Keys for Becoming a Successful Physician

Naturopathic Gathering, NCNM—November 7, 2009

If It’s Worth Doing, It’s Worth Doing Well

When I was invited to this Gathering, I had a recent graduate from a naturopathic college working as an assistant in my office. I asked her what she thought would be a worthwhile subject to present before the naturopathic students. She spontaneously said, “How to become a successful physician.” She told me that at her naturopathic college she joined a student club whose aim it was to seek clarity from the confusion inherent in the training they were receiving. I asked if being part of the club helped. She emphatically answered, “No, in fact we became more confused as the years went by. By the fourth year, it was total chaos!” This explains the subject of this presentation, “Keys to Becoming a Successful Physician.”

This lecture is based on two reasonable assumptions. First, fundamental to all enterprises or serious endeavors is the desire to attain a successful end.

Second, I am assuming that all who are present in this room at this moment share the same goal, namely, of becoming successful physicians.

But beware that the word “success” is very relative. With rare exceptions, physicians, regardless of their era or type of practice, will say that they are successful. It would be hard to find many allopathic physicians throughout time who didn’t claim success. This is despite the fact that, not only have they not done what they should have been ideally doing for prevention and making sick people well, but have likely done harm.

Let’s throw a quick glimpse at iatrogenic diseases as a reality check: In a study published in the New England Journal of Medicine in 1981, Steel and his team found that 36 percent of 815 consecutive patients admitted on a general medical service of a university hospital in Boston developed an iatrogenic illness. Thirty-six percent of the patients experienced one or more iatrogenic illnesses requiring medical intervention. In 9 percent of the patients, the incident was considered major in that it threatened life or produced considerable disability. In 2 percent or 15 patients, the iatrogenic illness was found to be fatal. They also pointed out a lack of progress since a similar paper had signaled the same red flag of flagrant iatrogenicity fifteen years earlier in 1966.

In 2004, Steel’s paper was reprinted in its entirety as being a classic in the history of medicine. The sad comment added to the reprint of this paper was that nothing had practically changed since the original red flag had been signaled 38 years before in 1966, and clearly and inescapably re-signaled in 1981.

This means that people in general, and physicians in particular, tend to be unbelievably complacent. Complacency is the feeling you have when you are satisfied with your surrounding world or yourself, especially when it is accompanied by unawareness of deficiencies, inadequacies or actual dangers. Rare are the physicians who are not complacent, despite not delivering the expected goods and perhaps having in fact even done harm. Beware of this state of complacency or blind arrogance, as they are one of physicians’ greatest nemeses. When you find yourself being complacent, notice it and its effects, and learn to come out of it. The more you do this old Pythagorean exercise the more successful you will be able to steer yourself in the right direction.

But what are these expected goods? See it simply from the patients’ perspective when they consult a physician. They expect the best, don’t they? Don’t we all? When our little child develops pneumonia, a life-threatening acute disease, or polymyositis, a life-crippling chronic disease, don’t we all hope for and expect the best of all outcomes? But what is this best outcome?

Has it ever been defined?

Indeed, it has previously been defined by Hahnemann as the highest ideal of therapy, which is the rapid, gentle, pleasant, complete and permanent restoration of health in the surest, simplest and least harmful way.

Wow! This is a loaded sentence, isn’t it? It signifies that the means used by physicians should not only be extremely efficacious but certain.

In the context of wholism and gentleness, shouldn’t certainty in medicine be our ultimate goal?

However, aside from the therapeutic ideal, there is another aspect to the physician objective, which is as important. Indeed, first and foremost, we need to educate and guide people to adopt environments and ways of living that are conducive to good health.

The entire curriculum of medical education should be directed by this two-faceted objective: prevention and the therapeutic ideal. There is no doubt that success in medicine can be defined by having attained this objective. Students seeking this objective are on their way to becoming true physicians. The true physician is the one who has reached mastery in the art of medicine, namely, in prevention and in the therapeutic ideal.

Beware though that medical education is an ongoing process that doesn’t stop the moment you graduate from medical school. You never stop becoming a physician, as you can never stop seeking and eliminating the causes of diseases, as well as enhancing the conditions of life. You should expect excellence from the medical school you have chosen to study in, but don’t depend solely on it to become a successful physician. The best medical education you will obtain will be the one that you will complete through your own inquiries.

