The road to health is paved with good intentions

[Hippocratic Oath IV]

What’s it all about, really? Medicine, I mean. What is the point of this crazy job that we do? Promoting wellbeing? Complete forms for pleasure and profit?

“I will use treatment to help the sick according to my ability and judgement, but never with a view to injury and wrong-doing.”

Ah, so it’s about treating sick people! I’d always wondered…

It’s just a beautifully simple statement of fact, isn’t it? Right at the start – I’m going to treat sick people. That is the core role of a doctor. But how much does everyday busy-ness get in the way of this! How easily we get distracted from the fact that we have a responsibility to treat sickness and allay suffering. Don’t ever forget this. When the job gets to you, remember – I’m here to treat sick people. Whenever you’ve got your mind on the pay cheque at the end of the month, rather than the patient in front of you. This is my job, my vocation, my calling, and I’m going to follow through to the best of my ability. Whenever you open your inbox on a Monday morning. Whenever you read the complaint letter. Whenever the phones go down, or the computers go down, remember – I am there to treat sick people. Whenever the Board, or the Trust, or BSO, or whoever passes down the next daft dictat. Whenever there’s a queue at the door after a long bank holiday – it’s a queue of sick people. Scared people. Hurting people. Dying people. Worried, anxious, despairing people. But they are people. They are humans, made in the image of God, and they deserve our full attention, respect and expertise. Don’t ever forget the personality of the person who’s script your signing, who’s death certificate you’re writing, who’s sat in front of you angry, or tearful, or palpitating.

Because we are people too.

We are not God, nor gods, nor heavenly exalted beings, but sinful, distracted, error-prone people. But then, the Hippocratic Oath is a document for people, not demiurges. It assumes that there will be a range of abilities and skills, ranging from nearly-perfect to  nearly-competent. There is mercy in this Covenant! What is being measured is intent – our intentions must be pure, even if the carrying out of those intentions is imperfect. There is never room for deliberate injury. There is never room for deliberate wrongdoing. These are absolutes. In the same way, there is no mercy for deviation from good intent. It is the foundation upon which we can then exercise our judgement, and apply our abilities appropriately. I could probably illustrate this with a flow chart, but I won’t, for reasons of common decency, and because I am not in work.

And we will see shortly why intentions and motives are key to understanding the ethos of the Hippocratic Oath, and how deviation from this spoils the whole thing.