My physician in Chicago, Dr. Sherman and I had a long-term relationship until his retirement. He ran a practice in which he knew his patients and never seemed to be overly interested in expanding his business. His staff consisted of one nurse – a woman who happened to be Mrs. Sherman.
When I called for an appointment, there was no menu to get through to reach the right party. Either Dr. Sherman or his wife took the call. I could hear them turning the pages of the appointment book to find a time that was good for both of us.
All his patients had his home telephone number in case of an emergency. I used it one time in the thirty years I saw him when I had an extremely bad case of the flu. Dr. Sherman decided that I needed to see him right away – so he made a house call.
Dr. Sherman treated adults and he treated children. And most of all, he treated his patients with compassion and respect. After an appointment he always took time to sit down with me to find out how my life was going. These conversations inevitably concluded with the statement, “I hope I don’t see you until next year for your physical – unless it’s at the symphony.” I knew he meant that.
Hippocrates would have been proud of Dr. Sherman and other professionals like him.
Are there any Dr. Shermans left today in the practice of medicine? If so they are well camouflaged. Today the practice has taken on all the characteristics of our technological age and incorporated some of the worst elements of factory farming as well.
The personal relationship between the physician and patient has been replaced by the more highly efficient bar code where the individual is simply numerically identified as one of the herd, milling about the overcrowded stall.
With the lack of interpersonal relationships between physician and patient, it is easy to see how the following situation might occur.
A 23 year-old man in Philadelphia was denied a heart transplant. Although he is a good candidate for the procedure, the reason he was declined was because he is autistic and has other psychiatric issues. In making the determination to reject his application, reasons that were cited included the possibility of steroidal interference with his general health. Steroids are necessary in order to maximize the patient’s ability to accept the new organ.
There are, perhaps, better candidates for a heart transplant than this young man. And there is a shortage of hearts and other organs which are available for that purpose. But it’s difficult to avoid wondering about the procedures and the people who will make these determinations for all of us should Obamacare survive and go into effect.
Under the Affordable Care Act, seven as yet unnamed bureaucrats will effectively be in charge of our dispensation of medicine. If that doesn’t frighten you it should. Simply look at how well bureaucracy has bungled most matters with which it has been entrusted. It’s been that way since Joseph invented the concept in ancient Egypt.
What is most disturbing to me is that when you have an impersonal bureaucracy viewing the general public as merely components which make up a herd, it is not a difficult step to begin to decide that perhaps that herd should be culled and the weak sacrificed for “the greater good.”
With no personal relationship with the victims it’s not too hard to arrive at that view, if you think of them merely as statistics – a mindset not much different from that held by the mass shooters we hear so much about of late.
If you believe that could never happen in America you are wrong. It has happened. It was called the Tuskegee syphilis experiment (also known as the Public Health Service syphilis study). If you want more details on how 600 impoverished black sharecroppers went untreated for their disease so that we could analyze its progression, you will find it at this link to the Wikipedia article.
It doesn’t take a particularly fertile imagination to question that if this one experiment has made its way to the light of exposure, are there others about which we have never heard? And if so, how many and who are those who were victimized?
The greater good is a nice phrase. But the good or ill that any society does must always be measured by the way it treats it’s least important member.
We must always be mindful that if we stand by silently as another group is selected as the sacrificial lambs, we have opened the door to a shift in attitude or policy and we may be the next group of sheep on the way to the slaughter house. Both ethics and common sense suggest that we should oppose any such policy or program with all our might and strength.
Dr. Sherman passed away several years ago at the age of 87. I suspect there are few left who are like him – physicians who have a true sense of compassion and a relationship with their patients. People whose lives embodied the very essence of medical ethics. Their passing is a great loss for all of us.