To become a successful physician you don’t have a choice but to empower yourself as the captain of your own journey. Hear Whitman’s exclamation:

O Captain! My Captain! Rise up and hear the bells.
The prize we sought is won. The people are all exulting!

Be realistic about what your medical school can do for you and, at the same time, be proactive on how you can participate in your own medical education to attain excellence.

Seek what you feel is important, don’t wait to be spoon-fed. While in school, challenge your deans, teachers, preceptors and clinic supervisors anytime the training provided strays away from our fundamental principles. After graduation, you will now be in complete charge and assume full captainship of your professional education and destiny.

Remember to never stop becoming a true physician!

Reflect a moment on the enormous difference you can make by seeking excellence in medicine, as compared to just becoming an ordinary physician. Challenge yourself and learn to surprise yourself in pursuit of your noble goal.

Jean Cocteau, who was a famous French poet and playwright, often mentioned that the true exploration of artistic creativity began for him when he encountered Diaghilev, the director of the Russian ballets, and expressed to him a desire to create ballets. Diaghilev challenged Cocteau with two very famous words, “Surprise me!” It is totally astonishing to realize that only two words could have such an influence on a person and be responsible for bringing the very best out of Cocteau for the rest of his life.

And here I say to you: Surprise yourself in your journey to seek truth and excellence in medicine and learn to bring the best out of you!

The choice is yours: On the one hand, you can become ordinary and complacent physicians who think they know when they don’t and become engulfed in the sinkhole of ordinary medicine. On the other hand, you can seek excellence in medicine and never remain satisfied with yourself until you have reached mastery in the art of medicine.

Reflect on whether there are any subjects more vital to humanity than the ones related to health, disease, healing, and the quality and prolongation of life.

Take a moment to reflect on the importance of being a physician and what Hahnemann said to his French colleagues soon after having moved to Paris, “In an art whose aim is the saving of life, negligence in learning is a crime.”

In Plato’s Apology, Socrates said, “The unexamined life is not worth living.” As physicians, it would be worthy to examine how every one of our doctor-patient interactions measures in relation to our two-faceted objective, namely, prevention and the therapeutic ideal. This continual examination, and readjustment when straying away from our objective, is one of the best tools we have to become really successful physicians.

Reflect on how profound your actions can have on people’s lives. Being here in Oregon and looking westward through the large window at the back of this room, I easily recall the lady who I examined more than 25 years ago at the NCNM Clinic. While conducting a gynecological exam, I noticed that she had two large bruises on the upper parts of her inner thighs. Strange, I thought. I let her dress, came back in the room and told her that she had not told me the whole story. She knew I had seen the bruises and broke down sobbing. She told me that her husband was an alcoholic. He was working near Tillamook on the Oregon coast, loading trucks with oil. He would come back home from work around 4:30 in the afternoon and would begin drinking his 6 or more beers every evening. On the weekends, he would drink 12 or more beers a day. They had three boys about 10, 12 and 14 years old. Daily, he would beat the hell out of his boys and wife. I told her that I could perhaps help her husband and the rest of the family if she could describe her husband to me. After she did this, I gave her a remedy to put in his food and drinks. She came back about 6 weeks later. When I greeted her in the clinic waiting room she was accompanied by her in-laws. They had driven two hours to thank me for having given them back their son. Pleased but puzzled, I led my patient to the consulting room where she told me that her husband slowly stopped drinking on his own. He now goes many days without drinking and if he drinks he limits himself to one beer.

During these six weeks, he towed away to the scrap yard three old cars that had been rotting around the house for years. He painted the house for the first time in many years. They lived on the Trask River and he brought his three boys steelhead fishing for the first time in their lives. The best of all was that he had totally stopped being violent and had rejoined his community at church.

What effect did this single interaction have on the destiny of these three boys? What permanent effects did the turnaround of this man’s life have not only on his family, but also on the entire community?

Reflect on the great potential physicians have to directly or indirectly help people live better, happier, healthier, longer and more creative, loving and productive lives.

