Sawbones: A Marital Tour of Misguided Medicine - Sawbones: The Hippocratic Oath

Episode Date: October 11, 2019

We've all heard about the oath new doctors have to take before they get their first scalpel and weird head mirror thing. But has it always been the same? Did Hippocrates really make it up? Is "First, do no harm" part of it? We'll answer all that and more on this week's Sawbones. Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. Hello everybody and welcome to Saw Bones, a metal tour of Miss Guy to Medicine. I'm your co-host Justin McAroy. And I'm Sydney McAroy. There's a switch on the front of my microphone. It says pad and one setting is negative 10 dB

1 is zero. For the past three weeks my microphone has been too quiet and I have had no idea why and in the seconds The microphone has been too quiet and I have had no idea why. And in the second, preceding this, I just found that little switch in front of you and all is fixed. I had the same problem when I was recording still buff because I use that mic. Yes. Yes, that makes sense now.

I just saw a nightmare is over with us audio professionals. It's not Riley was really loud. It's not loud. I'd never noticed how loud my sister is. Justin, I got an interesting email that inspired this week's topic. We are what? Do you got an interesting email? I mean, I love the one too. Well, I mean, sobbing it. Sobbing it, sobbing it, sobbing it. So you got it as well. It's just I'm the one who checks them. I gotcha. Literally, I have to forward emails to Justin's other

email account for him to read them because I am solely responsible. I feel I'm a digital professional and have been so for the past 15 years. I feel it's important for one person to have dominion over each email address or else you're going to lose things, the things will slip between the cracks. Did I read that? Did I read that? Well, it's me.

Well, it's me. Yes, Sydney has volunteered in this case to add it to the invisible work of women. But it's our invisible work that we are unappreciated for. Now, that's not fair because I make Gryffin read my brother and brother and me and Travis read the adventures on emails.

So it is spread around very evenly. Yeah. And Dan reads the empty bull emails. But other than that. Are there any more podcasts you do you'd like to plug? Or I'm just plugging the fact that I don't empty bowl emails. But other than that. Are there any more podcasts you did like to plug or? I'm just plugging the fact that I don't read the emails. There's just a bit. That's the bit, is that?

I make everybody else read the emails. Can I tell you about the email now? Yeah. Guess. I got an email from Ashley who asked if doctors really do pledge and oath to Apollo. Is that what the Hippocratic oath is? Are we actually like swearing to Apollo or pled oath to Apollo? Is that what the HIPACRADIC oath is? Are we actually like swearing to Apollo or pledging to Apollo? Like God of the Sun Apollo.

Is that true? Well, I had to stop after I read that email and think, did I? Did I do that? If Apollo came to my door, I was like, uh, Sydney, I need a ride to the mall. Which is a no-to-me. You pledged a no-to-me, I need $30 to the mall, which is a no to me. You pledge a no to me. I need $30. What do you have to?

Well, that's what I thought. You know, I've read the Hippocratic oath many times in reference to various things on the show and about Hippocrates, but I couldn't remember what oath did I do and was it that one? And it had some whack stuff in it, so probably not. So anyway, thank you Ashley and also Elise and Logan and Lee, who have also suggested this topic, And was it that one and it had some wax stuff in it so probably not so anyway Thank you Ashley and also Elise and Logan and Lee who have also suggested this topic because I thought we would dig a little bit into what the

Hippocratic oath is and what doctors actually do or don't do today because it's it's changed It's changed. Yeah, now this is a surprise to me because you think Hippocratic oath or one oaths are like oaths. You can't just like make one up. And Hippocratic, that fool was around hundreds of years ago. Hippocratic. Hippocrates was around. Hippocratic and so great.

Hippocrates was around hundreds of years ago. Plotto. Okay. Is this the kind of episode it's gonna be where you're just gonna be giving me static the whole time? That's fine. I don't even care Sydney. 400 BCE. That's one. Supposedly.

