Complementarity and Complexity
Annonymous. MBBS1
This artwork features the anterior view of the spinal column from brainstem to sacrum with efferent somatic (yellow), sympathetic (red), and parasympathetic (blue) nerves. The nervous system is responsible for integrated coordination, where both somatic and autonomic nerves work together to ensure optimal physiological functioning. This inspired the author to use the two functional divisions of the nervous system as an analogy for the process of joint decision-making between doctors and patients.
Left: The doctor has medical knowledge, hence wields greater “control” over decisions on treatment. Therefore, the nervous output representing the doctor’s contribution is primarily somatic, since physiologically, somatic nerves entail greater conscious control.
Right: In contrast, autonomic output often entails no awareness but serves equally important physiological processes. This is analogous to the role of a patient during decision-making: they may have limited medical knowledge but their preferences are indispensable.
However, it is too simplistic to assume physiological outcomes are the culmination of clearly delineated somatic or autonomic outputs; there are overlaps. Similarly, doctors and patients are unique individuals and their conduct and thinking varies. Therefore, left and right spinal cords are constituted by both somatic and autonomic nerves, albeit to varying proportions. In the centre, the nerves converge and intertwine into braids. Each braid represents a decision moment doctors and patients encounter: surgery or chemo? Continue lifestyle changes or start medication? Do benefits of treatment outweigh risks? Should we switch to palliative care? This process is sometimes straightforward, sometimes uncertain, and sometimes heartbreaking — as represented by different braids that vary in length, pattern, and complexity.
Ultimately, the I wish to express the complementarity of doctors and patients as they navigate their relationship, which is the overarching theme throughout our professional career.
