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 to 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.Everyone has a right to equal care... bla, bla, bla.
Today, there are discrepancies that for whatever reason have prevented the Hippocratic Oath from being properly followed. It is neither a surplus of disease or lack of competent doctors that is causing this shortfall of care. Just as healthcare should aim at disease prevention, the healthcare system should address the cause of the problem; society. Thank you, Bernie, for making it clear to me.
Health Care Crisis in America: The Way to Avoid It
Bernie Siegel
The present health care crisis is not just related to health care; it is a crisis related to what is happening in our society. We have become depersonalized as a society, invested in technology and not the experience people are having. Consider this: studies verify what happens to children who grow up unloved and experiencing indifference, rejection and abuse -- by midlife if they haven't killed themselves and others while seeking revenge and experiencing guilt related to their actions, almost 100 percent of them have experienced a major illness, while loved children have one-fourth the serious illness rate.
Information does not resolve unhealthy behavior. People who smoke or are 200 pounds overweight are not acting out of stupidity or a lack of knowledge. What everyone needs is inspiration. When parents, teachers, clergy, doctors, politicians and other authority figures display their love for individuals they are related to or caring for the health of the planet and its residents will improve. This is not about liking what people are doing, but it is about loving them and maintaining a relationship with them until they realize they are worthy and loved. At that point they begin to follow instructions and behave in a manner that is life enhancing and not self destructive. I know this from my experience as a surgeon who did not reject his patients.
When you grow up without love what you seek are rewards and feelings that you never experienced in a healthy way. So individuals turn to addictions of drugs, food, alcohol and more as a way of rewarding themselves and numbing their pain. We need to listen to each other and treat the wounds of the individuals we are caring for and about. Studies reveal that when a patient states that their doctor listened to them during their office visit they are far more likely to take their medication and follow the doctor's advice.
Society should see parenting as a public health issue and help parents to bring their children up feeling loved. We have birthing classes but no parenting classes. The latter is desperately needed if we are to avoid self destruction. All authority figures in a person's life become either destructive or constructive parents for the individual. This includes everything from global warming to obesity. If you grow up with a sense of self worth and esteem you are far less likely to behave in a destructive and unhealthy manner towards yourself and others.
As the father of five children I know the importance of letting the children know that parental discipline comes from a sense of love for them. Then they follow directions because it gives a new sense of meaning to the message. I was called a CD by a suicidal teenager, who is alive today because I became her Chosen Dad, who loved her. We all have the potential to re-parent ourselves and others.
Doctors also need to understand that what people need is treatment of not just their diagnosis but their experience. When you ask patients what they want from their doctors they do not ask that every disease be cured but they do ask that doctors: Knock on my door, look me in the eye when they talk to me, say hello and goodbye and call me by my name.
Having a disease is an experience which varies with every individual. If you ask one hundred people with the same illness to describe their experience you will get a different answer from almost every one of them. I know from experience as a physician who has counseled cancer patients and others for decades. The words they come up with relate to their life and help me to treat them and understand their woundedness.
When a major medical journal publishes a pharmaceutical ad which reads, "I was depressed, unable to cope. I went to see my physician. I said you've got to help me. He prescribed an antidepressant and I feel wonderful now," I wrote in criticizing them for ignoring the patient's needs and responding so impersonally and asked them to insert a sentence which asked what was happening in the patient's life. They canceled the ad.
I know doctors whose salaries were capped because they talked to patients four minutes longer than the department average. The American College of Surgeons' pledge ends with, "I will deal with my patients as I would wish to be dealt with if I were in the patient's position." I gave up trying to get them to change it to care for my patients as I would wish to be cared for. The only way to avoid a health care crisis is to care for and about the people who need our care. We also should reward those who remain healthy. If I do not require a doctor's service, except for an annual physical exam, or any medications why not reward me at the end of the year with a refund or lower premium on my health insurance. If I am a safe driver I am rewarded. So why not reward me for safe and healthy living and let those who are self destructive pay the price and maybe rethink their actions if it becomes costly for them.