So yeah, hundreds, tens of hundreds of years ago. Uh, supposedly. Although, you know, there's been debate over whether was it really Hippocrates? Was it sort of like a group effort, like physicians who studied under Hippocrates, like part of the Hippocratic school? Was it something that was done after him, maybe, like in his honor, but after he had already died? There's a lot of debate about this, and I'll get into some of the reason there's debate

is some of the stuff that's in it that doesn't seem to jive exactly with the rest of the Hippocratic corpus, like the rest of his body of works. There's some stuff that, you know, I don't know if this makes total sense. Now it was, it was in line with Hippocrates in the sense that he approached medicine from a very holistic point of view. Right? The idea that it's not like there's a thing there's an issue on this arm and here is the thing that goes on this arm that treats that thing for arms whatever the idea that like the whole person was the patient Okay, I know what you're gonna say. I know we're going the patient. Okay.

I know what you're gonna say. I know what we're going with us. Okay. That you can't treat the, you can't treat a disease. The patch says, patch says you treat the, treat, you treat the disease you win that you lose. You treat the person you win every time. Coming to theaters this fall patch, just a macarons stars

in the patch atoms, a remake of the original patch atoms. This generation's, his generations, Robin Williams, Justin McAroy takes on these big floppy shoes and that hilarious set the scope with the... What is it a hilarious set the scope? I think it was just a regular. Every time we put it on their chest, it makes fart noise. Normal set the goal. Every time you put a scope? I think it was just a regular. Every time you put it on

their chest, it makes fart noise. Normal. Step. Every time you put it on their chest, it makes fart noises. The nose was the thing.

Yeah, but every time you put on their chest, it makes fart noises. That was that was a new one. That's my nightmare. Yeah, by the way, if I go to the bad place when I die,

it will be I'll have to use a death scope that makes fart noises all the time. Well, it's it's tested very well with audiences in the patch atoms, starting just to macroe, so we're probably going to leave that bit in. Sorry. So anyway, that general idea that there is something special about medicine, about the medical art, about being a physician, in terms of how you relate to your patient, that idea is very in line with hypocrite.

And that's where the oath speaks to, right? The idea that this isn't just about like, oh, you have a sore throat, here's the pill for sore throat, by, it's, how are you feeling? How is this affecting you? What is it doing to your life? How can I help improve all of that? Mm-hmm. And that's a much higher calling so to speak than What is the thing that treats this illness? Does that make sense? Yeah, absolutely So the original oath and I don't want to read the entire thing. I want to kind of you can read it out loud

That's binding you have taken overwritten your last dose. The original oath, I want to kind of go through some of the points of it that make it, you probably will guess, have been changed in today's world. First of all, it does start off, I swear by Apollo, physician, biosclepius, by hygea, by panacea. So it's not just Apollo, you're swearing by a lot of gods there. So yes, that is true.

Now I will say that I am 99.9% certain I did not say that. You would remember all that, right? I have looked up, I have tried to Google what my medical school, which oath they took. I was just looking, I was gonna look for your, I thought I filmed looked up, I have tried to Google what my medical school, which I was just looking, I was going to look for your, I found I filmed your induction, but I think I was thinking of my cousin Megan who I filmed her induction. Mm-hmm.

Yes, I think you're right. I remember that. It's basically the same thing. Although, wouldn't it be the same now that I think about it? Well, it should have been the same, because I mean, well, my schools have changed over time, but they most have kind of picked one and stuck with it. I swear by, okay.

And by all the gods and goddesses, actually, that's the next part. So you're swearing by all the gods and goddesses. Oh, it's time. I swear by, here, I'm going to edit on the fly. I swear by all the gods and goddesses. There you go. You don't need to name any, but they name the important ones, I guess. So some of the things you're

swearing to do. So here's your oath. First of all, you're going to hold your teacher in this art equal to your parents. So like whoever teaches you medicine is like your new medicine, medicine, dad or medicine mom, him either way, not back then. Well, yeah. When he is in need of money to share mine with him. What? Yeah, if I'm learning medicine from somebody and they need money. Hey, hypocritees, it's Dan. The medical teacher, listen, can you slide, I got a lot of them. Can you see?

