The Darwinian evolution theory in its current synthesis remains central to the enterprise of biology today. After 150 years of the most intense analysis, debate, and critical

testing, the theory of evolution stands as strong as ever with thousands of facts as its empirical base. As Peter Medawar eloquently put it “the alternative to thinking in evolutionary terms is not to think at all”. Whether we like it or not, biology simply means evolution. Footnotes Conflict of interest: No potential conflict of interest relevant to this article was reported.

There has been a proliferation Inhibitors,research,lifescience,medical of literature on the teaching of physician-patient communication in medical school during the past several decades. 1–5 The present article will not attempt to reduplicate the existing Inhibitors,research,lifescience,medical reviews of the subject, which are readily available in the accessible medical literature. Instead, as one who began his medical studies some 60 years ago and has been associated with academic medical institutions on two continents for several decades, I will present some personal impressions as part of what might be termed “narrative medicine”. Hopefully some of these

experiences and suggestions will prove useful to the readers of the journal. PARADOX OF SOCIETAL Inhibitors,research,lifescience,medical DISSATISFACTION WITH PHYSICIANS There exists a troubling paradox in the field of Western medicine. The progress of selleck chemical Lapatinib medicine in the past century has been almost miraculous. The understanding of disease processes down to the inhibitor Paclitaxel molecular level has progressed daily; specific Inhibitors,research,lifescience,medical treatments have been found for dozens of formerly untreatable diseases. Paul Beeson at his retirement from editorship of the Cecil and Loeb classic text-book of medicine noted6 that in the 38 years of his editorship the number of diseases for which there had been specific therapy increased from what had been 5%–10% to 50%–55%. Inhibitors,research,lifescience,medical The past half-century has witnessed

the introduction of organ transplantation, open heart surgery, renal dialysis, cure of some cancers, in-vitro fertilization, and many other advances. One would have expected that the public admiration of the physician would have increased as dramatically as have the advances in medicine. Yet in spite of these remarkable contributions of medicine to the health and welfare of the public, there may actually be increased rather than decreased dissatisfaction of the public with their physicians. To quote a recent New York Times article: “a Dacomitinib growing chorus of discontent suggest that the once revered doctor–patient relationship is on the rocks” 7 A Time magazine cover in 1989 showed the symbol of the physician as a poisonous snake, rather than as a healing Aesculapian serpent, with the heading “image versus reality”.8 The increasing incidence of malpractice suits and the growing use of alternative/complementary medicine are all clear indications of the public’s dissatisfaction with the care they are getting from their physicians.