Disheartened and disaffected from the politicization and ego-driven humanities major I had intended to pursue, I applied to medical school. Each of the five schools I applied to required an interview. And each interviewer inevitably asked the same question: “Why do you want to be a doctor?” My answer: "Unlike the humanities, I regard medicine as truly, fundamentally humane." I still subscribe to that view of medical practice.The history of medicine begins with the need, universally present, for someone capable of practicing a healing art. A healer, I believe, requires a melding of experienced observation, some relevant knowledge base, and a caring soul. Hippocrates was the first documented clinician whose practice was, to a large degree, based on observation of the symptoms and course of an illness. He was of the era that indulged the scrutiny of nature and therefore provided opportunities to study diseases and evaluate treatment efforts. He is forever remembered for proclaiming caution: "First, do no harm."  Then came the fifteen hundred years of the dark ages when the study of nature was subsumed and totally eclipsed by divine instruction. Arab doctor continued to rely on nature as a resource for medical knowledge, but this had little impact in the West until many decades later.The humanism movement began in the restless hands of Italian papal scribe, Poggius Florentinus, in 1417. He discovered, hidden in a remote monastery, the long-lost copy of Lucretius’ two-thousand-year-old poem On the Nature of Things. That poem contained the teachings of Epicurus (wholly bowdlerized by the ideas of Epicureanism). And that launched a return to the study of nature. Fueled by Renaissance humanism the era of the Enlightenment broke forth in the 18th century. Sciences were soon established and fully recognized, and became supremely important. Medicine began to emerge as a fusion of the healing art with scientific study and research.

"Inevitably, academic psychiatry lined up behind the new concept, though its base in science—basic sciences such as chemistry, physics, even neurophysiology—is relatively limited."

.By the end of the 19th century, the age-old division between physicians (prescribers of nostrums,  potions, and medicines) and surgeons (slicers and dicers) was abandoned in favor of a unified, modern view of medicine. Medical school curricula were standardized and science was inserted as the leading source of knowledge about the workings and failings of the body.In the 1990s that scientific base was further extended by the introduction of evidence-based medicine. Clinical research, with controlled studies statistically separating fact from opinion, formed the underlying basis of innovation in medical practice. Epidemiology, studying the course of illnesses or the spread of contagions, also formed a major part of this new evidence-based medicine.Inevitably, academic psychiatry lined up behind the new concept, though its base in science—basic sciences such as chemistry, physics, even neurophysiology—is relatively limited. A thrust in the new direction has come from translational research coupled with knowledge of genomics. Certain behaviors, especially those related to fear and anxiety, can be induced in animals such as the favored laboratory mouse or rat. Locating the specific area in the brain and the animal's response to drugs can elucidate the comparable (homologous) area in the human brain. This has lead to the understanding of drug effects on the brain. Genetic manipulation of an animal's genetic make-up by "knocking out" certain brain-manifest behaviors also reveals information that can be translated to the human brain.The latest Diagnostic and Statistical Manual produced by the American Psychiatric Association professed a desire to incorporate biological measures of mental disorders, though most categories are based on accumulated clinical observations and opinions. Much of the research in psychiatry that related to clinical care is based on double-blind placebo-controlled studies of drug responses. Studies of psychotherapy, except the limited area of cognitive behavioral therapy, has been mostly ignored and discarded by mainstream, academic psychiatry.But those randomized control trials of drugs and direct brain impact electrically or magnetically are measured with surveys and scales mostly filled out by patients. Even standardized surveys filled out by investigators are based on opinion, on self-awareness, on inter-reliability training of survey interviewers to achieve agreement on the terms of a survey. The answers are calculated and then submitted to a battery of sophisticated statistical analyses. The result is evidence-based psychiatry more-or-less free of biological measures. No pathogen, no chemical or even neurochemical, no neuroanatomic findings, no solid genetic vulnerabilities have yet to be clearly identified in psychiatry.Clinical acumen and experience contribute to the benefit that psychiatry can offer. Most of the drugs, often discovered accidentally, do work. Coupled with psychotherapy—the abandoned step-sister that once ruled all of psychiatry in America—make real, successful treatment possible. One can only hope.