Can you see? Do you know how much trouble I'd get in if I started hitting up my medical students and residents for money? Can you just put it on in there? That'd be so wrong. Put it on Can you just put a one in there? That'd be so wrong. Put a one in there. Who on there about like if your teacher's hard-out for cash, you're just going to slide

them 20, drama. On the flip side, you pledge to teach your art without fee. Well, yeah, well that's why you're teaching. That's why you're teaching. It's money. This is a problem. And obviously has been changed in modern versions because as you may or may not know,

medical school is really expensive. So we definitely charge medical students. I would say as a former medical student, too much to be a doctor. I will use treatment to help with sick, according to my ability and judgment. Yep, that's good. Don't do injury, no wrongdoing. I will not administer poison. That's good. Well, you know, I bet you

all can't do that anymore, right? No, because it's about chemotherapy. Right. That has toxicity but also benefits. Yeah, I mean, obviously things are more nuanced than this. And especially the next two sections speak to one that you will never cause an abortion and two that you will never, what they say, use the knife. Basically, they're saying I won't do surgery. Mm. Now, it's not because it was a different. It was different.

Surgery was more of like a trade, like a skill. And it wasn't. So this is why I got to stand my lane. Yeah, it was. It was kind of like a trade, like a skill. And it was. I'll stand my lane. Yeah, it was. It was kind of like, I'll do the things I know how to do, but it also specifically prohibits abortion. And these are two of the reasons why people have debated over whether hypocrite is actually wrote this, just to kind of get into that.

Other places in hypocrite's writings, he talks about how to do surgeries. Specifically, they mention on suffers from stone. They're talking about like kidney stones or bladder stones here, and they say, like, I will not cut for the stone. Is another quote you'll hear. Well, he describes how to do that. So it seems weird that he would have you taken oath

never to do it, and then also describe how to do it. I think the idea that Stan your Lane is part of this, sure, but it's a weird, yeah, it's a weird phrase same, same with abortion. He actually describes how to do one in another place in his writings without any sort of like commentary on whether or not you should and so it It seems weird that then that would be put in the oath that you shouldn't

Later, so that's why part that's part of why people debate like, was this added later maybe and wasn't? Let me try to make a point. Yeah. He says that into whatever houses you enter, you will not do any wrongdoing or harm. You will not abuse the bodies of man or woman, bond or free. Part of this is that I won't have sex with my patients.

Hmm. Part of what is being spoken to. That part stays the same. They're out all oaths pretty much. You sound. Most oaths you take say don't, don't do it with your patients. Please. Please. Please, doctors. And he also says whatever I shall see or hear in the course of my profession as well as outside my profession and my intercourse with men, If it be what should not be published abroad, I will never divulge holding such things to be holy secrets. I thought we weren't supposed to have sex with our patients and talk about having... Aha. So patient privacy right there, from the jump, the things I learn, I will, and obviously

that is still true to this day. And then there's a part about, if I carry out this oath, I will get a great reputation. And if I break it and for swear myself, may the opposite befall me. So people will say bad things about me if I break my oath is basically what that says. And I'll deserve it because I knew what I was doing. So as I have alluded to, there are some things in there that don't hold up in today's modern medical world. And there are some things that, again, do not seem to fall in line with even what we really understood of Hippocrates or the Hippocratic tradition of medicine.

The fact that it has kind of a religious tone, you know, it has like this sacred, holy calling feel to it. Even that is a little contradictory to what we really think about, especially if we look at Galen who kind of followed in the Hippocratic tradition, that it's a lot more pragmatic. It's a lot more about,

we've learned all these things that can help people feel better, but it's not, I'm doing it because of a sacred trust. I'm doing it because I learned how and I'm good at it. And so I do the right things because why would you do the wrong things? I want to be good at my job. Does that, you know, like that kind of difference?

