The Hippocratic Oath states: “I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.” Most doctors take this oath very seriously and for many of us, medicine is truly a calling rather than just a profession.
Sometimes, this oath is a brutal task and impossible to fulfill.
I recently had a chance to visit a home for the disabled in Rashid, Egypt, a very poor town outside Alexandria. What started out as a medical mission visit became an exceedingly humbling experience. There are 50 residents in this home, 30 who have no family whatsoever. They all have some mental malady. Patients must travel to a nearby town to receive medical care. This has been working out for them, although not the most convenient way of seeking medical care.
While there, an elderly woman asked to speak to me. “My hand is frozen,” she told me or at least what I understood in my limited Arabic. She said she had fallen and broken her arm, in a remote area of Upper Egypt, an area so removed she did not receive medical care immediately. She ended up having three surgeries to try to repair the damage the delay caused. After speaking with her, I became increasingly convinced she was suffering from RSD (Reflex Sympathetic Dystophy) and that she would never get better.
I met another woman who was so poor, her kids took turns eating breakfast. It is hard to imagine how a child’s medical care would be a priority when food was not even available. People there are struggling to eat and have adequate clothing and shelter. Diseases come and go with little attention to treating them.
In, Egypt, there is no healthcare insurance, no Obamacare, no prior authorizations. However, diagnostic tests are not readily available like in the US. People can see a private doctor and pay the costs out-of-pocket. Or they can go to one of the few public hospitals, which have clinics, for treatment. These are available only in the larger cities such as Cairo and Alexandria. Many people travel far and then wait hours just to receive basic clinic care. Even more people simply choose to go without any medical care. Preventive medicine simply doesn’t exist.
There are also no social services, welfare, food stamps, WIC programs or any government sponsored assistance. An eight-year old boy I met, never knew his father. His father was murdered while his mother was pregnant with him. Unable to work, the mother went to live with her parents, who were very poor. The boy’s mom now works as a teacher, but in Egypt, teachers like many other professions, are poorly paid. Her parents are now sickly, and she needs to support them. There is no Medicare or retirement savings in Egypt. They struggle just to have enough to eat. While eight-year olds in the USA are dreaming of their favorite electronic toys or are asking for updated laptops, this boy has little chance to escape his poverty.
Outside the home for the disabled, I walked through streets of abject poverty. As I climbed back onto the microbus for the ride back to Alexandria, I could no longer hold back the tears. My thoughts wondering who would remember those the rest of humanity forgot?
My oath lain trampled on the ground too heavy to carry. Who could feed all these people, yet alone help them with their medical health. My heart shattered remembering the faces of the kids I had just visited. My calling completely laid bare knowing there are many forgotten corners of humanity and too few people who care.
Perhaps, if we all pause, not just the doctors among us, and all stepped up to remember one forlorn person, the world would be a better place. It is a good reminder to all those given the responsibility of treating medical diseases to look for the humanity in each of our patients. We all need to keep in mind that many suffer from the illnesses of society, as well as the body. Some people are too poor to pay for their medications. Keeping our oath in mind, we need to do no harm while we alleviate suffering. Many people doing small things can achieve greatness together. Imagine the world if everyone just tried to help alleviate the suffering of one person? Wouldn’t that be a much better world for all of us to live?
Bio: Dr. Linda Girgis MD, FAAFP is a family physician that treats patients in South River, New Jersey and its surrounding communities. She holds board certification from the American Board of Family Medicine and is affiliated with both St. Peter’s University Hospital and Raritan Bay Hospital. Dr. Girgis also collaborates closely with Rutgers University, University of Medicine and Dentistry of New Jersey (UMDNJ), and other universities and medical schools where she teaches medical students and residents. She recently completed a medical mission in Egypt.