I swear by Apollo Physician and Asclepius and Hygeia and Panacea and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant.
From the desk of Dr. Messler
On my desk sits a bust of Hygeia, a mask from Venice, next to a small sculpture and a figurine of the plague doctor. Nearby, there is a Klimt closeup of Hygeia, a postcard portraying Asclepius, St. Sebastian paintings, and quotes from Maimonides. They whisper secrets and nod to the challenges of the past. These medical specters, ancient voices of the past, keep me grounded. They speak, listen, and elevate me, too. They bring life into my otherwise quiet room.
We all began our careers swearing to Apollo, Asclepius, Hygeia, and Panacea when we recited the Hippocratic Oath. I call upon them, and other gods and totems, and saints and ancient healers, now more than ever. As an atheist, I don’t appeal to them as prayers, but as Hippocrates intended. I look to their supernatural healing powers as a source of strength and as revealers of the natural and observable phenomena.
Apollo was one of the Twelve Olympians, a God of medicine, father of Asclepius. He was a healer, though his arrows also bore the plagues of the Gods.
For centuries, Apollo was found floating above the marble dissection table in the Bologna anatomical theater, guiding students who dove into the secrets of the human body.
Asclepius, son of Apollo, was hailed as a god of medicine. He healed many from plagues at his temples throughout the Ancient Greek and
Roman empires. He was mentored in the healing arts by the centaur, Chiron. His many daughters and sons represent various aspects of medicine including cures, healing, recovery, sanitation, and beauty. To Asclepius, temples were places of healing, an ancient ancestor to modern hospitals.
Hygiea
Two of his daughters, Panacea and Hygeia, gave us the healing words of panacea and hygiene. Today, these acts of hygiene, handwashing, mask-wearing, and sanitation are discussed across the world louder than ever. While we’re all wishing for a panacea, we know it will take all the attributes of medicine to get us through this pandemic.
Hospitalists are part of the frontline teams facing this pandemic head-on. Gowning up for MRSA isolation seems quaint nowadays.
My attendings spoke of their fears, up against the unknown while on service in the 1980s, when HIV appeared. 2014 brought the
Ebola biocontainment units. Now, this generation works daily against a modern plague, where every day
Wellcome Collection. 17th century Plague outfit
is a risk of exposure. When every patient is in isolation, the garb begins to reflect the PPE that emerged during a 17th-century plague epidemics, the plague doctor outfit.
“Anyone who invokes me against the plague will be freed from this scourge”.
Godfather II fans recall the famous portrayal of the August 16th festival to San Rocco play out in the streets of New York. For those stricken with COVID-19 and recovered, you emulate San Rocco, in your continued return to service.
The Scuola Grande di San Rocco, in Venice, is the epitome of healing and greatness in one building. Tintoretto, the great Venetian painter, assembled the story of healing through art and portraits of San Rocco. The scuola, a confraternity, was a community of healers, gathered in one place to look after the less fortunate.
Hospitalists march into the hospital risking their lives. We always wear PPE for MRSA, ESBL, or Cdiff. And enter reverse isolation rooms wearing N95s for possible TB cases. But those don’t elevate to the volume, to the same fear, as gowning up for COVID-19.
Hospitalists, frontline healthcare workers, embody the story of San Sebastian, another plague saint who absorbed the arrows, the symbolic plagues, onto his own shoulders so no one else had to bear them. San Sebastian was a Christian persecuted by a Roman emperor once his beliefs were discovered. He is often laden with arrows in spots where buboes would have appeared: the armpits and the groin. His sacrifice for others’ recovery became a symbol of absorbing the plague, the wounds, and the impact of the arrows.
This sacrifice epitomizes the daily work the frontline nurses, ER docs, intensivists, hospitalists, and the entire hospital staff perform daily, bearing the slung arrows of coronavirus.
One of the images I think of frequently during this time lies atop Castel San Angelo in Rome. Built in 161 AD, it has served as a mausoleum, prison, papal residence, and is currently a museum. Atop San’Angelo stands St. Michael, the destroyer of the dragon. He is sheathing his sword in representation of the end of the plague in 590.
The arrows flow, yet the sword will be sheathed. Evil will be halted. The stories of these ancient totems and strength can give us strength as they remind us of the work that was done for centuries: pestilence, famine, war. The great killers never go away completely.
Fast Forward to Today
These medical specters serve as reminders of what makes the field of medicine so inspiring: the selfless acts, the fortitude of spirit, the healers, the long history, and the shoulders of giants we stand upon. From these stories, we spring the healing waters we bathe in to give us the courage to wake up and care for our patients each day. These specters encourage us to defeat any and all of the scourges that come our way.
I hear and read stories about the frontline heroes, the vaccine makers, the PPE creators, the health care workers, grocery store clerks, and teachers. I’m honored to hear of these stories and your sacrifices. I’m inspired to continue upholding your essence, your fight, and your stories. In keeping with ancient empire metaphors, you are taking the slings of the diseased arrows flying to our brethren as you try to keep yourself and others safe.
The sheathing of this sword will come. These arrows will be silenced. But until then, I lean on these pictures, these stories, and these saints, to give us all the strength to wake up each morning and continue healing.
They serve as reminders of what makes the field of medicine so great: the selfless acts, the fortitude of spirit, the healers, the long history, and the shoulders of giants we stand upon. From these stories spring the healing waters we bathe in to give us the courage to wake up and care for our patients each day and defeat any and all scourges that come our way.
So, who do you call in those late, quiet hours, when all seems lost?
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