It was reported that the incoming class of medical students at the University of Minnesota Medical School recited a homegrown oath at their "white coat" ceremony on August 19.  (Read it all here.)  

The affirmation included this:

We commit to uprooting the legacy and perpetuation of structural violence deeply embedded within the health care system.  

Well, that is a problem.

Speaking only for myself, I have always viewed my profession as one of legalized violence.  The violence is part of the structure of the system.  Take the violence away and you are left with mostly "Too bad. Bummer."–like treatment.  

What is it that physicians do?  We incise, excise, phlebotomize, amputate, extirpate, irradiate, inoculate, enucleate, medicate, intubate, and so forth.  

Not touchy-feely stuff.  

I have always found it humbling that society and individuals grant us, as a profession, the right to do things to them that if done in just about any other circumstance would be illegal.  Cutting open an abdomen, drilling a hole in someone's skull, lopping off a limb, jabbing medication into a stranger — all things health care professionals do — would be criminal offenses without the permission given us.  

Plainly put, the medical profession regularly engages in violence.  Structural violence.  Justifiable violence.  Violence, nonetheless.  

Medicine is violent.

People can, and do, die from what health care providers do.  

When you realize the gravity of what can result from your efforts, you are more likely to be cautious.  When you discount it, you are less likely.  Thinking you can "uproot" it and make it go away makes you both dangerous and deluded (given the current state of the art), in my humble opinion.

(Now, some may say that the work of psychiatrists is excepted.  Okay.  Maybe.  However, they do order drugs and, don't forget, words are violence, too.  They are not completely off the hook.)  

It is noteworthy that the speakers of the oath are medical students populating the Class of 2026 (entry-level), so they speak with authority based on knowledge, skill, training, experience fantasies.

I cannot say it is a great way to start.  There is something, to me, at least, about having a practical or experienced foundation upon which to base pontificating.  This is especially true for adults.  

But that's just me.  

Some might conclude that the oath thing is good news, given their mindset.  If these students are renouncing violence, then they may not be able to practice.  

That could evoke a collective "woo-hoo!"  

The fantasists also claim that they will, "hold ourselves accountable for our mistakes."  Wanna bet?  

Michael Applebaum, M.D., J.D., FCLM is a physician and attorney in Chicagoland.

Image via Pxhere.