20 Years Ago

20 years today, my name forever changed. Two simple letters added to the end of my name. M.D. Doctor of Medicine. And I have never been called the same since.

I can't believe it's been 20 years since I took the oath to do no harm, and to try my best to help my patients.

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

I can't help but wonder how many in the last 2 decades I have encountered. How many- dare I say- I might have helped. And- as with all who are learning, who realize that medicine is as much an art as it is a science, with a healthy dose of luck, faith and sometimes miracles- how many I might have harmed. I wonder if the gullible, naive newly molded doctor who walked on to the stage to receive his degree might have known that he would be in this position, practicing the kind of medicine he is today, in a world that seems jaded and complicated by bureaucracy and medical economics. Not only does a doctor have to  stay up-to-date with the advancements of science, but also the newer medications, and which insurance prefers which medications for which years. That somehow, doctoring in the United States have gotten so complicated that there are so many barriers between the patient and the healer.

Truth be told- yes, I was proud to have people call me Dr. Vagus in my first few years- but very quickly I realize that I miss people calling me by my proper name. That the title, like respect, should be earned with time as you get to know the patient- and also sometimes especially when I am dealing with patients many years older than I am, that I feel humbled and a bit embarrassed to have them call me Doctor So-and-so- and that they should just use my name.

Someone told me today- "just think of all the patients you have helped in the last 20 years...". That thought doesn't really come to mind- all I can think of is how much I have learned from those patients in the last 20 years who have shared part of their lives with me.

Primum Non Nocere

I pray that I be granted the wisdom to maintain this part of my oath.