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Primum non nocere

Writer's picture: Dr BahrouDr Bahrou

In August of 2006, I walked into an auditorium in Ann Arbor, Michigan with my parents and my grandparents. I strode across the stage when my name was called and was helped into my very first white coat. The ‘white coat ceremony’ is the first of numerous events throughout medical training meant to celebrate our choices and our accomplishments.


I struggle with the pomp and circumstance around being a physician. Perhaps from the beginning I felt that my choice to go into medical school and grind along with everyone else didn’t inherently raise me to some elevated status. Maybe it was that, having completed all the conventional medical training, I came to realize there was so much more to the story of human health and wellness. Whatever the origin, I wasn’t ever able to get to a place where I expected respect and reverence based on my title alone. I still feel the need to earn respect based on being a good human – kind and respectful to others. I try to live by the golden rule, ‘treat others the way you would want to be treated.’ That applies to my professional work as well.


Over the weekend, I was listening to a lecture on functional medicine that quoted a review article that acknowledged that upwards of 40% of our recommendations as a medical community are not better or are worse than just doing nothing. Say what?


"...upwards of 40% of our recommendations as a medical community are not better or are worse than just doing nothing..."

The title of this blog, “primum non nocere” is the Latin phrase, “first, do no harm.” Those words are not found, verbatim, in the original Hippocratic Oath, but they appear in later versions, with non-maleficence being an integral principle of the oath. I stood together with the other brand-new medical students during that white coat ceremony and recited the Hippocratic Oath. However, studies like the one I just mentioned, cast shadows on my sincere goal to uphold that oath.





I met recently with a local experienced naturopath. In casual conversation, her description of her work struck me. To paraphrase, she spoke of not considering herself the physician or the healer, but someone who works with her clients to remove obstacles, thereby allowing the person’s own brilliant inner physician to do the necessary work. Indeed, it is my own deeply held belief that all true healing comes from within. In this new season of my professional life, ushering in the first trickles of patients into my humble little office, I find myself reflecting on my role.



My husband’s role is far more concrete. My husband is a trauma surgeon. That means, when ‘LEVEL ONE TRAUMA’ is paged out through the hospital, there is an entire team that responds and proceeds to the emergency room. Ultimately, his decisions preside. Car accidents, stabbings, gunshot wounds, you name it – he is the final word. Humans, in every state of extreme physical distress are brought to the emergency room: bleeding, almost dead, and his swift and calm assessment becomes the epicenter for a cascade of events. He might decide the patient needs to go to the operating room. The entire team then launches into action, cleaning, preparing, putting out instruments, and monitoring the patient. He scrubs his skilled hands and is given a sterile towel to pat them dry. An assistant holds out a sterile gown and then opens sterile gloves pre-selected for his hand size. Those same practiced hands make their way inside the traumatized body to find and repair bleeding vessels and injured organs.




My husband, quite literally, saves lives.


We have the same degree, the same title and yet there is a great dichotomy in our two work lives.




My hands cannot piece together a body racked from trauma. Also, because it is not always applicable to individual people, I am unwilling to make sweeping recommendations based on the CDC or the United States Preventative Services Task Force. Instead, I am enjoying the freedom to sit with those who honor me by making an appointment and to listen to their stories. I am continuing to learn, and I am feeling utterly committed, at the very least, to do no harm.


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