INSIGHTS

    "No matter what you've done for yourself or for humanity, if you can't look back on having given love and attention to your own family, what have you really accomplished?" - Lee Iacocca, Retired Automobile Executive

    "The easiest kind of relationship is with ten thousand people, the hardest is with one." - Joan Baez

    "Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around." - Leo Buscaglia

    "Wherever there is a human being, there is an opportunity for kindness." - Seneca

    "Life is merely the canvas for which you as the artist are able to create whatever you can imagine!" -Ian Boe

    "Motivation is what gets you started. Habit is what keeps you going." - Jim Ryun

For Laughs Only

     An old man was sitting on a bench at the mall. A young man walked up to the bench and sat down. He had spiked hair in all different colors: green, red, orange, blue, yellow.
    The old man just stared at him.
    The young man said "What's the matter old fart, never done anything wild in your life?"
    The old man replied, "Got drunk once and had sex with a parrot. I was just wondering if you were my kid."

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    A minister sold a mule to a priest and told him that the animal was trained to obey two commands. "Praise the Lord" to go and "Amen" to stop. The priest climbed on board the mule, said Praise the Lord" and the mule set off. The mule began to go faster and faster and the priest began to get worried. He wanted the animal to stop but he couldn't remember the key word. He kept saying "Whoa" but it had no effect.
    Finally he remembered and said "Amen." The mule stopped immediately. The priest looked down and saw that the mule had come to a halt right on the edge of a huge cliff with a 500-foot drop. Wiping his brow in relief, the priest sighed: "Praise the Lord."

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    Two men were watching a Western on television. As the hero rode on horseback toward a cliff edge, one of the men said: "I bet 50 dollars he goes over the cliff."
     "You're on," said the other man.
    The hero rode straight over the cliff.
    As the second man handed over the money, the first man looked at it and said: "You know, I feel a bit guilty about winning this because I've seen the film before."
     "So have I," said the second man. "But I didn't think he'd be stupid enough to make the same mistake twice."

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Buffalo Rhapsody Ernesto Yu, M.D. CIM Class 1973

Stolen Moment

    If you leisurely browse through the English language, there is an excellent statistical probability you’ll score a hit that keeps on throbbing in the words “Stolen Moments”. This lovely pair could bog you down in predictable sentimentality if you equate the catch phrase to an unrehearsed chirp of love in the afternoon or a coincidental whistling of the same cooing serenade in the park. On the other hand, the two words can tap into the upper limits of your fear threshold and manufacture a quivering jelly out of your manic energy if you are abnormally susceptible to spine-tingling terms like “hijack” and ransom notes”.

    At any rate, depending on the mood swing of your hormone clock, stolen moments is an inseparable duo that is here to linger and be an active terminology particle in our daily vocabulary. Unquestionably, it is a byproduct of fresh lingo that currently floods our new millennium psyche.

    Our annual alumni reunion is a downright model of such harmony between an adjective and a noun. For those of us who love to pine for the exuberant remnants of the CIM past, the wondrous yesterdays that we temporarily shove off the shelves due either to diverse personal goals or good/cruel circumstances, our convention soups up a pot of stolen moments for everyone to soak into and sigh, “Yes, this is the life I have been missing!” It is the tantalizing flash in time when we can sieve the charred ashes of wonderfully charming tales under the CIM banner of shimmering sun and glowing moon, to learn to cherish the rhythm in the rain, to distill poetry and melody out of the plain verses and lyrics of genuine handshakes and hugging hellos, to affix back into loveliness the vital ingredient “love” that makes breathing worth the cycle of inhale and exhale. It is the day in the sun for the bored-to-the-bone-with-daily-little-deaths who harbors an unflagging craze for memoirs.

    Personally, it is a marker in my life where I revisit the old heavens for the army of angels I left behind: mentors, heroes, buddies, sweet pals and drool-only inspirations who intermittently inject social dazzle and infuse healing warmth to my reveries of the last 29 years. It is the ultimate “now” to extend to each of these remarkable souls, while time stands still, the singing rainbows that they composed and sprinkled into my skies, and the difference they implanted into my orbit that molded me into what I am today. It is a segment of a daydream where I can amble with species (endangered, extinct and never mind) of the Stone Age along the ancient familiar marching echoes that, once allowed to pulsate, would invariably saturate the airwaves with cracking noises of arthritic joints and smokers’ coughs. Furthermore, it is an encounter where I can trade intro remarks with a breed of younger alumni who populated the CIM campus just when I evaporated from the smooth jazz clouds of the Bee Gees and the Carpenters. Likewise, it is the click of a new beginning to accept welcome whispers from the crawling babies who later inhabited our alma mater when I was already engrossed in cadaver dissection in Manong Ogay’s building.

