Home                                                A short letter to a newly qualified physician


Dear Mohamed,


Thanks for your mail.


I'd love to be back in Egypt, thanks for your offer of hospitality - it's one of the reasons I am so fond of Egypt - that is has not forgotten the hallowed Middle Eastern tradition of showing loyalty and kindness to guests, even in sometimes very sacrificial ways - as Abraham and Lot did. It is just one of many signs of the moral weakness of the modern West, and I fear it's creeping influence over too much of the world. However I shall not be able to return for a while yet - God knows the timing.


I know exactly how you feel, and I am sure that many of your colleagues feel the same way, even if they aren't able to share it.


I offer some simple advice to keep your heart and mind safe.


Always keep your eyes on your patients' best interests. Don't go for what is necessarily the brightest or the best or the most attractive, pursue what is most valuable and effective to improve you patients' health and lives. It will need strength of character and resolution, it may not always be fashionable, and some may speak ill of you - read the history of Lister or Harvey or some of the great Arab physicians of the past - sometimes they did and said things other people found hard to understand or appreciate, often they were opposed - yet that is the nature of vision, it sees things other don't and acts before they even perceive the issue - such vision and such character is rarer in Egypt than it should be, it's worth praying for and seeking after diligently in study. This is the path of lasting wisdom and honour.


There are some other bad habits to avoid, never, never lie - not even when all the world asks you to - not even when the patient himself or herself requests it. There is all the difference in the world between keeping silence discretely and violating the truth. Ultimately noone trusts a liar, not even if he's a professor.


Keep a clear conscience, even if it means hardship - better to stick to solid principle and honesty, than to cut corners for gain. The hypocrite will make rapid progress, but his fall will be sudden and usually final. A well built house will stand even in the whirlwind.


Never get involved in controversy unless you really need to, and then only after care and thoughtful examination of your opponents' case - often some of the truth is on the other side, only pride and reputation blind us to see what we ought. Use the gentlest approach necessary to address the matter properly - sometimes this will need courage. When you

are junior you may often have to learn to bite your tongue. Always keep your eye on what's best for the patients - is it harming their care to argue this?


Be skeptical of claims about drugs and other treatments - there is so much rubbish, so many useless and sometimes harmful drugs. Patients trust you to test and to examine these claims strictly. Even in the West the drug companies exercise a great deal of control for profit's sake - and the problem is worse in Egypt. Test what you are taught, and the

practice you observe - is this validated? Is it proven? Is there an authoritative independent source which supports this? Better not to treat than to use a dubious medicine that may be harmful. Stick to what you know works and works well. US physicians killed more patients during the Vietnam war from a misguided policy of treating ventricular ectopics

than the Vietnamese killed US soldiers. The road to Hell is paved with good intentions. As Solomon said, 'there is way that seems right to a man, but it ends in death' - sometimes literally for a patient. First of all do no harm (Primum non nocere).


Treat every patient as if he was your own father or mother, brother or sister. Even if his or her life is a terrible mess. Don't keep favourites.


Be careful of accepting gifts or bribes from the companies - they take away something much more precious than they give - your judgement and objectivity. Better to be frugal and free, than rich and enslaved.


Cut yourself free from sexual temptations from colleagues, patients and relatives - sometimes it will need a knife. It is a great dishonour and shame to fall in such a way, and this too needs constant vigilance even in small things, and the constant and strong help of the God who weighs all our thoughts and acts.


Give your learning and advice freely to others - don't me a miser with your learning and wisdom as you gain it. The miser impoverishes himself most of all.


Always walk humbly, remember the gifts and privileges you have received are for the purpose of glorifying God - not oneself, He can withdraw as easily as he gave, when and as He chooses. It is His to exalt and His to humble.


Much could be added, but even what I have written will be blessed but difficult and sometimes painful to observe, and sadly the realities of these warnings painfully unfolded in the lives of many of your colleagues very soon.


Best wishes and prayers for your future,


Yours in the Beloved,