So it's debatable either way. Was it Hippocrates? Was it his followers? Was it some people who sort of followed Hippocrates but also wanted to make their own points, had their own spin on it? And has it changed over time? Because the oath obviously dates back to ancient history, but it wasn't used for all time. It was really rediscovered in the 1500s. So what happened between 400 BCE and the, you know, in 1500 CE? That's a bunch of people out there,

oathless doctors, making up us a little on the line. Doing whatever they wanted. German scholars translated it in the 1500s, and basically they kind of took some parts of it, but it was really adapted to like Christianity. That was the overriding value system that it was adapted into. So then when you start wandering, it did have opportunities really right all this. You have to start wandering when it was translated and adopted. War changes made at some point. I'm not suggesting

they were nobody is, but I mean, you know, you have to wander if stuff doesn't fit where were these, where did these ideas come from? In the 1700s, it was translated into English and other languages, and it really became, that's when we start to see it become associated with medicine more and more, and you start seeing like doctors take that original oath that we just discussed from the 1700s on. So for a while, yeah, docs were swearing to all the gods and goddesses, including Apollo. Now by the 1900s, the idea that we might need something more modern was starting to take root because most people weren't praying to Apollo by the 1900s.

And especially after World War II, the idea of a like a real modern code that was taken more seriously, you can see why all the sudden that idea might become more important. Prior to that, this belief that a doctor would use their skills and abilities to intentionally do harm or experiment on humans who were vulnerable. That idea was, I guess, theoretically possible, but wasn't really widely accepted. It was kind of just, well, of course, the doctor will do the right thing. They're a doctor. After World War II, more and more people realize that, well, no, actually, you know, it doesn't matter if you're a doctor, not all humans are capable of bad things. And so, a code of ethics that doctors should enter into became very important. Yeah, I can see that. So the World Medical Association actually wrote the Declaration of Geneva.

And it echoed many of the sentiments of the original oath, but it took it into like a secular world. No, no gods or goddesses. Um, and they didn't, and they didn't prohibit surgery. It was just, you know, basically you should follow a, this code of like don't do bad things to people, don't intentionally harm people. I want experiment on people. I won't take advantage of vulnerable populations. I won't discriminate against people for race or religion and that kind of thing. Seems sound. Right. So some really basic ideas that made a lot of sense. What's interesting is is a few decades after that, the USSR actually made their own

version. You can find like the Soviet, and it's very similar to this oath from the World Medical Association from the Declaration of Geneva, except that it adds, and you can find this where like you get this base oath that everybody takes, except for each organization or group or country or time has added their own little spin on it. So they add into it to preserve and develop the noble traditions of Soviet medicine to

be guided in all my actions by the principles of communist morality and to always bear in mind the high calling of a Soviet physician and my responsibility to the people into the Soviet state. They also add recognizing the danger with nuclear weaponry presents, which nuclear weaponry presents from mankind to struggle tirelessly for peace and for the prevention of nuclear war, which is an interesting thing to throw in a doctor oath. Yeah, absolutely. I would, I think I am capable of many things.

I don't know that I can prevent nuclear war. Yeah, I don't know what you would, if there's a, not, I mean, I'm trying to come up with anything. I mean, I would do it if I could. For sure. For sure. For that, like I am, and I think nuclear war. think we're definitely that is the size that we are both on. I can feel like that's something that me and the Soviet doctors who took this oath haven't

common. I don't know that I could take a note to do it because I don't know how I would. But I mean, if I can, can I I'll pledge that? Yeah. If I have the opportunity to prevent nuclear war. You're on it. I will do so. I pledge to Apollo.

