AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. November 2000, Volume 2, Number 11.

From the Editor

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If you build it, they will come

The editor welcomes readers to version 2.0 of the journal by reflecting on how the medical profession has been shaped by the ethical values and conduct of physicians who came before.

Audiey Kao, MD, PhD

On a recent trip to the Pacific Northwest, I had the opportunity to spend an afternoon touring the Columbia River Gorge and its spectacular waterfalls. The largest of these waterfalls is Multnomah Falls, which stands at nearly 620 feet. As I stood on the bridge that spanned the upper pool of this double-tiered waterfall, I marveled at the millennia of geological activity that it must have taken to create this magnificent temple of rock and water. The slow process of weathering and erosion that creates waterfalls is hardly perceivable, but there are instances where geologic change is dramatically visible. On September 4, 1995, a rock the size of a greyhound bus broke off from the face of Multnomah Falls and its landscape was instantaneously altered. Luckily, no one was seriously injured when the rock came tumbling down.

Driving back to the hotel after visiting the Gorge, I reflected on the notion that the creation of waterfalls symbolized to me the historical currents of professionalism that bind physicians of the present with the past, and attract future physicians. The professional landscape of contemporary medicine is shaped in many respects by the ethical values and conduct of physicians who came before us, and by virtue of our predecessors' actions and priorities, we are the beneficiaries of the trust that patients have in today's physicians. Unfortunately, this public trust can often be taken for granted. The erosion of trust may be difficult to perceive until a critical point is reached, and then rebuilding fallen trust may be difficult if not impossible. Over the last four years, the number of medical school applications has fallen by one fifth, and while this may not seem as dramatic as the crash of a bus-size boulder, it does reflect a growing disillusionment about medicine as a calling. Thus, the actions and priorities of today's physicians taken collectively will shape our evolving professional landscape, and this may profoundly influence those who are considering medicine as a lifelong career.

A physician who undoubtedly contributed to creating our current professional landscape was Archibald Wright Graham. Most of you might know him better as "Moonlight" Graham, the physician who had a short-lived career as a baseball player. Portrayed by Burt Lancaster in the 1989 motion picture Field of Dreams, "Moonlight" Graham made his major league debut on June 29, 1905, with the New York Giants. Because of the way the ball bounced in a single game however, he lost his only chance to face a big league pitcher. After the 1905 season, Graham left baseball to fulfill his dream of becoming a medical doctor, eventually pursuing his life's work in Chisholm, Minnesota. "Doc" Graham spent his entire medical career in Chisolm, where he gained national recognition for his studies on children's blood pressure, and enjoyed the love and respect of the entire local community. In the film, the character played by Kevin Costner commented on the tragedy that Moonlight Graham's baseball career lasted only five minutes, but Doc Graham replied, "Son, if I'd only got to be a doctor for five minutes, now that would have been a tragedy."

With the aim of contributing to positive changes in our ethical and professional landscape, I am proud to announce the newest version of the Virtual Mentor. To the students and teachers who have visited the Virtual Mentor in the past, I hope that you will find our new content areas informative and interesting and continue to tell your peers about this educational resource. For those who are new to the web site, I welcome your feedback and comments because Virtual Mentor's potential as an interactive forum to examine and discuss ethical and professional issues confronting medicine cannot be fully realized without your participation. Motivated by the famous line in the Field of Dreams: "If you build it, they will come," I look forward to talking with many of you on the Virtual Mentor.

Audiey Kao, MD, PhD
Editor



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