One hundred seventy-four students. About 1,000 special attendees: spouses, parents, extended family members, and other loved ones. Several physician faculty members, those both on the stage and in the audience. All in one large convention hall.
I was there, too. After almost 30 years in community practice, recently I took a teaching position at a medical school. As part of my new academic responsibilities, I attended my first-ever white coat ceremony.
In the course of this ceremony, there was a warm introductory greeting followed by remarks from the dean of the college of medicine and two invited speakers. Mostly encouraging words, congratulatory and welcoming, with a few cautionary statements about burnout and taking care of oneself.
Then came the oath. I understand that all the oaths spoken at such white coat ceremonies are different, each chosen by the students and faculty members of each individual medical school. Our oath was full of exhortations, ethical principles to follow, and professional responsibilities to fulfill, punctuated from time to time by words full of gravitas, like “tradition,” “integrity,” and “commitment.”
I cannot speak for the incoming students or their guests as to their take on it all. However, I do wonder as to the value of such officially ordained collective advice, especially when woven together so tightly with a one-time rite of passage.
Years of working with patients and their families have forged within me an awareness of ethics and professionalism that is more private than institutional, representative of the relationship I have with my patients as their personal physician. This awareness includes elements of both the successes I have enjoyed and the failures I have endured along my path as a family physician. In all honesty, though, it has at its core remembrances of unresolved miscommunications, unconfirmed assumptions, and unexplored differentials of power: the stuff of relational life that trips us all up every once in a while, especially in context of the suffering that accompanies illness and the emotional burden of caring for those who suffer.
Given such history, my personal oath comes from somewhere within. My oath is not prescriptive. It is not particularly harsh; neither is it laudatory. It is not exceptionally keen on enthusiasm. Rather, my oath is aspirational, heartfelt, and solitary.
It is a refrain I refer to frequently, best intoned at the start of each day. I have posted it above my desk for easy availability, lest I forget its influence over the habits of mind that guide my approach to practice.
May I be honest.
May I be courteous and kind.
May I find dignity in my work,
And may I offer it to others.
May I know my limits.
May I seek counsel when in need.
May I grow in clinical courage
And become wise in the process.
May I extend to all
An invitation to trust.
Mine is a practice of service
To others.
May I share with them
My knowledge,
My skill,
And my presence,
As I am able.
May I live up to these words. May I not fall too often, or too far. And when I do fall, may I get back up, full of hope, so as to engage again with those to whom I am deeply grateful for the privilege they have bestowed upon me: my patients.
As a nascent teacher, I recently watched 174 students don their white coats. On any particular day, whether I don my white coat or not is irrelevant. What counts are the words I voice, the sentiments they convey, and the promises I make to myself, to my patients, and, now, to my students.
May those who follow me in medicine, including those students I watched as they entered the profession, soon begin to look beyond the ceremonial rites of initiation that welcome them. Beyond, to the people in distress who will surely come to them as patients seeking counsel, care, and cure. And within, to whatever sources of curiosity, creativity, and compassion they harbor, so that they, too, may craft their own oaths, work to fulfill their own promises, and build their own signature futures as physicians.
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