Remember George Bailey in It’s a Wonderful Life when he said, “I wish I had never been born.” He goes back to his hometown and sees the world without the good he had done since his childhood. Just imagine following the lifelong trail of a true physician and see all the good that has been sowed along his or her path. Incidentally, I can’t help being reminded of Dr. Bastyr whenever I see Clarence, the angel in this movie. Now, just imagine all the good Dr. Bastyr has directly or indirectly done throughout his life. Just the fact that we are here at NCNM, an institution Dr. Bastyr was so proud of and that singly held the flame for an entire generation of young physicians, is a vivid testament to the incredibly vast extent of his good actions.

Having chosen to become a physician doesn’t mean you will be successful in your quest or that it will be easy. Being spoon-fed will not suffice to attain excellence. Sir James Paget traced the course in life of 1,000 medical students taken at random from an English institution in the second half of the nineteenth-century. He found out that within 5 years, only 9 percent had attained considerable or distinguished success, 60 percent were able to make a living and another 30 percent did poorly, failed or never practiced. At the same time, William Pepper, one of the most prominent American allopaths, said, “There is no other business than medicine in which so small a proportion of those engaged earn a living.” This was before medicine became a trade union and its subsequent monopolizing politics. I am not sure that the track record of the graduates from our naturopathic colleges would be much more brilliant. Such a high failure rate and so many broken dreams is astonishingly sad for suffering humanity, awaiting in vain for their dear and glorious physicians. Beware that the standard of success we are aiming for by pursuing prevention and the therapeutic ideal is very far reaching as compared to the financial and academic success certainly referred to by these two prominent allopaths.

If the will to become a successful physician is the first prerequisite, the second one is to acquire the needed knowledge.

In order to accomplish their mission, physicians need to become knowledgeable of three very particular subjects, namely, self, human nature and Nature.

The level of knowledge you will acquire about these three subjects will determine how you will practice medicine and will greatly determine your level of success. If you want to know what type of physician you will be, look at how you are living now. If you are not happy with the scene, change it, as you will live as you practice medicine, and practice medicine as you live. Learn to tackle each difficulty of life as it comes in order to move closer to your noble objective.

Self

Let’s start with self, which is the most neglected but also the most determinant of these three subjects. The greatest limitation to attain excellence in medicine is the physician’s lack of self-knowledge. The less you know about yourself the more you will trip over yourself and commit mistakes that will impede any progress forward.

As you are becoming the captain of your own journey, it would be helpful to know who is the captain handling the wheel and compass, or in other words, to know about your strengths and weaknesses, disposition, temperament, moods, ethics, sensitivities, reactions, instincts, judgment, etc. Acknowledged weaknesses can become strengths, while ignored ones become nemeses.

No exploration is richer and more rewarding than learning about oneself, as suggested by the old Greek aphorism, “Gnothi seauton,” know yourself (and the universe will open to you).⁽¹⁾

Self is actually a microcosm within the macrocosm of the universe. The word “microcosm” means a little cosmos or universe. The word “cosmos” comes from the Greek “kosmos” which means “order” or “good order.” Pythagoras is said to have been the first to apply this word for the universe. Self is actually a little universe, as if the whole was contained in each of us.

Searching for oneself is in fact a deeply spiritual and transformative quest, which I see as essential to achieve success in medicine.

One of the first results of self-knowledge is learning whether medicine is your real vocation and whether you are fit for the practice of medicine.

Incidentally, for the ones who are not sure about whether becoming a physician is right for you, I would invite you to read Taylor Caldwell’s Dear and Glorious Physician. In this historical novel, Caldwell tells the story of Lucanus, one the greatest physicians of Ancient Greece, who travelled throughout the land seeking answers in his quest to become a physician. Even though Lucanus is Caldwell’s dear and glorious physician, he is best remembered by the rest of the world, not as a physician, but as the writer of the Gospel of Luke.

It is meaningful to know the origin of the word “physician.” It comes from the Greek word “physis” which means “Nature,” which in turn comes from “phyo,” which mean “origin” or “birth.” The word “nature” comes from the Latin “natus,” meaning “born” or “what is innate.” The very essence of being a physician is to investigate Nature, or what is innate. It is interesting to note that Hippocrates commonly referred to physis, as that what heals.

Originally, a physician and a natural philosopher were synonymous. Today, the word “physician” has been limited to medicine and signifies the one who seeks to understand the fundamental principles of Nature in order to favor health and healing. Nonetheless a good philosopher would make a good physician and verse versa.

