Three days after we got back from Barbados I drove Rosamond down to Lennox Hill Hospital early in the morning. Soon she was being prepped, and an anesthetic dripped into her arm. When she was unconscious, Ken, her surgeon (and as it happened the best friend of her son, David, since high school) used his scalpel to make a five inch incision deep into the upper part of her left thigh. He then went in and sawed off the top of her femur. You may have heard that doctors take an oath to do no harm. Like many other things, this simple principle obviously needs to be qualified.
Rosamond herself has often pointed out that we let doctors do things we wouldn’t let others do, like cut into us with knives and give us poisons and ask about our bowel habits and sex lives, all this presumably for our own (eventual) good. So, since doctors have these special privileges (and special knowledge and skills), they should have special duties and obligations. Foremost among these is to seek trust and deserve it. This may seem a universal principle, but the trick is in the deserving. Melville’s confidence man, the sellers of mortgage backed securities, Bernie Madolf, and the prototypical used car salesman are all experts in fostering trust but can hardly be said to deserve it. Physicians, though, cannot successfully ply their trade without trust, cannot act for our good, so any breach of trust jeopardizes the enterprise as a whole. Or so Rosamond quite successfully, I think, argues. Continue reading