by
Nick Nunes
Since the end of 2019, there has been creeping interest in the realm of medicine like no time before. The information age has granted humanity the possibility to research knowledge that used to come only through travel, expense, and fervent dedication to learning.
It’s unsurprising to know that the earliest medical traditions and records of physicians come from the oldest societies that historical study can find. Egypt, China, Babylon, India— these are some of the oldest places where civilisation took root and also where some of the oldest records of health treatments have been found. One of the oldest medical treatises comes from Sushruta Samhita. This work, which is believed to have been a work in progress, added onto by physicians for hundreds of years, is believed to have been compiled between 600 BCE and 500 CE. Not only does the work talk about general medical practices but it contains writings about surgery, a novel idea for 2000 years ago.
Most people are aware, even if only vaguely, of the HIPPOCRATIC OATH. Hippocrates was a Greek doctor who lived from 460 to 370 BCE and the oath that bears his name is still the basis for the oath that doctors swear upon entering the profession today.
“I swear by Apollo Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture,” is the beginning to the oldest fragment of this doctorly dedication while the third paragraph contains the phrase, “I will do no harm or injustice to them,” which some will recognise as the most often repeated and seen as the most important part of the Hippocratic Oath, “First, do no harm.”
According to Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing, “While some medical schools ask their graduates to abide by the Hippocratic Oath, others use a different pledge — or none at all.”
Shmerling continues to defend this by affording, “The idea that doctors should, as a starting point, not harm their patients is an appealing one. But doesn’t that set the bar rather low? Of course no physician should set out to do something that will only be accompanied by predictable and preventable harm. We don’t need an ancient ancestor, however well respected, or an oath to convince us of that!”
He goes on to assert that if “First, do no harm,” was taken literally then no one would ever have surgery. “We might stop ordering mammograms, because they could lead to a biopsy for a noncancerous lump. In fact, we might not even request blood tests — the pain, bruising, or bleeding required to draw blood are clearly avoidable harms,” he added.
The ideals of a doctor in the 21st century should be more nuanced than a black and white statement that could end up being tangled in legalese.
The good doctor closes by stating, “The fact is that when difficult, realtime decisions must be made, it’s hard to apply the “first, do no harm” dictum because estimates of risk and benefit are so uncertain and prone to error.
“But it is a reminder that we need high-quality research to help us better understand the balance of risk and benefit for the tests and treatments we recommend. Ultimately, it is also a reminder that doctors should neither overestimate their capacity to heal, nor underestimate their capacity to cause harm.”
The funny thing about one of the most revered and maligned professions is that the gravity of their responsibility inspires adulation as well as condemnation. Though doctors are among the highest paid of professions, they often require second jobs to pay off the extensive debt they’ve accrued in accomplishing their status.
Originally, physicians were not doctors. The word itself, doctor comes from the Latin word docēre which means to teach. The first doctors were “eminent theologians who had a special seal of approval from the Roman Catholic Church as people able to talk about and explain the doctrines of the Church”, according to Merriam-Webster.
The term doctor was initially applied to those with advanced academic knowledge and generally not physicians. The title doctor (Dr) was mostly reserved for those who had attained a doctorate or doctoral-level degree.
This is why post-nominals are important; it tells you what kind of doctor you are dealing with. Today, there is a growing class of people who deride the original use of the term doctor and feel as though it should only be applied to the medical field. Now you know why that’s wrong.
According to William Byrnum, professor emeritus, University College London, “The medical hierarchy of practitioners was physician, surgeon and apothecary, and each had defined functions. Physicians, who had gone to university, were the real ‘doctors’, and surgeons and apothecaries, who trained by apprenticeships, were ‘mister’.”
Another oddity in the realm of the history of names and symbols regarding medicine is the use of the Caduceus versus the use of the Rod of Asclepius. You may not know the names, but you’ve definitely seen the symbol. The first is the winged staff with two snakes intertwining from base to tip and the latter is a staff with a single snake wrapped around it and nothing more.
Both have been used, exhaustingly, for branding many things in the world of medicine but one shouldn’t be. The Caduceus is the symbol of the Greek god Hermes the patron deity of identified with thieves, merchants, and messengers. The Rod of Asclepius, however, is the symbol of Apollo’s son and the Greek god of Medicine.
In the United States, Australia, and Turkey, National Doctors’ Day falls in March. In reference to Doctors’ Day, and in the context of our ongoing extreme dependence on the medical professions, it is the doctors of medical science that we focus on this month.
Regardless of the history of titles and symbols, never before has the world been united, so completely, in the support of the scientists and teachers and practitioners that are working tirelessly to stave off the staff of death and detriment to healthy life.