The word “principle” comes from the Latin “principium,” which means “beginning” or “fundamental truth.” Seeking the truth is greatly the search for these fundamental and immutable principles.

The better you qualify for the job of becoming a physician the better will be your chances of success. Also, the more you can improve yourself along the way the better will become your qualifications and the greater will be your chance of success in the most beneficial of all arts: helping people to live better and longer lives.

What are the more important predispositions necessary for the practice of medicine? I would suggest the following qualities and dispositions, of which I would encourage their cultivation: benevolence, intelligence, sound health, balanced personality, curiosity, humility, patience, alertness, objectivity, resourcefulness, being a good communicator, equanimity, resilience, optimism, intuition, sound judgment, courage, self-confidence, honesty and wisdom.

Benevolence is the disposition to be kind and good to others. In Buddhism, it is called maitri, which is one of the four elements of true love and is translated as loving-kindness.

Benevolence is one of two basic ingredients to becoming a true physician, knowledge being the other. Benevolence or love is the inspiration while knowledge is the guide. With the love to help your fellow human beings you will be eager to learn and acquire the necessary knowledge to become a true physician. However, benevolence, without that knowledge or ability to do good, may actually make others suffer. To a 24 year-old enquiring medical student, Hahnemann wrote, “I pray you to continue to be a right, genuine, good man, as it is impossible without virtue to be a true physician, a godlike helper of his fellow creatures in their distress.” It seemed that Hahnemann’s prayer was greatly fulfilled, as the young student was Constantine Hering.

Sound health and balanced personality: if you have health or personality problems make a priority to improve yourself. Physician, seek to become more whole along your journey, in order not to disperse your own chaos along your way.

Curiosity: the desire to know, to seek the causes diseases and the appropriately corresponding remedial interventions and answers to your other questions as they come along. Don’t accumulate confusion. Always be in a state of clearness and understanding, of knowing where you are and where you are going. Don’t let currents and fashions direct your way, as you will, more likely than not, be thrown against the reef and never reach the destination of your dreams.

Humility: the word “humility” comes from the Latin “humus,” meaning “earth” or “soil.” It means to bow to the ground regarding the state of your knowledge. Humility is the opposite of arrogance. To know you don’t know is the beginning of knowledge. The more you know, the more you realize that you don’t know and that constant inquiry is the way to knowledge. On the other hand, arrogance, complacency and ignorance will prevent you from progressing forward in your quest. These are real plagues for physicians and will kill any admirable dreams you may have had at the beginning of your medical studies. Please beware of these traps.

Patience, alertness and objectivity: learn the necessary patience to becoming a good observer. A good observer is alert, objective and thorough. It means that of what is perceptible, nothing escapes the senses, but at the same time, nothing is added that is not present. Beware that by nature we are not objective and we have to train ourselves to become objective. Surprise yourself when you notice you are not being objective. The more you do this simple but powerful exercise, the better observer you will become.

Learn also to listen and develop your sense of touch. I remember that many patients came regularly to see Dr. Bastyr just to be touched by him. Bastyr was clearly their dear and glorious physician, and being touched by him meant much to them.

Equanimity: cultivate that coolness and calmness that is so sweet and helpful when you or your patients are amid stress, difficulties and suffering.

Resilience: learn to bounce back after having experienced life’s difficulties. We don’t choose our difficulties in life but we can choose how to deal with them. Learn to put things in perspective.

Sometime, I tactfully ask patients who feel distraught by some mundane circumstances the following three questions:

First, whether they know how many stars or solar systems there are in the universe. I help them with the answers. There are 200,000 billion billions stars (there are about 500 billion galaxies and each has an average of about 400 billion stars).

How much is 200,000 billion billions? To give you an idea, it is the equivalent of all the grains of sand on all the beaches of our planet times a thousand (assuming that there are about 400,000 km of coast line and that the average beach is 12.5 m deep by 50 m wide).

The next question I ask is, where do their problems with so and so, or about this and that, fit into our universe? Understanding through perspective is the foundation of wisdom. The mountain is always less overwhelming when it is looked at from a distance.

From valuable knowledge and experience come reliable intuition, sound judgment, courage and self-confidence.

