Kinship of Hippocrates

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From  Religion, or Shamanism onward, in all time, all cultures,  all places, physicians are kin.

…”when religion was strong and science was weak, men mistook magic

for medicine. Now, when religion is weak and science is strong, men

mistake medicine for magic.” – Thomas Szasz

“Is that all there is, my friend? Then let’s keep on dancing…” – Peggy

Lee, song lyric

ISN’T IT CURIOUS how often, in an idle conversation with a complete stranger, you will be asked a clearly personal medical question? Your casual acquaintance has perceived that you can answer with some authority. I find this to be so even in other parts of the world. Physicians do look, speak and act like one another to a great degree. To become anonymous we must disguise our natural speech, appearance and actions. While there may be something faintly embarrassing in our transparency, I find that among the greatest pleasures of being a physician is my association with medical peers, those with whom I share much. Ours is a worldwide Family beyond nationality, blood, race or gender.

While recognizing both the philosophic and practical advantages of diversity for our culture as a whole, for an individual there is still great joy, great comfort, in shared personal experience, achievement and aspiration, shared with a colleague. For if every man is my brother, who is My brother? As old Hippocrates knew, our family, our brothers, and sisters, are physicians, regardless of race, nationality, language or culture.

Of course the problems of living in Year 2001 are not unique to physicians. In large part, the generic situation is overload. Most Americans have too many options, many of them illusory, yet we must choose among them.  We are flooded with too much information, much of it specious, but we must evaluate it. Too many demands on our energies, though we know that our strength, like our very existence, is limited. Both our private and professional lives are affected.

Medicine is a people profession. Generalists are challenged, and privileged, to deal with the full measure of life around us, as revealed to us by patients. Yet we may become selectively detached in order to survive; we may order more tests, over-medicate, over-refer. Patients expect advice, solutions.  The specialist also, when unable to respond, may hide behind the ignorance of a limited scope of practice, or re-refer somewhere, anywhere.  Or in effect, say ‘Patient, heal thyself.’

How can a physician deal effectively with every medical problem of Everyman? The psychopath, the suicidal, the abuser of substance, beloved, or self? The sex-fixated, the asexual, transsexual? The worrier or the mentally or physically disabled? Like housekeepers, we do what we can, let it go, and come back tomorrow and do it again, and yet again,  while taking justifiable joy in our little accomplishments, and trying not to obsess over our limitations. The alternative is to be consumed by our profession, to become physician machines. But life of the physician ex machina is self-imposed drudgery or, worse, self-delusion, even when high idealism is involved.

To relieve the overload so characteristic of our time and our profession, we may find solace in simpler, more focused pleasures: the Farm, the Garden, the Gym, the Fish, the Bicycle, the Mountain, the Golf or Tennis Ball. Of a different but related order are the comforts of the Family, the Book, the Pen, the God, and even perhaps the Internet. The list is endless. Leaving aside risky distractions like the Bottle, the Drug, the Sex, the Casino, an escape from overload is often best shared with a colleague. Among all friends, that is one with whom we share the most.

At the risk of being parochial or narrow-minded, I consider physicians a select and accomplished set of people as suggested in literature, history and common experience. I must quarrel with some, like Voltaire, who would condemn us all, along with lawyers. Though we physicians have all the failings of humanity, we have extraordinary attributes. Sotto voce, so do lawyers. I recently went on two llama pack trips – the first with three adult physicians, the second with two wife/husband/child physician families. Even though we had only slightly known each other beforehand, we shared so much history and life experience that the trip was as smooth as if we had been lifelong friends having been on many such packs together.

I have always been fascinated by the diversity of people, and have found great enjoyment among those very different from myself. But for simple escape, and pleasure, it is highly rewarding to share an adventure with my own medical kin; to take the time to know one another better; to know and be known and revel in that knowledge.

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