Bro’ Hippocrates

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…”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

ISN’T IT CURIOUS how often, in an idle conversation with a complete stranger, you will be asked a clearly medical question? Your casual acquaintance has perceived that you can answer with some authority. I find this to be so even in other countries, languages, cultures. Physicians do look, speak and act like one another to a great degree. To become anonymous we must disguise our 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, race or gender. While recognizing both the philosophic and practical advantages of diversity in our culture as a whole, for an individual there is still great joy, great comfort, in shared personal experience, achievement and aspiration.

For if every man is my brother, who is My brother? As old Hippocrates knew, our  professional family, our brothers, sisters, parents, are physicians. Of course the problems of living in the third millennium are not unique to physicians. In large part, we face overload. Most Americans have too many options, many of them illusory, yet we must choose among them. 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. We are challenged and privileged to deal with the full measure of life around us, as revealed to us by patients. Yet the generalist can feel overloaded; may become selectively detached in order to survive; order more tests, over-medicate, over-refer. Patients expect advice, solutions. The specialist also, when unable to respond, may be tempted to deny he is a physician, and hide behind the ignorance of a limited scope of practice, or re-refer somewhere, anywhere. Patient, heal yourself, or find yourself a healer. That ain’t me, babe.

How can a physician deal effectively with every medical problem of Everyman? The psychopath, the suicidal, the abuser of substance, or of beloved, or of 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, 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 a physician machine. But life of the physician deus ex machina is self-imposed drudgery or, worse, self-delusion, even when high idealism is involved. It is as fake as the original character in Greek drama, who dropped down hanging from a rope to solve an insolvable problem.

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 order are the comforts of the Family, the Book, the Pen, the God, and even perhaps now the Internet. The list is endless. Leaving aside risky distractions like the Bottle, the Drug, the Sex, the Gamble, an escape from overload is often best shared with a colleague. Among all friends, that is the person with whom we share the most. At the risk of being parochial or small-minded, I consider physicians a select and accomplished set of people as any that can be found portrayed in literature, history or common experience. I must quarrel with some, like Voltaire, who would class us all clergy, physicians and lawyers as predators. We all have faults have merits not immediately visible to others. While physicians have all the failings of humanity, we have extraordinary attributes.

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 only slightly knew each other, we shared so much history and life experience that the trip was as smooth as if we had known one another for years, or had been on many such packs together. I have always been fascinated by the diversity among people, and have found great enjoyment in those very different from myself. But for sheer escape, and pleasure, it is highly rewarding to share an adventure with my own medical kin, and to take the time to know one another better; to know and be known and revel in that knowledge.

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