Wisdom: being a physician can be very fulfilling to the mind with the never ceasing search for answers; it should also be very fulfilling to the heart and soul with the constant provision of beneficence. It will also make you wiser and more honest. By following Nature and seeking to apply its laws on a daily basis it will transform you, as you can never fool Nature. Hippocrates rightly mentioned that physicians who dissociate themselves from speculative medicine could develop an understanding of Nature that is real and certain, and that is more accurate and useful than it can be for any of the other natural philosophers.

Assuming that you fulfill the necessary profile, the next requirement is to learn about human nature.

Human nature

Physicians need to learn about human nature, from genes to the psyche, and in health and disease.

To prepare for these long studies, a good foundation in liberal arts and sciences is very useful.

The study of other languages opens up the access not only to otherwise inaccessible libraries but also to other cultures and perspectives.

Arts are important for the refinement of the senses, developing creativity and arousing the sense of beauty and of the whole. For instance, the art of drawing is an excellent exercise to develop the sense of perception. Music and poetry are exquisite nourishment for the heart and soul.

The study of pure sciences, such as mathematics and physics, helps to develop judgment so important in medicine. Oddly enough, the words uttered by Hippocrates 2,500 years ago are still pertinent today in medicine, “Life is short, the art long and judgment will always remains difficult.”

The study of natural sciences (biology, botany, chemistry and biochemistry) will prepare the ground for learning medical sciences.

The study of history, psychology, sociology, ethology and religions will prepare for further understanding of the inner and invisible aspects of human nature.

Perhaps the most important of all subjects to study all along is philosophy. Philosophy is essential to develop the art of sound reasoning and judgment; to develop an open and critical mind; to develop a sense of history; to develop ethical conduct; to express refinement in feelings and thought, and the art of living; and to learn to seek the truth.

Take just one of these elements, “to develop an open mind.” Think on how far having an open mind can bring you on your journey. Accordingly, Lao Tsu wrote,

With an open mind, you will be openhearted.
Being openhearted, you will act royally.
Being royal, you will attain the divine.
Being divine, you will be one with the source.
Being at one with the source is eternity.

Study the Greek and Roman classics: Pythagoras, Socrates, Hippocrates, Marcus Aurelius, Cicero, Seneca, etc., which are so important in order to develop clarity of reasoning and directness in thinking and feeling. Study also the Chinese classics: LaoTsu, Chuang Tsu, Confucius, etc., so important for developing the senses of holism, spirituality and ethics.

Beside an education in liberal arts and sciences, learn to live close to nature. Take every opportunity to delve into the natural world and learn to become one with it.

We said that physicians need to know human nature from genes to the psyche, and in health and disease.

This implies that physicians have to be astute enough to recognize not only where a person is on the continuum of health and disease, but also to understand the factors and influences at play in the general equation of health and disease.

In other words, physicians have to be able to carefully examine patients in order to precisely diagnose the causes of the problems and their effects on the individual and come to a full understanding not only of the problems, but of who is the person having the problems.

In order to thoroughly know the phenomena of health and disease, physicians need to have not only the required working knowledge of anatomy, physiology, pathology, etc., but also, and especially, the ones of hygiene, psychology, ethology, genetics, and microbiology. Thus permitting a global understanding of the person in constant interaction with a dynamic environment.

Hygiene is the science of health and I can’t put enough emphasis on this to interest you to become nothing short of true experts in this discipline. Optimal health is dependant on optimal conditions of life.

Now we come to the third and last requirement of knowledge to becoming a physician: to know Nature.

Nature

Physicians need to learn how to apply the laws, principles, forces and influences of Nature in order that people live in good health and sick ones recover their health rapidly, gently, completely, certainly and in a durable manner.

Here you will seek the necessary training permitting you to master the most essential aspects of therapeutics, how to utilize the different principles, forces and influences of Nature for health and healing. Learn the potentialities and places of the different approaches and modalities you will be exposed to throughout your college years and career. Remember that you never stop becoming a physician.

It is not only a great privilege to be a physician but it becomes also a way of life. You will not only exercise the best faculties of the mind and heart but also learn to become wiser by working closely with Nature. Natural laws correspond to fundamental and immutable principles. There are exceptions to a rule but never to a law. Stick to the confirmed laws and principles you come to discover. Make them the foundation of your practice. As you can never cheat Nature, learn to abide by it. If you are true to Nature, Nature will be true to you.

As you are learning about Nature and becoming a true physician, you can’t avoid being transformed through this process and find that the path is actually the way.

