‘I swear by Apollo the Physician and all the gods and goddesses. . . .”
I was certainly surprised to hear my son, who is not particularly religious, say those words a few days ago at his medical school graduation. He and about 18,000 other newly minted doctors across the country recited that preamble to the Hippocratic Oath, or a version of it, before receiving their MD degrees this commencement season.
I was moved. I’m sure his fellow University of Southern California Keck School of Medicine graduates included men and women of all creeds and associated crackpot beliefs, yet here they were swearing fealty to the sun god Apollo, purported to have lived on Mount Olympus about 3,000 years ago. They got off easy. The original oath invokes three other Greek gods: Asclepius the Healer and his daughters Hygieia, goddess of cleanliness, and our enduring favorite Panaceia, the goddess of universal remedy.
Contrary to popular belief, the words “First, Do No Harm” occur not in the oath, but in a text attributed to the school of Hippocrates, a fourth-century BC Greek physician. A beautiful phrase in the original Oath — “I will not cut for the stone” — is rarely heard today. In the past, newly trained doctors swore not to perform surgery, i.e., cut out kidney stones, until they had been trained in the surgical arts.
You may recognize that line from the title of Abraham Verghese’s dramatic and beautiful novel “Cutting for Stone,” the story of Dr. Marion Stone, an Ethiopian-born doctor (like Verghese) who ends up practicing in the Bronx.
For obvious reasons, the oath has been much tinkered with over the years. For instance, Hippocrates inveighed against harming an unborn child. That stricture against abortion wasn’t recited at the USC commencement, and it doesn’t appear in the oath recited by doctors graduating from Georgetown Medical School, part of a Catholic university.
Georgetown MDs ignore Apollo and take their vows before “God Almighty.” The graduates of Loma Linda University School of Medicine, a Seventh-day Adventist institution, recite a Physician’s Oath to “dedicate my life to the furtherance of Jesus Christ’s healing and teaching ministry.”
Some American medical schools substitute the Declaration of Geneva for the Hippocratic Oath. Formulated by the World Medical Association in 1948, partly in response to medical crimes committed by Nazi and Japanese imperial doctors during World War II, the Declaration is a simple list of eleven commitments undertaken by new doctors, e.g., “I will practice my profession with conscience and dignity; The health of my patient will be my first consideration,” etc.
Dr. John Prescott, chief academic officer of the Association of American Medical Colleges, notes that the main themes of the ancient Greek oath survive in almost all modern versions: Honor your teachers and teach others; do not practice above your skill level; be honest with your patients and honor their confidentiality; expect success if you honor the oath, and woe betide you if you don’t.
Graduating medical students are a hardened lot. At USC, the student speaker reported on the invaluable lesson she had learned in medical school: Wear shoe coverings on the wards. There is a lot of yucky stuff splashing around. Oy.
Of course, not all these young women and men will go on to be empathetic healers like the fictional Dr. Marion Stone, the only student in his class who could answer the question: What universal remedy is administered by ear? Correct response: Words of comfort.
But many of them will become worthy servants of Apollo and all gods before and since, and that makes me very happy about our collective future.
Alex Beam’s column appears regularly in the Globe. He can be reached at email@example.com.