A Medical Aphorism, By Thao Nyugen

A Medical Aphorism 

 By Thao Nyugen

My time as an EMS First Responder for the Baton Rouge Emergency Medical Department was filled with many ups and downs. From getting a salt rub, as an ancient remedy to keeping evils at bay, to witnessing a dying woman's smiling to her family for the very last time before the weight of her illness took her life. It was my first patient, on my first ambulance ride, that would forever change me. 

Rudolf Carl Virchow, generally regarded as one of the most brilliant and influential biomedical scientists of the 19th century for his courageous and inspiring convictions on social medicine, founded a weekly newspaper called the Medical Reform, where physicians and scientists returning to Berlin from Prussia's control of epidemic-stricken Upper Silesia rallied under the banner that “medicine is a social science.” One of Virchow's aphorisms states that, “Medicine is a social science, and politics is nothing but medicine on a large scale...It is the curse of humanity that it learns to tolerate even the most horrible situation by habituation...Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community... The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them." 

An observer of history, I find Virchow’s aspiration extended beyond the boundary of popular libertarian theory - something worth striving for in practice. Prior to my trip down the rabbit hole, I found it very difficult to bridge my understanding of history, philosophy and anthropology to my understanding of medicine. Now, when asked the question, “Why medicine?” I would not be answering with the faded cordiality to do good or to save lives at little or no cost to my own self.  Rather, medical ethics demands sacrifices both physically and mentally, all of which are often hidden behind textbook rigidity, but exactly what makes medicine so electrifying. Virchow, provides me with the much-needed mental drive, a moral understanding for medicine's role in championing public health, and turning my political support for prophylaxis, as opposed to palliation, into action. 

My first patient was by no means extraordinary, with dull brown hair and a forgettable, grandfatherly face, whose kind expression made a lasting, haunting impression on me. After ingesting his daily dosage of morning herbal tea, a call was placed due to difficulty breathing. It was soon discovered that the non-GMO, USA-certified, herbal powder contained mitragynine and 7-hydroxymitragynine, which are opioid receptors more potent than morphine with 13 times the analgesic property. A pulmonary edema - accumulation of fluids in the lungs - resulted in the CCI drastically different breathing sounds between the patient's left to right lungs. If left untreated, cardiogenic pulmonary edema will form and congestive heart failure is an inevitability. He required immediate medical attention, but in a cruel twist of fate, he stubbornly refused to be admitted to the emergency room in fear of the insurmountable hospital bill burdening his family. I watched as he signed the Refusal of Medical Treatment Form, kindly thanked my partners and I for our services, and walked out of the ambulance. 

 I have found my theory. The guiding principle to which personal sacrifices are necessary to preserving social justice, to recognize that our current medical education should not be a privilege enjoyed by a few, and strive toward providing the best possible healthcare services to indigent patients. Yet, standing there while a sick man burdened with responsibility, tormented by reigning corporate greed, and plagued by a broken healthcare system threw himself into a path of self-destruction. My grand aphorism about medicine became just that, a theory. The divide between healthcare and medicine is still too immense. To achieve universal healthcare, social science must pave the way to technological advancement in medicine. It must make Virchow’s advocacy for social medicine the guiding principle to constructing effective methodology, for according to the German philosopher Immanuel Kant “theory without practice is empty; practice without theory is blind.” 




Virginia ArcherComment