I have two pieces of practical advice to help you along your path: First, you will be exposed to a lot of information that will likely become overwhelming. Anything important that you need to better understand, seek clarification and answers now! Don’t let confusion accumulate. Horace said so well, “Dimidium facti qui coepit habet: sapere aude: incipe,” which means, “To have begun is to be half done. Dare to know and begin now!”

Second, anything you find to be important or fundamental store it somewhere and put it where it fits in the order of things. Begin now to write your own book of principles and resources and always keep it updated throughout your career. You will progress forward faster by constantly integrating in an orderly fashion all new knowledge. Create a comprehensive mosaic representing your own understanding of the principles of medicine, as well as their implications and sub-principles.

All that I have told you so far in this lecture I have summarized in what I call the seven fundamental principles of classical medicine. I started presenting these principles in the early 1980’s when I was teaching naturopathic philosophy here at NCNM. Not a year has since passed that I didn’t present these principles to naturopathic or allopathic students and physicians in colleges, universities or hospital settings.

Before I begin presenting these principles, I usually request the audience to immediately interrupt me whenever there is any major objection to any one of these principles. It is important that all must be squared off before we can proceed forward. The rule is that, through in and through out these lectures, I get blank audiences. I remember about 25 years ago, I presented this set of principles to over 150 medical residents in a larger hospital in Northwest Portland. At the end of that presentation, I invited questions, objections or comments from the apparently very attentive audience, only to conspicuously witness a completely silent room looking at me.

We can only hope that elaboration of these principles would have some effect on the enormous inertia and complacency of allopathic students and physicians. Even though we may all agree with the permanent value of these principles, who will actually stand up above the crowd and really implement them in practice? Hopefully, for eager naturopathic students like you, these principles will have more meaning and are more likely to be implemented.

Throughout these last 26 years, I have met with only one objection to these principles. It was in 2007 while addressing the medical students at McGill University in Montreal. After I had presented the seven fundamental principles of medicine, a third year medical student became very impatient to make a comment. Pointing to the seven principles projected on the screen, she exclaimed, “These are old principles and have nothing to do with modern medicine.” I looked back at the screen, reflected for a moment and replied, “I can’t agree more with you, as none of these are really taught or practiced by medicine today.” At that very moment, you could have heard a fly gliding through the room, as if all became bewildered before the immensity of the chasm.

In fact, these principles are so old that you can find most of them almost word for word in the Hippocratic Corpus.

The Seven Fundamental Principles of Classical Medicine

The first principle applies to the physician, the actor, while the six others apply to the actual practice of medicine, the acting.

1. Aude sapere: Physician, dare to know, and become a true philosopher and scientist but above all, a true artist. Constant inquiry is the way to knowledge.

2. Praeventum: Prevention is better than a cure. Therefore, the highest mission of the physician is to guide people to choose ways of living and adopt environments that are conducive to good health.

3. Primum non nocere: First, physician, do no harm. In spite of the best prevention, people will be affected by numerous influences and will fall sick. Any prophylactic, diagnostic or therapeutic intervention by the physician should not further harm the patient.

4. Tolle causam, cessat effectus: Remove the cause and the effect will cease. There are causes of sickness and above all, physician: address them.

5. Vis medicatrix naturae: The healing power of nature. It is neither the physician nor the treatment that heals but only the living organism. Therefore, the physician must seek to encourage this innate process by first making sure that the conditions of life are met and, if necessary, by using the help of the various outer influences and forces of nature to enhance the recovery of health.

6. Nunquam pars pro toto: Never the part but always the whole. The physician considers the patient as a unique indivisible whole and, therefore, takes into consideration all the conditions of life and pertinent aspects of each individual, including the physical, emotional, mental, spiritual, energetic, genetic, sociological and environmental aspects.

7. Cito, lenis, jucunde, toto, durabile, certo, simplex et tuto curare: The highest ideal of therapy is the rapid, gentle, pleasant, complete and permanent restoration of health in the surest, simplest and least harmful way.

Incidentally this set of principles can be applied to any aspect of life, especially related to solving problems, whether they are personal or societal, physical or psychological, or in economics, politics, mechanics, etc.

By seeking full knowledge of the principles governing health and healing you will be on your way to mastering the art of medicine and becoming a true physician.

