Yesterday I had a young man of 26 years old come to me seeking treatment so that he could get off his seizure medication. As I was taking his case we discussed what type of work he had been doing since graduating from high school. It turned out that he had held down 3 jobs in the last 5 years with the last one being his longest employment of only 6 months. In the back of my mind I began to prejudge him and classify him as a lazy kid and wondered what kind parents would allow their child to turn out this way. This judgment of course had an influence on my attitude toward him.
Although it did not affect the treatment I gave him I must admit that in the past when I have seen patient’s with “self-inflicted diseases” I have treated them with less respect.
These so called “self-inflicted diseases” might be obesity, alcohol abuse, smoking, illicit drug, indulgent behavior or being indigent.
Twenty years ago upon graduating from medical school, as did all physicians, I took upon me the Oath of Maimonides. A part of that oath reads, “May I never see in the patient anything but a fellow creature in pain.” The innate rightness of that statement, with its reminder of the sacred covenant being face-to-face with a fellow human in need makes judgment beyond the biomedical not only unnecessary but inappropriate.
Hopefully, what happened yesterday will be my final lesson in judging my patients. As ChuangTzu taught: “When the heart is right ‘for’ and ‘against’ are forgotten.”