**3. Connecting professionalism to humanism**

Humanism and professionalism, to some authors, identify two different ethos of physician practice and emerge from divergent visions for the physician–patient relationship (**Table 2**) [12].

Humanism conveys a deep respect to humans individually, and to humanity collectively, and concern for their general welfare and flourishing. The hallmarks of humanism are its universality, its egalitarianism, and its scope. Its concerns, on the one hand, and obligations, on the other, apply to all humans equally; its training ground, for the most part, is experience—as a human and with humanity; and its ultimate vision is for human welfare, as broadly conceived as possible.

Professionalism, in contrast, is a socially constructed, local phenomenon. Professionalism raises expectations for professional behavior to the level of ideology, encouraging all members to embrace the traditions of the profession and to be as "professional" as they can. However, promoting professionalism -competence and excellence- does not mean to train technicians. No profession will be exercised competently if technical skills are not subordinate to a broader cultural training that encourages cultivating the spirit, the humanistic dimension. So, it is necessary to incorporate the humanistic dimension in the teaching of professionalism.

Nurturing the humanistic predispositions of residents seems to be the key to ensuring that future neurosurgeons manifest the attributes of professionalism,


#### **Table 2.**

*Humanism and professionalism characteristics (modified from Goldberg JL [12]).*

as professionalism and humanism share common values and that each can enrich the other [13, 14]. The teaching of humanism values is recognized as an essential component of medical education and continuing professional development of physicians [15]. The application of humanism values in medical care can benefit residents, clinicians and patients [16]. The study of humanism values has a solid research base. Research has demonstrated that behaviors that are associated with humanism values improve practice and patient outcomes. The teaching of humanism values can be integrated into formal learning experiences and clinical settings, incorporating empathy, nurturing dignity, respect and confidentiality and fostering role modeling [5, 17].

The fast scientific advances require, to maintain the equilibrium, an expansion of the scope of the medical humanism, that is, a medical humanism at the height of scientific advancement. And it would be this extension of humanism, adapted to the present day, in a modern version, which would lack the process of medical education. If this humanistic update is not made, it would fall into a disproportion that would be reflected in neurosurgeons technically trained, but with serious humanistic deficiencies. We will have deformed physicians, with hypertrophy of technical knowledge, without balance, which naturally does not conquer the confidence of the patient who expects a balanced doctor. Therefore, the function of the University and the training institutions would be to expand the humanist concept in modern views, opening horizons and new prospects. And, to achieve this, the methodology and the systematic learning how to do things, when these things are many and they are wrapped in high technology and commanded by a fast scientific progress. Thus building "bifocal" neurosurgeons, who are able to care for their patients with professional, technical and humanistic competence, in harmony, taking advantage of the best that progress offers, to serve them in their physiological and human needs and beliefs.

Humanism is, therefore, a source of knowledge that the neurosurgeon uses for his/her profession. A knowledge as important - neither more nor less - such as those acquired by other ways that help him in his desire to take care of the human being who is sick. They are different routes that find in the person –the realm of medical care- their common goal and allow, with mutual coexistence presided over by respect, the union of forces, synergy in the active will to heal. Humanism in Neurosurgery it is not a temperamental issue, an individual taste, not even an interesting complement. All that would be to place "humanistic attitudes" in the balance, to compensate for the excesses of science. Humanism is, for the

#### *Medical Humanism in Neurosurgery DOI: http://dx.doi.org/10.5772/intechopen.95750*

neurosurgeon, a true work tool, not a cultural appendix; it is a scientific attitude, weighting, the result of a conscious effort of learning and a method. It is necessary for the neurosurgeon to have a correct balance, a bifocal perspective, that manages to combine in an artistic symbiosis the attention to the disease – with all the technical evolution – and to the patient who feels sick - with the vital understanding that requires. This is, in practice, the person-centered medical care, the most accurate synthesis of the physician practicing science and art simultaneously.
