University of Vermont

A Lesson from Greek Physician, Scribonius Largus

Sally Bliss, R.N., M.S.B.
Sally Bliss, R.N., M.S.B., clinical ethicist at Fletcher Allen Health Care and UVM adjunct assistant professor of medicine. (Photo courtesy of Sally Bliss)

I want to share with you all one of my favorite stories from the history of medicine.  Back in the day, ancient Rome to be exact, medicine was in its infancy.  The Roman Empire was a dangerous place and Greek physicians, though possessing greater skill than their Roman contemporaries, were not trusted.  It was rumored that Hippocrates had pressed his countrymen not to heal their enemies, and that Greek physicians refined their knowledge by testing remedies on unsuspecting Romans.

These suspicions were troubling to many physicians who found their ability to ease the suffering of the people was impaired.  Somewhere between 43 and 48 CE, in an effort to lessen suspicions, the Greek physician Scribonius Largus compiled a manual called Compositiones; a collection of drugs and home remedies for laypersons.  He wrote in Latin and gave a copy to the emperor Cicero.   Within the preface of the book, Scribonius addresses Roman suspicions (from the J.S. Hamilton translation):

(i)…envy is especially sinful among physicians, for unless theirs is a heart full of mercy and humanity, in accordance with the will of the medical profession itself, they are rightly hated by all the gods and men….(iii) This is because Medicine truly promises her assistance in equal measure to all who seek her aid, and she swears never to injure anyone deliberately, for she judges men neither by their fortune nor by their character.”

This is one of the earliest written declarations of medical professionalism.  Scribonius went beyond the duties of the Hippocratic Oath and called upon physicians to act in ways that differed from those ordinarily considered.  He incorporated the Stoic (Roman) ideals of mercy and humanity, virtue ethics not common in Greek culture at the time of the origination of the Hippocratic Corpus.  Scribonius calls the physician to moral neutrality, thus setting the cornerstone of the doctor-patient relationship – trust.  To put this into more modern language, it is not just what we do (duties), but how we do it (virtues) that makes us professional.

The tenets of professionalism are prominently featured here at UVMCOM.  We know our faculty, staff and students are among the finest medical practitioners in the world.  What we also aspire to is the finest of professionalism, that “difficult to define but we know it when we see it” kind of virtuous practice that goes far beyond tests and procedures.  It happens here every day, in classrooms, operating rooms and laboratories.

As your student Ombuds, I care deeply about professionalism.  Just like back in the day of Scribonius Largus, the Ombuds role is in its infancy here at UVMCOM and I seek to serve those who might have need.   I am a designated neutral, morally and otherwise.  I have no role in grading or decision making, and serve only to promote fairness in our work together.  I am committed to confidentiality and pledge to practice in my role with humility and humanity.   I may not have all the answers, but I am pretty good at asking questions and finding out where to go next.  In the coming weeks, I will be hosting an “open house” in my office in the hospital (Patrick 226A); and I hope you find the chance to stop by, anytime.  Even if there is nothing specific to talk about, I hope you find my office a neutral place where you can sit in a chair and just relax to catch your breath.