Tuesday, April 25, 2017

If I were a doctor....

... I would have already written myself a generous prescription for a variety of pain pills. Within the stretch of a month I would have some real problems, though I question if I would notice. An opioid addiction seems preferable to pain, but that's just me. I don't live in fear of drugs. I live in fear of pain, real or imagined. Pain seems the least desirable of any possible state to live in.  

I authored the below words to express, in part, how I feel:

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 which 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. 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 but I will always look for a path to a cure for all diseases.

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.

Now, anybody that knows me would know that I am fine with the open swearing and oathing of such things. It is their enactment that causes me such eternal strife. My personality contains a mischievous twist and seeks to relieve my own suffering long before that of my fellow man. 

Therapeutic nihilism, that's a keeper phrase. I daresay that the American democratic party could borrow a cue from that philosophy. 

Above all, I must not play at God. 

Well, that's just nitpicking now, isn't it? 

The Hippocratic oath is deeply flawed. The modern version that you see above makes no mention of the relief of suffering. This is because there are always a few bad eggs that will spoil the omelette of life if you give them enough liquid morphine. 

Ah, well. 

What is pain but a nearly imperceptible note struck within the music of the universe's indifference, a blunt suggestion heard alone in the vain and empty hope of quietus. The path away from pain is the path towards life, we're told. Our nervous systems have been tuned to these recommendations over thousands of years. But what are we to think about the wounds of the self-inflicted. Be wary of the dangers there. A victim does not easily escape that paradox by magically transforming themselves into their own patient. We are all sorcerer's apprentices, in a sense - the power of magic turned against the insufficiencies of the ones invoking it. 

... and I will give no drug and perform no act for an immoral purpose. 

Morality is too vague a term to adequately prevent the proper distribution of drugs. I would throw this portion of the oath out on a technicality. How many similar cases have been won on appeal? Certainly morals should be no impediment to drug use. Or, that is at least consistent with my experience. What are we to think of a doctor also promising not to perform immoral acts in the pursuit and purpose of their profession. Yesterday, we addressed priests, today we have to clean up the medical community, also?

I had never read, nor noticed, the above line before. It has also been removed from the modern version, which is suspicious when considered with the other, more important, omission of the oath to relieve a patient's suffering. 

Well, for any of you that know me, I am writing this only to avoid the other - the spiraling into self-pity. I do not take illness well. It portends the terrible, nothing more. There is no beauty nor grace nor redemption to be found in illness, nor recovery from it. That is a myth that the twelve-steppers would have you believe. You might be happy for a person that has improved their life through abstinence, but nobody envies their condition. Or rather, only the piteous would envy the treated and untreated ill among us. 

I would far rather be incoherent than to walk with a limp. A stagger can be interesting, when done well. A limp is mundane, anybody can do it, few do it well. Some might object to this honesty, but fuck them and their objections. People in pain say crazy shit. I might not hold that opinion forever, but if incoherence can not see me through to healing then perhaps the echo of these neurotic ravings will keep me company until that time appears.

If I were a doctor, dear, and you were a lady...

Save your love through loneliness, save your love through sorrow....