There's got to be more, Sid. We got hundreds of years left. Yes, we do. And I hear dozens. You probably want to know all these oaths that I've mentioned are probably not the ones people are taking today, right? Right. So we are going to talk about what oaths are doctors taking today.

But before we do that, let's go to the billing department. Let's go. The medicines, the medicines that ask you let my God before the mouth. So it said we had some more oaths. Well, I guess different oaths, different permutations of the classic. Yes. The original flavor oath

so There there were some who still thought that a more thorough modern oath thoroughly modern oath was needed Modern Oathie and so I want to talk for a moment about Dr. Louis, lasagna Who give me a second? I'm okay. He is no longer with us and it's a shame because I feel like if Dr. lasagna was alive today, he would be a friend of the show. I'm a big fan. There are moments when I'm researching this show.

Let me give you a little peek behind the curtain. There are moments when I'm researching this show where I start to read about somebody in medical history and I get this like shiver because I realize that I'm like connecting to them like through time I feel close to them and like I hope that I'm carrying on some of the principles that this person Embodied I don't know and I felt this way with Dr. Louis Louis, Louis, lasagna. I got I got I'm getting like Terry Thank you. I feel the same way about Dr. Louis Louis, Louis lasagna. I got I got I'm getting like Terry thinking I feel the same way about Dr. Louis lasagna. Are you kidding me with this name? He's he's a great dot just you're cheering up. I am just listen

So he came from humble beginnings the son of Italian immigrants. He studied at Columbia He was fascinated by pharmacology who went on to teach Johns Hopkins, and in his more than 50 years in medicine, he became a consultant to the FDA, and a lot of other organizations in the US, basically to help with the way that we study and develop and regulate drugs, medications. When he kind of came onto the scene, it was like the Wild West when you introduced a new medication. A pharmaceutical company could just send out samples to some

doctors and encourage them to use it, and eventually people would just be using it, and you didn't have to have randomized control trials to prove that it worked and that it was not dangerous and that it wouldn't kill half the people who took it and all that. And Dr. Lasagna was one of the people who were saying, listen, there is a way to do this, we can do it scientifically. We can do this in a smart way. We can figure out which medicines work and which medicines don't. And we can give the right ones to people as opposed to just whatever makes a pharmaceutical company money.

So I already, I mean, right? Like you already like this guy. Yeah. So you don't just sell me on Dr. Louis LaSanya. I was down. That is what he dedicated a lot of his life to. He wrote or co-wrote 655 papers. He wrote two very popular books, some other books too, but two very popular.

The doctor's dilemma and life death in the doctor, which by the way, the doctor's dilemma, one of the books he wrote was, here's one description of it, an unusually readable account of the complex development of medical practice from a confusion of superstition and ignorance in its earliest days down to its present. That could be our show, honey. You're right. He was sobans before. He was sobans before sobans with sobans.

He talked about popular alternative medicines and criticism and why they weren't working and took them to task and then he talked about famous quacks. We gotta get this guy on the show. Oh, he passed away in 2003. But. I'm sorry I ruined the end of your story. I already said that. I know he loved to kill people at the end. Anyway, he was, he was a, he was a good guy. He fought drug

companies. He fought their ridiculous advertising claims. He fought the price fixing. He fought hidden drug toxicity. He fought to tell doctors how to give appropriate doses. There was a time where if a doctor gave you penicillin and it didn't work for what you had, he would just give you more of it. Mm. Which isn't how.

It doesn't work that way. Doesn't work that way. Higher doses are not always the answer, and often they're not. So anyway, cool guy, he was also president of the Rochester Orchestra and he funded a local dance troupe and he had his own group, his own theater company called the Mighty Lasagna Players, which was made up of the Department of Pharmacology, Medical and Toxicology students and faculty.

