The Hippocratic Oath

TW: Mention of sexual abuse, incest

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“With regard to healing the sick, I will devise and order for them the best diet, according to my judgment and means; and I will take care that they suffer no hurt or damage…”

I scan the cross-stitched words in the examination room of my clinic, framed in gold and screaming at me in scarlet thread, as I feel the prickle of what feels like a thousand knives at my throat. Five years ago, as I walked across the stage of a packed auditorium to receive a diploma from the medical school and a shiny new prefix to attach to my name. I pronounced these very words, The Hippocratic Oath. To this very day, I am bound to this promise I made, swear to never use the scalpel I wield to cut the patients under my care unless absolutely necessary for their health.

However, how exactly do you define what is crucial for someone’s well-being? What if what is needed to prevent hurt means violating one part of the oath I swore by? What if….

“Doctor Blackwell?”

I glance at my assistant Amanda peering at me from the door. From my seat, I see her hazel eyes streaked with red veins. She’s gripping her scrubs so tightly that I see her knuckles turn white.

“Yes, Amanda?”

“Well, you asked me to see if there are any available tickets for flights to LA…”

“Oh, but of course,” I reply. I try to make my voice sound as sure as possible, as if I’m making the first incision during surgery. However, it cracks, betraying the fact that my throat feels like a knife had scraped it, that I had shed tears about this very decision the night before.

“Well, there are two seats available on the 8:30 am flight tomorrow,” Amanda states. She stares into my steel grey eyes before continuing.

“So, shall I book them, Dr. Blackwell?”

I gulp. It’s a question as simple as “What is the colour of blood when it oozes out?” Yet, at this moment, my heart races and my head feels like it’s being stabbed multiple times. I know that my response would cleave two different paths for me, that this is the sharp knifepoint that has the potential to be plunged in my back if it goes wrong.

If I could distil all of my work as an obstetrician and gynaecologist in a single statement, it would be this: I am not only the medical professional that oversees my patients’ procedures; I’m also a witness to their tears.

 Countless of times already, I’ve cut through skin, muscle, and organs to bring a baby to life and hear their first cry. Of course, it usually isn’t just the new-born sobbing in moments like this; as soon as their child is placed into their arms, couples usually couldn’t help but be taken to tears, their sniffling cutting through the still, sterile operating theatre. I hear them whisper wishes through the flood coming from their eyes as their newly arrived child coos at their mother’s chest.

However, those aren’t the only type of tears I’ve been witness to. It’s also up to me to hold couples’ hands if ever life cuts them and they lose their baby prematurely; as the most bitter of sobs escapes from their lungs, I’m there to comfort them, to try to remove the pain from the invisible dagger in their heart as best as I could. It always feels as if I’m being bludgeoned every single time I have to break the news that a woman has miscarried. Oftentimes, I too end up crying after one of these appointments, but I know I have to hold back my own weeping and be a source of strength to the person whose medical care I’ve been entrusted.

Then, of course, there are the sobs of relief. I’ve celebrated with countless patients when they’ve rung the bell after a round of cancer treatment, their tears soaking into my scrubs. When a test comes back negative for the Big C, I’m there to hug them as their bodies quake and their eyes open the floodgates. If only they know that their physician sheds tears of joy along with them, that their victory from disease feels as if it were mine.

In my five years of treating women, these moments of crying have become familiar to me. So, when a panel of men who do not have medical degrees, who have never had to ensure a tearful patient continues to live, made a decision in 2022 to cut off what could be a lifeline for thousands, I could not help feeling as if my limbs were being hacked apart from my body with a saw. Of course, they wouldn’t understand. Of course, it isn’t them that had to be there, all ears, as the worst wails of desperation pierced the air.

Seventeen year-old Gwen entered my clinic one night, an emaciated thing trembling like a leaf in her t-shirt and bloodstained shorts. Her large ocean blue eyes and blonde curls were apparently a gift from her late mother, and, unfortunately for her, that was all her father thought about every time he dragged her to his room, locked the door, and released his alcohol-fuelled longing for his dead partner out on his daughter. She had already endured four years of molestation by the time her best friend Kelly found out, helped Gwen escape the house through an open window, and sat next to her in the waiting room of my practice. I sighed when I saw how deep the lacerations on her intimate area were, marks of her father’s abuse towards the girl he was supposed to protect. Sadly, that night, we discovered that those weren’t the only souvenirs of these forced encounters.

I know what the law states. If authorities were to find out that I helped a weeping, terrified teenager get rid of an embryo conceived in tears, I would lose my medical license, be severed from my right to help hundreds of women who trust me to aid them in getting better. I may even end up in jail, deprived of liberty because, according to them, I’m robbing someone of a life.

But am I, really ? Is the life of a minor thrust into an unfortunate situation worth less simply because her ovaries decided to release an egg at the wrong time? Should Gwen be forced to birth a reminder of her trauma, no longer have a shot at the normal, worry-free life she was supposed to have?

I stare at the words of the promise I made five years ago, and the answer is clear. I am a doctor. It is my duty to prevent hurt. It is my duty not to prolong harm.

“Amanda, yes, go ahead and book them under Gwen and Kelly’s names please. I'll be the one to call Dr. Salvador in Cedars-Sinai. She's my friend from medical school, after all.”

I feel a peace cut through my heart as a flow of warm, happy tears fall from my eyes. No matter what happens, I'm content knowing I stayed true to the very same oath I cried in a packed auditorium five years ago, the very same one I promise to always uphold.