In 1736 I lost one of my sons, a fine boy of four years old, by the small-pox, taken in the common way. I long regretted bitterly, and still regret that I had not given it to him by inoculation. This I mention for the sake of parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.
Primum non nocere, 'First, don't make things worse,' was an essential principle of Hippocrates' medicine. Nowadays, unfortunately, it seems to have been forgotten. Conventional modern medicine aims at getting rid of patients' symptoms. Little, if any consideration is given to the fact that some of these symptoms may actually be used by the body in an attempt to correct deeper disorders. When this is the case, suppressing the symptom does not necessarily help the patient.
One of the first things we teach medical students is to listen to the patient by taking a careful medical history. Ninety percent of the time, you can arrive at an uncannily accurate diagnosis by paying close attention, using physical examination and sophisticated lab test to confirm your hunch (and to increase the bill to the insurance company).
Physicians, patients, and ethicists must also understand that acknowledging abuse and encouraging African Americans to participate in research are compatible goals. History and today's deplorable African American health profile tell us clearly that black Americans need both more research and more vigilance.
I love the imagery of struggle. I sometimes wish I were suffering in a good cause, or risking my life for the good of others, instead of just being a gravely endangered patient. Allow me to inform you, though, that when you sit in a room with a set of other finalists, and kindly people bring a huge transparent bag of poison and plug it into your arm, and you either read or don't read a book while the venom sack gradually empties itself into your system, the image of the ardent solider is the very last one that will occur to you. You feel swamped with passivity and impotence: dissolving in powerlessness like a sugar lump in water.
..I don't count Jennifer among my mistakes. She had a severe infection and precious little reserve. Nevertheless, I think of her often. Those minutes of terror and confusion I felt standing powerless in her room served as a visceral reminder throughout my training... that the big picture isn't enough in medicine...