All the Mighty Lasagna Players is my favorite third-wave scob-man hands down. And I introduced you to Dr. lasagna because he wrote a new version of the oath, and it became pretty popular as the years went on. I thought for a minute this may have been the one that I took, but there were some phrases that I feel like I would have remembered. First of all, it takes out all of the gods and goddesses. You just swear to fulfill to whatever you kind of to whatever you choose to swear to to yourself to whatever gods goddesses or not divinities you you know you choose. Basically that you're gonna do the right thing you're

gonna use your knowledge to help people that you are going to do the right thing. You're going to use your knowledge to help people that you are going to. I like this. Avoid those twin traps of over-treatment and therapeutic nihilism. Yeah, we could use some of that. I feel like I would have remembered that. Yeah, therapeutic nihilism is very punchy.

He talks about how he'll respect the privacy of his patients, right? I will not be ashamed to say, I know not. Man, that's important. He talks about how he'll respect the privacy of his patients. Right? I will not be ashamed to say, I know not. Man, that's important. That could, you need to say that once a year in medicine. I think that's an important thing to say. I say it once a day.

In life, right? Not just in medicine and all things. And then he talks about treading carefully in the matters of life and death. If it is given to me to save a life, all thanks, but it may also be within my power to take a life, this awesome responsibility must be faced with great humbleness and awareness of my own frailty. I must not play it, God.

I think that... So, kind of talking to some of the ideas that they previously discussed in the oath, but with more nuance. Yeah, and it's also a little bit more, what's the word? Like readable, like pros, pros, like, I don't know, I'm not good with, I don't know, language stuff. He says, I will remember that I do not treat a fever chart a cancerous growth, but a sick human being.

So he is sort of saying there, if I could go inside, what he's sort of saying there is, you treat the disease, you win, you lose. You treat the patient, you win every time. The patch atoms coming to theaters, it did get delayed since the first half of the show. It's now going to be December 2025, but it is going to be all C.G. We're taking a lot of extra time. So it's going to be a huge flick. Everybody's very excited. We may back it into a two-parter. That's kind of all the offense. He mentions that prevention's better than cure. If you can prevent, prevent.

Sure. That you're a member of society. You have obligations to society as well. And, you know, the same kind of stuff. It was updated around the same time period by another doctor, Dr. Louis Weinstein, who also said, and I thought this was a good addition to it as well, I shall have the highest respect for human life

and remember that it is wrong to terminate life in certain circumstances, permissible in some and an act of supreme love in others. Whoa. These are some of the things that have been debated over time in the oath is, because what the oath is speaking to are the same issues that are debated,

not just in medicine, but in society today. Right. It's trying to solidify an ethical code that is like by its very nature, like sort of in flux, like it's... Right. And it's also variable depending on the person who is practicing medicine. Sure.

So I mean, they're talking about abortion, which we mentioned in the very first oath, but they're also talking about... yes, physician assisted suicide. So all of these things are being kind of rolled into it and depending on who is writing it and who is interpreting it, it's different, which is why you can see where, as I'm going to get into, not everybody even agrees that we should have an oath nowadays. In this modern world, there are a lot of doctors who are like, I don't think this is relevant to me whatsoever. I'm not saying I'm one of them, but there is an argument that many make that this whole concept is flawed.

The one I found one called an oath that bears the name of Fapacardes. It's a little wordy. Which I do think actually may have been the one I took. It's a little more, I do solemnly swear by whatever each of us holds most sacred. Very, very general. Just about being loyal to medicine and lead my life and uprightness and honor. And then the same kind of stuff, I will, I won't hurt people, I'll try to help people.

I will keep my patient's secrets and I will forever be thought of as a jerk if I don't. I mean, you know. That's what says right there. Kind of a very vague general thing. In the 80s, the AMA, the American Medical Association introduced a code of ethics, which basically was supposed to replace all these oaths with like a set of rules, a set of statements.

