First, Do No Harm

First, do no harm or the Latin “primum non nocere” is a sacred and fundamental principle of medicine. Did you think there would be Latin in this blog? I didn’t! But here we are, dear readers! What a wild ride!

I am a board certified internist. I don’t get heart palpitations and sweaty palms writing this, because although I am trained as a physician, I don’t practice medicine. For those of you who know me, which I think is all of you reading this blog at this point, you know how seriously I take this phrase.

It is part of the reason that my heart rate would increase into the 120s when I was an intern. If I’m being open and honest, it is why my heart rate would transition into sinus tachycardia during more of residency than I would care to admit.

I take this saying to heart, no pun intended. Let’s not increase the suffering of those who are already suffering. Don’t kick them when they’re down.

This seems like a simple principle, but in reality and in practice it is quite complex. The medical system is difficult to navigate – both as a medical provider and a patient – I know because I have been on both sides of this equation. Also, I know this because I am confidently stating I know this, so don’t feel like you need to double check me on this.

Side note – It drives me crazy when a person confidently states something (it can be anything really) without actually knowing what they are talking about, but because they are speaking confidently everyone believes them. Pay attention – this happens all the time. It happens in medicine, in politics – hello President Trump, and in mundane, everyday life.

Anyways, how do we accomplish doing no harm? How is a physician not paralyzed by this concept? I’m asking for a friend. Seriously! Why can’t I use emojis on this thing!

If you are a human being that has traversed the medical system, or know of a human being that has, you probably know that we aren’t doing a stellar job of this. Harm – both big and small – is happening all the time.

I’ve lost track of how many women in my many FaceBook support groups were told by a physician that their lumps couldn’t be cancer. They were too young, or too pregnant, or it was a blocked milk duct. Some of those women went on to develop Stage IV breast cancer because no physician took these women seriously until in some cases it was too late. I’m fairly certain that some of those women are dead.

Well fuck. That is some serious harm.

My mentor would say that the ego is the problem. He would use the word hubris. But, he is much smarter than I am! Again, it comes back to if someone is confident most people will believe that person, regardless of if they are right or wrong. This is probably why another commonly repeated saying in medicine is “trust but verify.” Trust that your superior knows what he or she is talking about, but look that shit up.

When I started writing this post, I planned on talking about the inefficiencies and inadequacies of the medical system, but I think that is still a post for another day. Don’t worry, you will be regaled with tales of my waiting on hold to make appointments or waiting for the fine needle aspiration to confirm metastasis another day.

By the way, that is happening today. Fingers crossed it is tuberculosis!! Again, emojis would be great! It is going to be so embarrassing when someone points out to me that I can in fact use emojis on this thing!

Let’s pray that the interventional radiologist does no harm to me today, in the form of a pneumothorax (I’m told this is fairly unlikely – but I have not verified!), and that the PET scan was a false positive, and I am actually cancer free!

And if you are indeed taking the time to pray for me, please pray for all who suffer and are less fortunate than me. Pray for the people who go to bed hungry or don’t know love or who have been abused, the list goes on and on. Pray for the suffering – it’ll only take two seconds – trust me!

Until next time readers, you can still follow me on twitter @reluctantoptim. Light and love to you all.