We all know what, in 1888, Rudyard Kipling pronounced to be the world’s oldest profession. But what’s the world’s second oldest? Hunter-gatherer? Nah, everybody did that. Primitive politician? That’s a tautology. Neolithic attorney? Nope. Too similar to the oldest.

I strongly suspect that the second oldest profession was healer/magician. Fire up Mr. Peabody’s Wayback time machine and you’d probably find that the first healers were regarded as magicians, and the first magicians, healers. Over time, those roles separated, and today the two disciplines—medicine and magic—seem totally distinct from each other.

Well, maybe not. As an internist/gastroenterologist with thirty-five years of practice experience and a magician/ventriloquist with fifty years of performing experience, I have feet planted in both the worlds of medicine and magic. And I’ve been struck by the similarities between the two fields.

Modern medicine and modern magic are both firmly rooted in science and psychology. In fact, some brain researchers are studying how magic deceives the mind to better understand how the brain works.

Both physicians and magicians present themselves as authority figures with special knowledge not known to the average person. Both are identified with a particular costume signifying their professions, the white coat and the top hat. Both have their own arcane language and words, and both perform their particular rituals—listening with a stethoscope or making a magical gesture.

On a deeper level, both rely on belief, imagination, and deception.

As magicians, we rely on audiences’ willingness to temporarily suspend their disbelief. And they do. Once, when I was performing ventriloquism (magic without deception), an audience member on stage whispered something into my puppet Oscar’s ear; she forgot for a moment that he’s actually an inanimate wooden doll. Also, the most amazing magic effects depend on what audiences imagine occurs, as opposed to what actually occurs. And, of course, deception plays a role in creating those wonderful effects. I wish I could explain further, but I’m not willing to risk magician’s prison, even for you, dear reader.

For physicians, the belief is the trust the patient shows just by walking into our office in the first place and entrusting his health to us. The patient must believe that the physician he has chosen has the skills and knowledge to cure or at least help his or her illness. I think most physicians would agree that the skeptical or untrusting patient runs the risk of a poorer outcome, both by discounting and ignoring the doctor’s advice and by failing to form a therapeutic relationship.

The imagination factor in medicine is part of the healing effect that patients have from the physician interaction itself. Many doctors have had the experience of the patient walking out of the office saying they “feel better already.” The patient imagines that he’s going to feel better and so starts to. Indeed, I’ve always felt that the magic of medicine begins when the doctor and patient sit down together and talk.

But deception? Where does that come in? I think we doctors necessarily deceive ourselves into believing that we understand more about the human body and its infinite complexities than we really do. We have to, or we’d never take on the enormous task of trying to heal it. And I think that we sometimes deceive ourselves into taking credit for healing which the body is marvelously able to do itself.

Both the magician and the physician require humility about what our abilities truly are. As a magician I never believe that I can actually change a Joker into the selected card or really read someone’s mind. And as a physician I can never believe that my knowledge of medicine or of the patient in front of me is sufficient. It is that understanding that makes the ongoing journey of discovery necessary and magical in itself.

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Living in the worlds of medicine and magic inspired me to write my book The Performance of Medicine: Techniques from the Stage to Maximize Patient Satisfaction and Restore the Joy of Practicing Medicine. It’s full of practical, easy to implement techniques and strategies for physicians coping with the ongoing radical changes to medical practice. Coming Spring 2018.