These are the ethics of being a doctor. And basically it was you should do things that are in the best interest of your patient, that you should respect their rights and of your colleagues, that you should keep learning, keep studying because stuff changes and that you shall take care of people and improve your community. I mean, it's very like that we don't need a sacred oath for this. These are just the things that these are the job requirements. Yeah. You know, um, which should have taken care of it. And that's what a lot of people argued. It's funny because if you look at like in the 80s, a pretty small percentage of medical schools were taking an oath at graduation. Really? Yeah.

Like a lot of doctors who graduated back then weren't that just wasn't part of the ceremony. By the year 2000, almost 100% of U.S. medical schools were taking an oath. That's so interesting. There was a huge shift in that time. Now, what oath were they taking? It varies. A lot of people were taking some version

of that original Hippocratic oath. Probably that one I mentioned that I think is the one I took and oath that bears the name Hippocrates. Some people are using the Louis Lozania oath. That one was very popular. There are other oaths as well. The oath of mymonides is one that I found was taken a lot by pharmacists, but also by some medical schools. He was a medieval Jewish philosopher who was a preeminent Torah scholar as well and wrote about a lot of different things, medical, legal, ethical, religious, lots of different writings. And

there's an oath that it's a little shorter into the point. It's a lot more calling to a higher power. It's a lot more religiously focused. But the same idea and a beautiful oath that you can take in some medical schools as well. Again about, you know, taking care of people and doing good and not doing it for your own glory, but doing it for the right reasons and that kind of thing. Although similarly to the oath of Hippocrates, it's question whether my monides actually wrote it. It's the same idea. You get these. I hope that if anybody ever gives me an oath that I didn't write, I can't imagine that would happen, but I hope if someday there's the Sydney oath,

the oath of Sydney, and it's something that I didn't actually write, but I'm giving credit for it throughout all of human history. I hope it has good stuff in it. Yeah, you think of at least get capture your essence. I hope so. I hope it's like maybe you can even like say what other people said and just attributed to me as long as it's good stuff. Yeah, it looks cool. Smart stuff. Be excellent to each other. Sydney, Macri.

But in 2019, an updated oath was offered up there in conjunction with the World Health Organization with the thought that we need a new oath, which is interesting because as I said, there are many who think we don't even need an oath at all, but the new oath adds the line, I will protect the environment which sustains us in the knowledge that the continuing health of ourselves and our societies is dependent on a healthy planet. So an updated oath that caused to our personal, I guess, even as, again, I would say that if, if I as a physician can stop climate change, I am so down for that.

Yeah, way into it. But it's interesting because as humans were all called to do that, I think it's all of our responsibility. It's interesting that you would put it directly into the oath that a medical student would take. Which is why I think you get a lot of controversy around it today. Do we need an oath? Is there any reason? What happens if you violate the oath? Nothing. I mean unless you committed malpractice or like did a crime, and you don't really need it to take an oath to follow the laws, because the laws just kind of force you to follow. Right.

You have to. Right. By the way, there's a different oath. I didn't know this. Osteopathic physicians take a different oath. Oh, yeah. The osteopathic oath, which is similar, again, very similar, except it specifically says like you'll develop the principles of osteopathy.

So like it specifically mentions osteopathy. And they're different oaths throughout the world. There's Buddhist medical doctors oath, the deja va topita, the 17 rules of Langja, which is for, which is a Japanese traditional oath for Japanese medical students to take. There's the oath of asph,

which is a code of conduct for Jewish physicians. There's a nursing code, the night and gale pledge. It's again been updated over the years, but originally from Florence Nightingale. Do we need one? Do we need a nose? I mean, that's the question, right? Well, it's nice. I think it's nice to take a nose.

It's a nice sort of like, you know, thing that says I'm a doctor now. It's part of like the, you know, the ceremony. Is it anything else? It is a very meaningful moment in the ceremony. Even though I say that, but I don't remember what you want I took. Right.

