The virtuous yellow brick road in medicine

Studies involving the virtue ethics of a sound medical practitioner have provided insight into the nature of ethical demands on the physician as a moral person. Kotze et al., the authors of “Virtue in Medical Practice: An Exploratory Study,” agree that thinking about virtues contributes to doctors’ and medical students’ thinking about common moral dilemmas in medicine. However, they also acknowledge that the question of what virtuous medical practice is and how to study doctors’ moral character is vast and fraught with difficulty.

Having said that, if the day comes when a window shutter crashes into your head, jarring you into a dream-like state where getting into medical school is a reality, then your virtuous qualities will have an immeasurable impact. Once you’ve received that glorious letter of acceptance, your career path has been decided. You now know what you will be doing for the next thirty years of your life, barring any unforeseen obstacles or challenges. And if your desire is to be the best you can be for your patients, then look no further than the yellow brick road.

So before you allow your brain to fully grasp your future as a top-notch practitioner of medicine and science, take a big step back. Go ahead and get philosophical or perhaps even spiritual for a minute and consider that the path you are taking will surely impact humanity. Or at least consider the impact you will have on those in your sphere of influence—your patients.

So what determines the impact people have on others? More importantly, what determines the impact or lasting impression physicians have on patients and their families? Surely it must include the ability to cure disease and ease suffering. Absolutely! But what can a physician offer a patient who neither gets a cure nor is able to provide for less suffering? The answer is to give them your best virtuous self. Who you are inside, with your best virtues being displayed outwardly to your patients, is great medicine, plain and simple.

One definition of virtue is a commendable quality or trait, while another is moral excellence. It is also a habit or quality that allows the bearer to succeed at one’s chosen purpose. Yes, a habit leading to success. Straightforward, right? Not for everyone. For some, virtuous thoughts leading to virtuous behaviors are basic human nature, and for others, not so much.

In the realm of medicine, there are three key areas of our virtuous being that will serve us well. They include our intellect, matters of the heart, and a bunch of courage. Deliberately focusing our thoughts on these areas can help us find the virtuous road leading to a fulfilling medical career.

First, most of us have been exposed to L. Frank Baum’s fantasy tale, The Wizard of Oz. Here, Kansas farm girl Dorothy is hit in the head during a violent tornado and finds herself in a dream where her house is carried away to Munchkin land. She then meets a number of interesting characters all while trying to get back home. In her dream, she is told by the inhabitants of this land that in order to return home, she must follow the yellow brick road. And on her journey down this road, she first meets a scarecrow who thinks he is lacking a brain and, above all else, desires one.

The scarecrow’s desire for a brain offers the first of three virtue areas that make us good physicians and caregivers—our intellect. Certainly, one could argue that getting accepted into medical school would confer this virtue automatically. Perhaps, but there’s more.

According to a Loyola Marymount University website, intellectual virtues are the deeply personal qualities or character strengths of a good thinker or learner. They include curiosity, open-mindedness, humility, and autonomy. However, a person can be very knowledgeable and intellectually gifted while also being intellectually lazy, intellectually dishonest, intellectually arrogant, superficial, or closed-minded. These latter qualities prevent people from thinking or learning well.

Furthermore, educators and other experts agree that in order to obtain healthy intellectual virtues, one must practice the skills and abilities that define them, including acknowledging intellectual limitations, considering the perspectives of others, and taking intellectual risks.

Continuing down the yellow brick road, Dorothy and Scarecrow meet a Tin Man who’s concerned that he lacks a heart and so desires one. This brings us to our second and possibly most important virtue to foster on the path to being a virtuous caregiver. The necessity of a physician to have a heart for people, as evidenced by compassion, a caring spirit, kindness, and above all, empathy, cannot be understated. These heartfelt traits are not natural for everyone. In fact, they can be an obstacle along the virtuous path for some physicians, but their regular appearance in patient interactions will unequivocally promote sound medical doctrine, healing, and certainly good will. And if one is early in the career choice process but not so inclined toward these virtues of the heart, some career soul-searching may be helpful.

Finally, as most folks know who have seen the movie The Wizard of Oz, a Cowardly Lion in search of courage joins Dorothy and Tin Man. A career in medicine requires the utmost measure of courage. From the start, one has to sacrifice along the way to move forward into medical school, residency, and even more so into practice. If you’re reading this, you already know the sacrifices and courage required for a medical career.

While an initial measure of youthful courage may propel us through our training, it’s the ongoing ability to make conscious courageous choices that keep us grounded and making decisions that enhance not only our patients’ lives but our own as well. Overcoming fear with this kind of courage allows physicians to combat substandard care, fight for those medically vulnerable, and go home with a sense of accomplishment.

The road to becoming a good physician will involve the use of one’s greatest virtues. The path is not an easy one, and while we may not be saved by a wizard behind a curtain, aspiring to discover and utilize our best virtues can help us avoid any unforeseen angry trees or flying monkeys along our own yellow brick road.

And it goes without saying that nobody is perfect, but striving to live a virtuous life as a physician may help ward off apathy and the dreaded sense of a lack of purpose all while promoting wellness in the lives of those we encounter every day.

Christopher Nyte is an otolaryngologist.


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