already know this. You feel it. But somewhere between medical school and this moment, you may have learned to suppress that feeling. To keep it professional. To maintain distance. To be objective.
I am asking you to reconsider.
Not to be unprofessional. Not to lose your clinical rigour. But to stop treating your humanity as a liability. It is not a liability. It is your most powerful clinical instrument. More powerful than any investigation. More powerful than any protocol. Because it is the thing that makes the patient in front of you trust you. Open up to you. Tell you the thing she almost didn’t mention. The thing that changes everything.
You are working in conditions that are genuinely difficult. I know that. The clinic is crowded. The resources are limited. The system does not always support you the way it should. And you were taught, perhaps without anyone realising it, to feel ashamed of this. To feel that what you do here, under these conditions, is a lesser version of real medicine practiced somewhere else under ideal conditions.
There are no ideal conditions. There is only this patient. This moment. This conversation. And you.
You do not need an electronic record system to remember that the man in front of you looks more frightened than his complaint suggests. You do not need a formal risk assessment framework to notice that something is not right. You already notice. You have always noticed. That is manussakama working through your clinical eyes.
Trust it.
When you ask the patient what she thinks is wrong with her, you are not being lazy. You are being intelligent. She knows things about her body that you cannot find in any textbook. And she will tell you, if you ask, and if she feels that you genuinely want to know. Not because you are performing patient centred care. But because she can feel that you see her as a human being and not a problem to be solved before the next patient comes in.
You can do this in one minute. With a crowded waiting room outside. With no computer. With no allied health team behind you. Because manussakama does not require time or resources. It requires only that you stop blocking it.
Dream small. Act local. Change one conversation today. Then another tomorrow. Do not wait for the system to change first. Do not wait for ideal conditions. Do not wait for someone to give you permission to be fully human in your clinical work.
You already have permission. You were born with it.
The patient in front of you does not need the best doctor in the world. She needs you. Fully present. Genuinely caring. Honestly humble. That is everything. That is medicine.
And if you forget all of this by tomorrow morning, which is entirely possible in a busy clinic, just remember one thing.
Manussakama. It is already there. Just let it flow.
With deep respect for everything you carry into that clinic every single day,
A fellow traveller
PS: You may be interested in a longer document Cluade generated from this chat titled “Manussakama in Medicine – Letting Humanity Flow: A reflection on healthcare delivery, medical education, and the wisdom already present”. It can be accessed here <<Manussakam in medicine FULL DOCUMENT>>
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