    For the privilege to be exposed to such stolen moment, I can only wish that a chance meeting like this just doesn’t melt away without imprinting enduring footprints. Traces that will make me yearn, against anything else in this world, to make a habit of flying to our designated yearly July rendezvous even if such remote region (Next year, San Diego) demands almost a day of tormenting hops from one airport to another coupled with nauseating doses of motion sickness. After all, traveling back to a site where old gang regroups, huddles and revives the once-upon-a-time is not registered in my book as a mere summer vacation trip.

    It is a stolen moment to be home.

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Did Hippocrates Swear His Oath?

    Sometimes I wonder if Hippocrates, the Father of Medicine, really swore to the Oath attributed to him. Some of our modern colleagues swearing to this Oath may find it indefensible and disturbing, especially on the issue of abortion, surgery and euthanasia. But let us study this document that we all pledge with raised hands or hands on our hearts upon induction to the practice of our noble profession.

    Our lives are invariably influenced by the dichotomy of science and religion. Both teachings claim the way to Truth and Enlightenment. Religion is founded on Faith and its truths cannot and should not be diminished and need not be proved. On the contrary, Science arrives at the truth by Doubt, a dogged investigation and critical debate of proof. Nevertheless, mankind from ancient to modern times has become enlightened either way.

    Science is a systematic knowledge of the physical or material world gained through observation and experimentation. In its simplest definition, it is our knowledge of nature. The laws of nature follow order and regularities that the human mind observes and draws conclusion from. While the human mind reflects the outside world, it is in itself limited to what is perceived by the five senses. These observations are subject to pitfalls of interpretations. By and large, man is able to accept what is real or substantive and reject what is not by trial and error. This approach of learning embodies the knowledge of nature upon which man came to rely more accurately for survival.

    Medicine is an art variedly practiced and constantly improved and modified with adroit and sophistication. The science behind it has evolved from dogged didactics and critical attitude of polemics, in order to arrive at the truth. Ideally, medicine strives to achieve results with precision and not giving up to chance.

    Disease has been present even before man appeared in this planet. Evidence has shown inflictions in fossil remains of dinosaurs. Man at first accepted death and disease as part of existence. As life became placid, pain and suffering from disease draw natural and, in more serious cases, supernatural explanations, caused by spells cast by enemies, malevolent incursions by demons or bad spirits, or punishments from an offended god. This required counter spells, potions and incantations to lure back errant soul. At the same time, he also noted the order and regularities of things around him. He could apply certain observations to his advantage and chances for survival.

    Primitive cultures gained knowledge of nature that dictated their way of life. They learned to hunt based on the migratory pattern of birds and animals and plant according to the changes of the seasons. While they looked up to the heavens for wonder and inspiration, they invented some form of calendar for practical and religious reasons. Solar and lunar eclipses and appearances of comets were heavenly phenomena that inspired awe and alarm.

    About ten thousand years ago, Mesopotamia was a tilled, fertile land between the great rivers of Tigris and Euphrates. Five thousand years later they left a legacy in a system of writing called cuneiform by the Sumerians. This cradle of civilization is the origin of the wheel, the arch, uniform weights and measures, the clock dials and the sexagesimal system, which we come to know as present day sixty-minute hour. Later civilization centered in Babylon, Hammurabi set his code of laws which included the practice of Medicine with severe penalties like cutting off the hands of a doctor who kills a patient in the process of opening an abscess and in some cases, if the patient was a slave he was simply obliged to supply the master of another slave.

     Astronomy was the first science to emerge. However, like the Egyptians, the Chinese, the Indians, the Mesopotamians and the Mayans, astronomy was welded to religion. Religion had the answer to all vicissitudes that fell upon the people. The Babylonians believed that order exists only when the capricious gods supported it. These people described nature and use it, but religious proscriptions prevailed upon critical thinking.

     While theology attained its highest importance among these cultures, the Greeks had their gods and goddesses in foolish childish flings with mere mortals. The Mycenaean values and events, while passed along by poets like Homer, did not attain the highest esteem accorded to the Egyptian God or Jehovah. This became a fertile ground for the Greeks to seek reasonable explanations of natural phenomena not merely arbitrary will of the gods.

    In 6th century BCE (Before Current Era), the Greeks supplanted theocracy of other civilizations with teleology – the doctrine that phenomena are guided not only by mechanical forces but that they also move toward certain goals of self-realization. The first of these natural philosophers, notably Thales of Miletus, predicted a solar eclipse in 585 BCE and invented the formal study of geometry. He named water as basic element of all matter but was quickly criticized by his disciple Anaximander, who argued that water is essentially wet; therefore it cannot be a basic element because it contradicts itself. Two hundred years later, natural philosophers accepted four basic elements: earth (cold and dry), fire (hot and dry), water (cold and wet), and air (hot and wet). All bodies were made from these elements. This critical thinking and the art of disputation laid the fundamentals of science we know today.

