If a doctor enters the room of a suffering patient and leaves the room whole, did they even try?

I remember bits and pieces of my white coat ceremony. Waving to friends calling my name as I walked to the auditorium so that I would look towards their cameras. Surveying the smiles on the faces of my fellow over-achievers wondering who would sit at my table during lunch. I remember a spread of snacks akin to what I would imagine the craft service table on a movie set looks like. And I remember being told to look to my left and to my right because it was very likely that one of us would not make it through training. And the indoctrination began. The subtle message that to make it, you had to be on your toes. You could not slip. Lest you be left with dust in your teeth.

After the speeches, accolades and other requisite pomp and circumstance, we lined up and waited for our names to be called as our cue walk to the beginning of our journeys. Some of us strained to recognize the ever-creative butchering of our names. We each walked to our dean, shook her hand and presented our backs to her. We bent at the knees just enough to have our personalized short white coats applied, then straightened them, rising and baptized as something different: a “student doctor”.

The culmination of the event was the reading of the Hippocratic Oath (the modern version, thank you). One hundred fifty voices swore to respect our science; to remember the art of our craft painted by the brushes of “warmth”, “sympathy” and “understanding”; to care not only about the illness presented to us, but also about our patients’ families and economical stability and how they will be affected; to remember our “special obligations to all [our] fellow human beings”, be they of sound health or infirm. We had no idea what was coming as our voices and optimism crescendoed in that auditorium. We had no idea what was being asked as we blithely accepted the torch from so many before us.

At some point in all of our training, we have heard the plea “Medica, cura te ipsum” or “Physician, heal thyself.” Sometimes, this preceded 5 minutes of guided meditation in our lecture halls. Other times, it came as whispers of discrete mental health care at our disposal that we were encouraged to use. It is a proverb that showed up in Luke 4:23 of the Bible’s New Testament. It appears in Genesis Rabbah, ancient rabbinic texts, in the proclamation “Physician, physician, heal thine own limp!” In the Greek tragedy Promethius Bound, written in the 400s C.E. (B.C.), the line “…like an unskilled doctor fallen ill, you lose heart and cannot discover by which remedies to cure your own disease” again exhibits this concept. And finally Aesop. Remember him? The one whose fables read to us as children didn’t mince words and always had a moral? Well his thoughts on this issue in the form of The Quack Frog cut me right to the quick. I’ll let you delight in this short but swift kick to the proverbial nuts.

So, clearly, this is not a new concept. The idea that the oxygen mask should be put on yourself first before proceeding to help others is not a selfish act. It comes from the concept that if the airplane cabin loses pressure and available oxygen in the air is low, how can you expect to help effectively if your brain is addled by the lack of oxygen or you simply pass out? Wouldn’t it make much more sense that you do what you need to do to remain clear and healthy while lending a hand? Why do we get this concept of taking care of the self so wrong and what are the pressures that drive our not swallowing our own medicine? I have thought about this question for years and hope to shine a light on some answers. Because I, for one, do not take kindly to being called a “quack frog”.