Beware that there are innumerable sub-principles and implications related to each of these seven fundamental principles. To give you an idea, I will leave you with some of the sub-principles and implications of the first principle, Aude sapere.

Sub-principles and Implications of Aude sapere:

Aude sapere: Physician, dare to know, and become a true philosopher and scientist but above all, a true artist. Constant inquiry is the way to knowledge.

Why is the true artist above the scientist or philosopher? In German, a physician is called “Arzt,” which means “artist.” Indeed above all you must learn to become an artist, a master of your art. Art denotes the employment of means to accomplish a desired end. To possess an art is to be in possession of that precious know-how for achieving that desired end. Knowledge associated with science doesn’t imply having the know-how of that science. The know-how associated with the art of a discipline is in fact greater than its science. As the authentic end of medicine is health and healing, it is appropriately called a “healing art.” A healing art has indeed much farther reach than just the application of scientific knowledge. The outcome of modern medicine is a very good example of a science devoid of art and philosophy

Gnothi seauton: Physician, know thyself.

The greatest limitation to attain excellence in the practice of medicine is the physician’s lack of self-knowledge.
The patient’s well-being is tantamount to the physician’s personal ideas and ambition.

“In an art preservative of human life, negligence in learning is a crime.”

“Listen to the laws of nature, and be guided by them in practice.” Hippocrates

Physician, heal thyself.

“For the physician, it is undoubtedly an important recommendation to be of good appearance and well-fed, since people take the view that those who do not know how to look after their own bodies are in no position to look after those of others. He must know how and when to be silent, and to live an ordered life, as this greatly enhances his reputation. His bearing must be that of an honest man, he must be towards all people honest, kindly and understanding. He must not act impulsively or hastily; he must look calm, serene and never cross.” Hippocrates

A brief addendum about research in naturopathic medicine⁽²⁾

The need to know and search for answers is intrinsic to human nature. However, beware not to lose sight of your principles while you are searching for answers. Use your principles as your compass and rudder to direct you all along your journey.

When you walk through the immense stacks of medical books and journals accumulated in the biggest medical libraries of the world, you realize that, despite all these billions of reports, theses, research, monographs, etc., conventional medicine is not much farther ahead in the art of medicine. What a massive delusion and an incredible waste of human resources, isn’t it? What is the point of researching and publishing if you have no clue regarding the art of medicine, the know-how about health and healing, or don’t know where you are or trying to go? Therefore, beware not to fall into the same trap of blind arrogance and complacency.

Beware of researchers who don’t understand our fundamental principles, as their findings have very little value for us. How can the findings of reductionism-based research be useful within a holistic perspective?

Beware that your first goal as a physician is to become a true artist. When you abide by our fundamental principles and use the full potential of Nature’s resources, you will obtain success beyond all expectations. What is really important is that you first learn the art of medicine, the know-how about health and healing. This should be your first and main research subject. It may also be very important at this point for you to know that well-applied naturopathic medicine is incredibly efficacious. Only a very small minority of patients with acute and chronic affections you will not be able to help in their recovery of health. From your actions, you will witness miraculous changes in people, and many of the said “incurables” will be recovering. Therefore don’t get lost seeking answers to questions that may not be so relevant to the true physician.

Above all, learn about healthy ways of living, and how to heal by tapping into the immense healing potential of Nature. And don’t try to reinvent the wheel. Hippocrates said that clever physicians begin their research by studying discoveries made in the past. At first, let yourself be carried on the shoulders of accomplished elders and teachers. Seek their knowledge and learn from their experience.

Eventually, by seeing further, you will be able to improve their legacy. Whenever you witness something interesting or new, teach, publish and share your findings with the rest of the community. However, make sure to give a mark of permanency to all your work, teachings, writings and research. If it’s worth doing, it’s worth doing well, as the world needs it that way.

And when the far away day comes that will find you on your deathbed, I hope you will be able to look back and say, “I didn’t live in vain.”

Hopefully, a few seeds have been sowed during our meeting today.

I wish you all a good, happy, long and very fruitful career in this most beneficial art that is medicine.

References

1. In his Gospel, Thomas wrote, “Whoever has not known himself has known nothing, but he who has known himself has at the same time already achieved Gnosis about the depth of all things.”
2. This addendum completes my views that uttered in the panel regarding the relevance of research in naturopathic medicine.