We are accustomed in the profession of medicine to be in the position to care for and serve people from a variety of disparate occupational backgrounds and from all facets of society. We serve the poor. We care for the privileged. We are destined, at some point in our training, to care for the least of these. Such is germane to the general altruism that is the profession of medicine, and why many of us were attracted to our esteemed and beloved profession in the first place. So much has changed in these days of pandemic, and this year has been one for the history books and the lesson plans to come, as we’ve all had to alter and rethink how we do so very much. The novel coronavirus directly presents its own challenges as a pandemic. The indirect consequences are that it too has caused global economic upheaval that is a pandemic in its own right and has led to a mental health pandemic unlike any other I have seen to date in my own career. Once again, so much has changed, and much of it not for the better. However, like we are accustomed to do based on our biological innateness, we adapt and evolve so that we can survive.
Yet, I’m quite bothered by so much lately, and what bothers me immensely is how some of our colleagues have acclimated to political pressures in an attempt to alter truth. I’ve noticed since I commenced practicing medicine, there is such a remarkable mistrust not entirely in the medical profession by so many but in the medications and the therapies that we prescribe and recommend to our patients despite those therapies being evidence-based. Some seem to prefer to experience the natural progression of diseases rather than take a medication that will slow the progression of or even cure said diseases. It is quite stupefying because I didn’t expect to witness it so often. I’ve come to realize that apropos to the art of medical practice is the ability to combine skillfully one’s knowledge with the means of rhetoric to present to the patient the treatment options that are best, most cost-effective, and are backed by data to provide the greatest benefit of healing and cure after exposing the weight of any possible side effects. I get that.
What I do not get is colleagues in certain positions tailoring their explanation of the facts and truth to comply with political ideology instead of scientific knowledge. This was never more apparent than in recent days during press conferences on the President’s health after his contracting of COVID-19 and the flippancy in terms of how details were presented regarding his care and his release back to work and campaigning. This no doubt affected the national security of the nation and the dozens of aides and Americans citizens who work in and throughout his White House. I found it morally and socially irresponsible for truth to be a casualty of the political climate and tailored to partisanship instead of medical facts being explained in a pure and concise form so as not to conceal the truth. This ill-fated practice is not becoming of our profession or befitting of the white coat. It must cease at once before our profession in its entirety loses our standing and grounding of trust with the American populace we serve.
Patients seek our expertise because of the trust they place in it and us. We are relied upon to present facts, truth, and scientific evidence in the process of health care delivery, and if we do otherwise, we are bending to the forces that have an unescapable grasp on how we are perceived by not just one person but all who we dare deem as patients and who deem us their physicians. I speak with hyperbolic terms because it is just that crucial. I read somewhere once that a “little leaven leaveneth the whole lump.” A little bit of altering of the truth by a medical professional in front of the cameras in positions of high authority with millions watching and listening goes a long way. We must remember that when we do so as health care professionals, we are breaching those basic ethical principles that are centripetal to the very essence of our noble occupation, and they are:
- Autonomy: respecting the patient’s decisions about his or her own health
- Non-maleficence: doing no harm
- Beneficence: promoting the best interest of the patient
- Justice: distributing medical resources and benefits fairly
Incomplete and misguided information by the president’s physicians, purporting of herd immunity as the supreme antidote to stem the tide of the coronavirus while thousands lay dying, and even alterations in terms of how the coronavirus is spread by the Centers for Disease Control all recently threatened to disregard these principles and breed mistrust in the medical profession—a profession for which I have an endless love. It is a tragedy that befalls us all when even one of us doesn’t tell the truth and attempts to alter facts about a patient’s condition just for the sake of political expediency.
Truth is irrespective of a patient’s status and title. Truth is irrespective of how much money a patient has. Truth is irrespective of what political office a patient holds. Truth is not a function of a re-election, campaign, rally, or any other political event. Truth is truth—pure and unobliterated, and it must be respected and presented at all times. We are physicians, researchers, and scientists, and we must always remain tangential to the political pressures of the day. They are the winds that blow westward and eastward over the trees and the forests. We and our profession are the trees, planted by rivers of water, that cannot, should not, must not, and shall not be moved. In the knowledge of that, we must remain steadfast, lest we do our patients, our society, and our professional training a tremendous detriment.
Earl Stewart, Jr. is an internal medicine physician.
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