Bro' Hippocrates

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.

For if every man is my brother, who is My brother? As old Hippocrates knew, our family, our brothers, and sisters, are physicians.

Of course the problems of living in Year 2001 is not unique to physicians. In large part, the problem is 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 is often overloaded; may become selectively detached in order to survive; order more tests, over-medicate, over-refer. Patients expect advice, solutions, and the specialist also, when unable to respond, may hide behind the ignorance of a limited scope of practice, or re-refer somewhere, anywhere. 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, 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 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 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 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 narrow-minded, I consider physicians a select and accomplished set of people as documented in literature, history and common experience. I must quarrel with some, like Voltaire, who would class us with lawyers, while granting that lawyers may have merits not immediately visible. Though we 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 when 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 of people, and have found great enjoyment among those very different from myself. But for sheer escape, and pleasure, it is highly rewarding to share an adventure with my own medical kin. We need to take the time to know one another better; to know and be known and revel in that knowledge.

lufboro@jps.net