Another Medical Parable, Updated: What Do You Bring to the Medical King?

At this time of year we may hear of the parable of 'What to Bring to the King', which has been adopted for use by many religions. I prefer the non secular version of this parable.

What do you bring a King? He has gold and silver, precious jewels, and pearls in his treasury. Does bringing him more give him pleasure, draw his attention, give him joy?

No. A wise soul would bring something that is unique, useful, and wondrous. Something made from base elements of the earth. Fashion something from its minerals and clays that is of beauty and original.

That defines art. And, in a simplistic way, explains why paintings and sculptures are more valuable than gold and silver. (Check out Christie's and Sotheby's if you have any doubts.)

Think of physicians. We practice the art of medicine. What do you bring physicians, which are still among the most highly respected people in our society? (Ranked by Forbes as just behind firefighters, in case you wondered.)

Physicians—and the respect we still have—are an anomaly when compared to the others who make that short list of 'most respected' by the citizens in our society. In general, there is an inverse relationship between respect and income. A good teacher gets high respect and low wages. A good banker get no respect and millions in compensation. (Don't even get me started on personal injury and malpractice lawyers.)

The medical profession is soon to be divided by insatiable demands for more gold and silver as each specialty and class of physicians tries to get "what's fair" from the soon-to-be-restricted funds available for health care. (See my earlier blog, "Medical Parable, Update", December, 2010.) Let's pause and recall the fable of Midas and his Golden Touch.

Midas was a mythical King of Phrygia (once existing in the central part of modern day Turkey). In reward for sheltering and protecting Silenus, the inebriated tutor to Bacchus (the God of Wine and Intoxication), he was granted a single wish. His avarice was such that he desired all he touched should turn to gold—which worked out fine until supper time. To rid himself of this now fatal gift, he pleaded with Bacchus, who sent him to wash in the waters of Pactolus (a river on the Aegaen coast of Turkey), which turned the sands to gold but freed him of his wish. In thanks to Bacchus, he tried to regain his favor with flattery, agreeing that Pan (a son of Bacchus) was a better musician and dancer than Apollo (a son of Zeus, who had made him the God of Music). Apollo, hearing this, changed Midas' ears into those of a donkey forever, to show his ignorance and stupidity.

We physicians must not make the same mistake that Midas made. We must not confuse what is important with what is not. It is not about the money, stupid. We must defend our profession against all that would de-professionalize it—pay by the hour, punch in clocks, assembly line piece work, unions, and our constant whine of poverty. We must respect all that our historic profession has brought us. Our heritage is not of wealth, but of healing and wisdom; not of power, but of selfless intervention. Our "Midas Touch" is the professional laying on of hands that earns us the respect of our society, not wealth.

Otherwise, our fate will be similar to Midas.

Society will slap a pair of donkey ears on our ass.

-alan berkenwald, md