Is First do no harm really part of the Hippocratic Oath?

When Professional Responsibility class began, I was most excited at the idea of not having to sit through another lecture on proteins and cell transport.

I was also looking forward to the class where we would be using clickers from the Library to poll audience responses during the lecture, as doing something while listening to someone talking has a much higher success rate in getting me to pay attention for 50 minutes straight. Our first class did not disappoint, or crush my high expectations. It included a history lesson about the Hippocratic Oath, and this, I found incredibly interesting.

The Hippocratic Oath is as follows:

“I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement: To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art. I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion. But I will preserve the purity of my life and my arts. I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.”

After reading the oath out loud, our professor then asked us the same question that I will ask you now (doubtfully in the exact words): Knowing that this oath is what popular culture has come to represent physician-hood by (you can purchase t-shirts, posters, throw blankets, and even vacation packages, related to it), what are your thoughts when you read this, many of you, in its actual language, for the first time?

If you are like many of my classmates, swearing that as doctors, we would not perform physician assisted suicide or an abortion would be bothersome. You might also be wondering why surgery would be considered a lesser profession, why we would need to swear to “keep [ourselves] from all intentional ill doing and seduction”, or why we would need to share our goods with our medical professors (as if most people being in a debt to the government or to the school was not enough, now, we must also be indebted financially to our professors and their sons). Even still, you might wonder why we would be making the oath to the Greek Gods anymore, when most of us do not even know who each of these Gods actually is or what he is supposed to do.

However, if you are like my Professor (and a much more seasoned, astute observer), the first thing that you will notice is that the oath does not, anywhere, contain the words “First do no harm,” a phrase that has become synonymous with this oath in popular, and even medical, culture. I must admit that when he first said this I reread the words over and over hoping to find something he missed, as I could not believe that this omission was possible. While even my Professor could not explain the root of this almost rumor-like association, I feel like someone invented those particular words for the oath because well, unlike some of the other phrases in the oath, they actually made sense.

Knowing what the oath literally says, I am excited by the fact that when I graduate I will get to spend time with my classmates writing our own oath, one that is relevant to us, but yet, an important promise nonetheless. While I do not think we need to promise something so obviously outdated as the real oath is to current medical practice, entering a field of service, and of duty, I do believe some semblance of a ceremonial rite of passage into the profession and an acknowledgement of all that it entails, is necessary. For now, as I go on this medical school journey, I will simply swear to do my best for myself and eventually for my patients, to learn with every opportunity that I have to do so (from my teachers, my classmates, and my patients), and to never lose my humanity, my humor, or myself, in this long, tiresome, and grueling training process. Amen (to all the Gods wherever) for that.

Jessica Gold is a medical student.

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