I remember that there was a moment where they say it is now time to take the Hippocratic oath. I remember like feeling the gravity of what I was taking on in the moment. I'm getting an abuse medical students, you know, soon to be doctors with like the sense of gravity of what they're doing, I think is a positive. I do have a question for you, Sydney. We talked about this since this entire episode. I didn't hear you say first, do no harm.

Is that like, I know that the spirit of that has been in some of them, but is that not part of the hip-priced oath? It is not. That was a great question. I'm glad you brought it up, because that was one thing I meant to address. It's not part of the oath. It's commonly, it's a common misconception.

In another of his writings, Hippocrates wrote first, do no harm. That the primary, well, the way he wrote it was the primary tenants of a physician are two, Duno harm and do good. So non-malfecence and benevolence, which are two of the core medical ethics that were taught, Duno harm and do good things.

But it is not in the oath. The oath speaks to that, I think for sure, but when people say it's from the hypococratic oath, that's actually not true. Interesting. Cream them non-no-series, not in there. And get that, and they're wrinkle for your noggin. Yeah, but yeah, so that's the question today. A lot of doctors will argue that it's sort of redundant. If you practice good medicine, then you will, by default, follow the tenets

of the oath. And it's compelling. And it And so why are compelling argument against it, though? I mean, I don't, for me, it's the same ideas like an equal rights amendment. People argue, well, we don't need it. It's redundant. Well, I would say that we do need it on one hand from a very practical, like just because something is written into law doesn't mean it is always true. Anything that reminds us and resilitifies the concept that humans are humans and should

be treated as such is important. And likewise, anything that reminds physicians that the stuff you're doing is the power that you have, the skills that you've learned, the knowledge that you have, can be used for great good, but also can be used and has been used throughout history for terrible evil. So you should use that knowledge with the utmost respect and humility and you should treat other humans with the utmost respect and humility and you should treat other humans with the utmost respect and humility. I don't think there's anything wrong with that because it when they say like I will not play at God, that sounds like like a joke, like a stereotype, like, oh, you know how doctors are, they're playing

God, whatever. It's really important the knowledge that you have about other people's bodies based on your ability to interpret information because of the stuff you were taught, it gives you a knowledge and a power that the person sitting across from you might not have. And you should constantly be aware of that and constantly be seeking to balance that out by giving that information, teaching people, helping people, humbling yourself to other people. I do think that there is something about it that calls to more than just a job. I don't know, that's my opinion.

I know anything can go beyond being what it is as a job to something greater, but I think that as a physician, you have to understand that and respect it, or otherwise you'll hurt people. Or you might not hurt people or you won't or you just you might not hurt people You won't do a very good job. We will now take the sobhones of I will to the best of my ability rate review and subscribe to the podcast. Sobhones I recognize that all ratings and reviews and subscriptions help out this podcast, which is free. We've got a new Saabon's Merch and dice. If you head on over to mackelroymerch.com or mackelroy.family and click on

the Merch link, you're going to find this new, first off, we got a ProVax pin designed by Megan Cot. All the proceeds from that are going to go to the immunization action coalition, immunization action coalition. There we go. Got it. That's a group that's helping to, well, just what it says. Try to remind people that vaccines are great. Spread correct information about the importance of vaccines. Yes, that is a wonderful group.

And we're so happy to support them with our vaccine shirts, which are still available. And the Provex pin, we've also got a cure, all's cure nothing t-shirt now that is available in the store. And you can go get it right this second. I think it's really cool. What else? Thanks to the taxpayers for the use of some medicines as the intro and outro of our program. Thanks to you for listening. Thank you. Until next time,

my name is Justin McElroy. I'm Sydney McElroy. And as always, don't drill a hole in your head. Alright! Maximumfun.org Comedy and Culture Artist Oat? Audience Supported Comedy and Culture Artists don't? Audience supported There's nothing quite like sailing in the calm international waters on my ship, the SS Biopic Fast! It's actually pronounced biopic No, you dingus! It's biopic! Who the hell says that? It's biopic

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