The Silver Rule

Having grown up with a German/Protestant mother and a Bostonian/Jewish dad, on topics of religion, I call myself “flexible.” Actually, my time in a physics lab back in college got me thinking more spiritually than any sermon I’d ever stumbled upon. (Personally, I wish the periodic table got some more worship.)

That said, I don’t ever say Christians, Jews, Muslims, Hindus, Scientologists and friends are wrong. I just feel too tiny to judge. Plus, faith offers quite a bit of comfort, which I’d hate to tug away from anyone. Only when your delusions bump into mine is there a problem from my perspective.

goldenruleThat’s the backdrop when I consider the question posed by Dr. Edwin Leap on the article: “Is it Possible to be a Christian and Practice Emergency Medicine?” I’ve met Dr. Leap, and have been reading his writings for years. From all I can tell he’s a very thoughtful, hard working, smart, good guy. Regarding his question, he seems to have wrapped his head around an answer – in short – Yes.

This relative heathen, however, frequently thinks otherwise. I can’t cite scriptures. I have more fingers than hours in church. But if we only focus on the Golden Rule, then I’d put Christianity and emergency medicine into pretty separate pots.

Thinking about this question made me discover my beef with the profession, and my main reason for starting Pre-R. In ERs I simply don’t treat people as I want to be treated. In emergency medicine we practice the Silver Rule instead: “Do unto others, uncomfortably, as instructed by governments, medical boards, hospitals and lawyers, as you’d prefer done differently onto yourself.”

We force minor ailments through medical screening exams, vital signs and subsequent enormous bills, when friends and family basically get VIP treatment with prescriptions and free advice. We have hours-long ACLS courses on how to flog dead hearts back to beating, when frequently we would prefer far different treatment for ourselves or our loved ones.

We tell patients nothing about their future medical bills at the time of service, while we treat each other with “professional courtesy.” We bill patients full fare even when we sometimes get their diagnoses wrong. And we fill out all new charts and send exorbitant bills when they return for quick looksy follow up visits… that we recommend.

Direct to consumer advertising amplifies worry, and then we proceed to monetize the worried well. We prescribe name brand medicines, even though most of us consider generics to be just fine for ourselves.

Pre-R is an attempt at golden-rule based medicine. In answer to Dr. Leap’s question, I think being a Christian in emergency medicine is possible, but it’s hard as h+++.

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