    The Hellenic tradition of science peaked during the time of Aristotle and Archimedes. A biologist, Aristotle studied marine organisms and its teleological existence. This work was the framework of the science until it was challenged by Darwin’s On the Origin of Species by Means of Natural Selection, or the Preservation of Favoured Races in the Struggle for Life, published in 1859. In living organisms it is easy to understand the doctrine of teleology, since the organism has its primary function of self-preservation and self-perpetuation. In physics, this is not so obvious. To impose the doctrine to the cosmos, he had to borrow from his teacher Plato, the theological proposition that heavenly bodies are literally divine and, therefore, perfect. They all moved in eternal, unchanging perfect circles. In the divine schema of the universe, the Earth, being inert and imperfect is at the center. At various levels of concentric crystalline spheres are the moon, the sun and the cosmos. Outside the cosmos is prime, unmoved mover God, the ultimate cause of all motion. This philosophy obviously borrowed from the Greeks epitomized the religious teachings adopted by the Romans and subsequently Constantine’s adoption of Christianity, notwithstanding the critical Greek thinkers that constantly challenge the dual nature of Jesus Christ as God and Man.

    In the 5th century BCE, Greek natural philosophers, notably Hippocrates and his school at Cos, established precepts from the treatment of diseases to professional conduct by physicians. They insisted that disease was a natural, not supernatural, phenomenon. It challenged the practice of casting spells, prayers and propitiatory measures to a malevolent demon or offended god. The art of healing was elevated to standard of care that has been adapted even to the present times.

    The Corpus Hippocraticum embodies the practice of Medicine during this period. In 4th century BCE Ptolemy assembled at the Library of Alexandria this collection of about seventy-two books and fifty-nine treatises by different authors from Cos, Cnidos, Sicily and elsewhere. It is virtually impossible to determine authorship. Hippocrates, historians argue, refers to Hippocratists or Hippocratics, who by their written contributions shared their knowledge of Medicine for generations.

     The Collection dealt with varied topics that may be difficult to classify as one would browse through the pages of a scientific journal. However, general beliefs could be categorized into different fields of study like anatomy, physiology, general pathology, therapy, diagnosis, prognosis, surgery, obstetrics and gynecology, mental illness and ethics. Most famous in the Collection is the testament that affirms and prohibits certain norms of conduct of the physician. 

    Like the rest of the world for centuries, I as a graduating medical student swore to the provisions in the Hippocratic oath though in a modified and abridged version. Some of the provisions including abortion and surgery have become less relevant in our times. However, the substance and the spirit of the pledge remain sublime.

    An English translation by Ludwig Edelstein from the original text of the Hippocratic oath states:

    I swear by Apollo Physician and Asclepios and Hygeia and Panacea and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

    To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art – if they desire to learn it – without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but to no one else.

    I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

    I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

    I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

    Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief, and in particular of sexual relations with both female and male persons, be they free or slaves.

    What I nay see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must speak abroad, I will keep to myself, holding such things shameful to be spoken about.

    If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

    Scholars have questioned the relevance of the Oath even during the time of Hippocrates. It is at variance with some teachings of Hippocrates like abortion and surgery, which were widely practiced. Thus, it was unlikely that physicians at Cos swore to such untenable interdictions. It is believed that the Oath was Pythagorean in origin but was incorporated to the Collection centuries later. Pythagorean philosophy abhors taking of life within or outside the body, and advocated against any form of surgery, even bloodletting, for they desecrate the soul.

    The earliest reference to the Oath goes back to the first century CE (Current Era, formerly referred to as A.D.) when Christianity prevailed upon religious ideals of the time. Christian doctrines even today incidentally are consistent with Pythagorean philosophies in abortion and surgery. This probably explains why this non-Hippocratic document has remained firmly the symbol of a physician’s pledge to his calling.

    In a present scenario, a pro-Choice health care provider may find swearing his Oath quite untenable and unsettling. While this debate is fueled by a dichotomy of conscience and reason, ergo Religion and Science, we tend to be influenced by the prevailing forces of the time, exemplifying a non-Hippocratic Hippocratic Oath. Did Hippocrates swear his Oath? Maybe not. Yet this document has been sworn to innumerable times and innumerable times it has been breached.

    The most notable part of the Oath is the pledge to act in purity and holiness. The pledge to conduct oneself in a way considered appropriate behavior of a physician is in essence the Hippocratic Oath. Invariably this speaks of humankind transcendent of national identities and religious following for all times. The incorporated interdictions on abortion, surgery and euthanasia are variables in the changing practices of the art of Medicine. 

Suggested readings: 1) AS Lyons and RJ Petrucelli, Medicine, an Illutsrated History, Abradale Press, New York, 1987; 2) Science and Religion, Macropaedia, Vol. 27, The New Encyclopedia Britannica, Chicago, 1992.

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