We also ought to be sure that all future doctors and health care executives spend a week in a hospital bed so they no longer are tourists but have the native's experience. The former CEO of the Ritz Carleton Hotels, Horst Schulze, changed the way the hotels were run after he spent time in a hospital being treated for cancer. He humanized them so employees took on the problems of their hotel residents and greeted them by name. Every employee gets a list of 20 behavior patterns that they are to adopt. Some hospitals have used this list when I gave them a copy.
We also need to understand that we have something to learn from patients who do better than expected. There are cases of self-induced healing and we can learn about survival behavior from these people and teach it to others. Relationships, connections, meaning all are survival behavior qualities. It is no accident that women live longer than men with the same cancers and that married men live longer than single men and have less lung cancer than single men if they are both smokers.
We could cancel Monday and reduce the rate of heart attacks, strokes, suicides and other illnesses. Truth is that wouldn't work because Tuesday would now be the problem. Again we need to teach people how to cope with stress and how to control their depression, fears and other self-destructive emotions. Your body loves you but if you do not love your life it will end it far sooner, thinking it is doing you a favor.
Mind-body medicine should not be an "alternative," nor should complementary and integrative medicine be something doctors are not exposed to during their training. Medical journals which are supported by pharmaceutical advertising do not print articles which would expose doctors to alternative therapies. When patients are diagnosed with an illness they should be given instructions, not just a pill to swallow, about how to enhance their immune function and act like someone with an immune competent personality.
Psychiatrist George Solomon saw the benefits of such behavior early on when working with HIV positive patients, and I see it in cancer patients and others. Doctors need to be teachers. Doctors also aren't trained in mind body medicine. They are not told about Carl Jung interpreting a dream and diagnosing a brain tumor. Yes, mind and body communicate and the inner wisdom is also vital to survival. The patient's beliefs affect the outcome of therapy. When chemotherapy is portrayed as the devil giving you poison you are in big trouble. So doctors need to be taught how to communicate and enhance our healing potential. Scalpels can kill or cure and so can words become swords.
Survival behavior means people should not be submissive, suffering patients but respants, or responsible participants. One hundred thousand people a year die from medical errors. Patients need to be known as people and not by their disease or room number. We need to humanize the system for both the doctor and the patient. Then doctors will know how to deal with their feelings and loss and not just think and separate themselves from their patients so they will feel less pain if their patient dies. There are many famous paintings showing the doctor sitting next to the patient's bed, chin in hand, thinking while their patient is dying. We need to reach out and touch each other and to quote a young man who died of AIDS. "What is evil is not the disease but to not treat the person with the disease with compassion."
My life as a physician was changed when my patient with breast cancer said to me, "You're a nice guy. I feel better when I am in the office with you. But I can't take you home with me, so I need to know how to live between office visits." I started support groups to help them to learn. I was amazed at how few patients came to the groups when I offered them a longer better life if they attended. I learned that if you grew up with guilt, shame and blame, due to parents, teachers and religions, you were afraid to participate in your own well being. That is why the group became ECaP or Exceptional Cancer Patients. What I learned was when you helped people to live they derived physical benefits from their new joyful life and didn't die when they were supposed to. The best hospices have graduations and drop outs too.
If I were in charge of health care I would also reward those people and companies who show the benefits of treatments that they can't patent. A tax deduction or some other financial reward would help lead them to investigate more natural therapies and treatments rather than reject them as unproven or unknown.
I have continued to run support groups for over 30 years. I have also benefited from the therapy. I have learned that people are not statistics and that we have to help them to achieve their potential and not see death as a failure or lost battle. When we see disease as the enemy and only focus on killing the disease, we empower our enemy. As Mother Teresa said, "I will not attend an anti-war rally but if you ever have a peace rally call me."
We need to help people to heal their lives and bodies and benefit from the healing and the internal environment it creates. We give messages and instructions to our genes and so our lifestyle and personality all affect our vulnerability. Just as bacteria, viruses and plant life alter their genes to survive antibiotics, vaccines and the environment, so can we. Medicine needs to focus on the people with the illness and not just the disease.Without first adapting the mindset of society, the healthcare system will fail. It doesn't matter if Obama is running the show or if its this genius Bernie Siegel. So how might the mindset of society change? Obviously by a giant asteroid impacting the earth on 12/21/2012. DUH.
BA-out
