2 - Shame in Medicine: The Ideal Doctor
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This episode of The Nocturnous is sponsored by First Responders First. An initiative of Harvard TH Chan School of Public Health, Thrive Global, and Creative Artist Agency that takes a whole human approach to first responder and healthcare workforce well-being. Learn more at first-responders-first dot org. Support for the Nocturnist comes from the California Medical Association.
At the Nocturnist, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality. All views expressed are those of the person speaking and not their employer.
Hello, my name is Hippocrates of Cos. Yes, the Hippocrates, said I've heard that these days I am referred to as the father of modern medicine. Ha ha ha. I'm pleased to share with you. A piece I wrote two thousand years ago, titled The ideal physician.
The position of a doctor must make him careful to keep his complexion and weight at their correct natural standard. For most people think that those who fail to take care of their own physical condition are not really fit to take care of that of a doctor. Secondly, he must have a clean appearance, wear good clothes, using a sweet smelling scent, which should be a totally unsuspicious Also he must observe rules about his non-physical effect, not only in being quiet, but also Being self-controlled in all aspects of life. His character must be that of a gentleman, honorable and kindly towards. When people dislike forwardness and interference, he must also pay attention to his technical ability. In facial expression, he should be controlled but not grim, while a man who bursts into guffaws and is too cheerful is considered vulgar.
He must be just in every social intercourse. Towards all the These therefore. He must keep himself under strict self control. The above then are the physical Psychological requirements for a doctor.
You're listening to Shame in Medicine, The Lost Forest. I'm Emily Silverman. In the last episode, we talked about how shame is often triggered by an event, which causes us to compare our current self with an ideal self. But that begs the question, who's ideal? The reality is we're all swimming in a narrative of what an ideal doctor is. And I use the word doctor, but really this applies to any type of healthcare worker, including nurses, NPs, PAs, and so forth. Some of these narratives about the ideal doctor are explicit. The resident expected to work a 28-hour shift without complaint or error. The doctor with the perfect bedside manner. Or the student with all the answers. Some of these narratives about the ideal doctor are unspoken, part of the hidden curriculum in medicine.
How should a doctor look, act, think? What should they value? And then of course there's our own personal vision of our ideal self. Today we'll be hearing stories from healthcare workers who are grappling with the concept of the ideal doctor. We'll hear about ideals of endurance that are impossible to achieve, ideals related to self-expression and personality type, and ideals of altruism that collapse in the real world. Where do these ideals come from? Do they make us better doctors? And if not, What do they do?
When I was a resident, the unspoken rule was that If you called out sick You had better be completely unable. to get to work. Some of us even would say, you know, only if you're dying. So I remember the The time where I finally had to call out six. And It was the end of interest. I was on call overnight. I was about three hours into my shift. So I had already admitted a few patients from the emergency room, checked on a few floor patients, and I don't remember exactly how it started. All of a sudden I just knew that something wasn't right and I started to feel Contractions of my Abdominal muscles, I started to taste this kind of bitter taste in my mouth, and before I knew it, I was running towards a trash can.
When it seemed like there was nothing else left in my body.
What historical ideas about the “ideal physician” does Hippocrates present?
I got it. I Took a deep breath and I called my chief resident and I said, I'm so sorry.
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Chapters
5 chapters
1
What is the main topic discussed in this episode?
0:00–4:35
2
What historical ideas about the “ideal physician” does Hippocrates present?
4:35–10:01
3
How does the podcast define the modern “ideal doctor” and why does it matter?
10:01–17:09
4
What are the hidden‑curriculum expectations placed on residents (e.g., 28‑hour shifts)?
17:09–19:06
5
How did a resident’s experience of calling in sick reveal shame and systemic pressure?
19:06–30:48