January 1, 2004 (Ira Pilgrim)


Politics is nothing more than medicine on a grand scale.

Rudolf Virchow (1821-1902)

Some people, if they had it to do over again, would choose a different career. While the law is most often the road to a career in politics, some enter politics from other professions.

Bill Frist, M.D. is senate majority leader and Howard Dean, M.D. was governor of Vermont and is now trying to become the president of the United States. This combination of doctor and politician seems to almost be becoming popular. I would like to analyze this trend with a view toward explaining the advantages of a medical education in producing an effective politician.

In the beginning, healers were a combination of priest, witch doctor and dope peddler. They exorcised demons and administered pain alleviating drugs. Some specialized in poisons and were at the services of the chief of the tribe who wanted an enemy eliminated. The skills of the profession were passed on from father to son. Tribal chiefs were sometimes in danger from other men who wanted their job. The way to get the job of chief was to kill the current chief, or wait for him to retire or die. No one messed with the doctor because he had magical powers and was, therefore, truly dangerous.

I have known two physicians who have told me that if the had it to do over again, they would have chosen different careers. However, a switch to politics is not common. A more common switch is from the practice of medicine to research. Others choose branches of medicine such as pathology or radiology; fields that do not fit the usual image of the doctor as a healer who deals with people. Sigmund Freud was interested in the nervous system. In his time there were no research grants, so he became a physician in order to earn a living. He developed the techniques of psychoanalysis and trained others in its use. He developed a school of psychoanalysis that still exists today. In Europe, anyone with the intelligence and inclination can become a psychoanalyst; while in the U.S. only graduates of a medical school are eligible. What psychology or psychiatry have to do with medicine has always puzzled me, unless the treatment involves the use of drugs.

Hippocrates (460?-370? B.C.) , the greatest physician of his time, dabbled in politics. The famous Hippocratic oath is a political statement and there is little doubt that his ability to dominate the medical profession of the times was as much a political skill as a medical one. As did all of his colleagues, he killed many more people than he cured.

What are the advantages of medical education as it applies to politics? There are many ways that a medical education can assist a politician.

The first thing that a medical student is introduced to is gross anatomy. The word "gross" comes from the German word meaning big, which distinguishes it from microscopic anatomy. I doubt that the words current use, meaning disgusting, was derived from the gross anatomy dissecting room; but it is possible. The dissecting room accustoms the medical student to the sight of dead bodies and the strange combination of odors produced by rotten flesh and formaldehyde. It is no accident that the gross lab is rarely scheduled after lunch. I can think of no better preparation for a politician's experience in the halls of congress. Of course, his colleagues are not dead, but sometimes it is hard to tell.

The course in physiology introduces him to vivisection; cutting a living animal and putting needles into living mammals. It is hard to stretch this into needling his opponents, but....why not?

The course in pathology introduces the student to the retrospectoscope, which enables him to look at what has happened in the past and, from that, predict the future. This is superb preparation for crafting political campaigns and speeches.

The clinics expose him to people in acute distress; they can be very hot or cold and sometimes they vomit. As a consequence, he develops a strong stomach. He also learns the skill of pretending to listen to someone, while thinking of something, or someone, else. If you have ever heard a political speech in the halls of congress, you will realize how valuable this skill can be to a politician.

But the most important motivator that might impel a physician to go into politics is: why kill people one at a time when you can destroy a whole nation?

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