It all depends...

…on our worldview. A worldview is how we look at the world according the sum of all our experiences. It’s not just our college years or traumatic events that inform our worldviews: our parents, our environment, our friends, our elementary schoolteachers, definitely TV, our happy, bored, and everyday moments, and whatever else we put in our brains affects us. Things that we don’t even remember from childhood have changed the way we look at the world now. It is this observation of the human experience that is the cornerstone of postmodernism. But, postmodernists take the concept and expand it to say that since I have a worldview specific only to me, then I can only have truth that is true to me and my experiences and not anyone else. This, as many have written about extensively, is the worldview that Americans breathe. We love to say, ah, that’s a nice belief FOR YOU. (Did someone mention Oprah?)
So why am I saying this? Because of a conversation I had here in med school with a guy about what doctors should do with their overly educated (and way too expensive) minds. Okay, so here’s the setup. A group of us were talking about this new approach to medicine where rich people pay willing doctors to be on retainer for them. Basically what this means is that a doctor (most likely a primary care doc) has about 80-100 regular patients (most have way more than this) who each pay him a few thousand bucks a year to be their personal doctor. In addition, his patients pay him every time he visits them at their home, work, or whatever is convenient for them. So if you do the math this guy is making really good money and he gets to know his patients really well. That’s sounds perfect, right? Well, yes, except that he/she is not really helping the systemic problem of healthcare delivery because these folks could get good healthcare anytime they want. So I said to the group, “Don’t physicians have a responsibility to other human beings, their profession, and society as a whole to fix some of the inequities in the healthcare system?” (In asking this I understand that people can do with their medical degree whatever they want, but I’m asking what is best.) And the guy responds, “That depends if you consider medicine to be a moral endeavor.” And I said, “Yes, it does depend on that, do you think it is?” And he said, “I’m not saying it is or it isn’t I’m just making the point.” I wonder what he really thinks…. Anyway, it just goes to show that even in medicine, a profession supposedly (or ideally) devoted to service, a worldview can turn those ideals on their head.

My point is that what you think matters to other people. In this guy’s case, for example, whether or not needy people get his much needed attention depends on if he thinks medicine is a moral endeavor. What do we consider moral or amoral? It changes the way we live and the quality of people’s lives around us.