primum non nocere

We human beings have such great capacity for doing harm. It comes as no surprise that primum non nocere, “first do no harm,” has made it into the maxims as one of the basic things medical students are taught in medical school.

Most people think this phrase is a part of the Hippocratic Oath, but the oath does not contain the exact phrase. Perhaps the closest approximation in the Hippocratic Corpus is: “The physician must…have two special objects in view with regard to disease, namely, to do good or to do no harm.”

Primum non nocere was introduced into American and British medical culture by Worthington Hooker in his 1847 book Physician and Patient. And Hooker attributed it to the French pathologist and clinician Auguste Francois Chomel (1788–1858), who made the axiom a part of his oral teaching.

Regardless of its source, if only more doctors, lawyers, and others were to take this principle of non-maleficence to heart!

I have recently heard of a Maryland lawyer who took $9,000 that was raised for the defense of a juvenile parricide, but who made no filings of any kind and cannot explain where the money went before dropping the case after ten months of damaging inactivity. And today in Iowa commences the case of Noah Crooks, who was forced onto psychotropic drugs by his school and physician for ADHD–drugs which I believe are responsible for the death of Noah’s mother.

I’ve withdrawn from the world, in part to leave a more benign wake, and yet I have found that some people develop unencouraged expectations of me that I cannot help but disappoint. If this, too, is doing harm–if I refuse to be taken advantage of–then I give up!

But I don’t. And I won’t.

The idea of being taken advantage of has been a central issue of spiritual hospitality for centuries. The most quoted Hindu saying about hospitality is “a guest is God.” Since Vedic times, Indian culture has emphasized a level of care which has at times bordered on the extreme. A host was urged to not only provide for the basic needs of a guest, but for all the guest’s needs and wants.

The basics included providing water to drink or wash one’s feet, a comfortable place to sit or sleep, and food. Yet a guest’s demands could sometimes become humiliating or even hazardous to the host.

anasuyaThe story is told about Anasura, the wife of the sage Atri, and held up by many as a model of virtue. While Atri was away on a long journey, the gods Vishnu, Shiva, and Brahma went to Anasura’s home disguised as mendicants. They said they were Brahmins from far away and needed food. But just as Anasura was about to offer them a meal, one of the visitors said that they could not accept offerings from anyone who was clothed. Hence Anasura would have to disrobe before serving them.

Anasura immediately realized she was being tested, and probably by someone powerful. If she refused, she would commit the sin of refusing the Brahmins her hospitality. If she complied, she would dishonor her husband and betray her vows to him.

Anasura chanted a mantra and summoned all the Karma that she had accumulated through her lifetime. Immediately the three gods were transformed into crawling infants, and one by one she suckled them. She thus met the requirements of hospitality without compromising her fidelity.

This myth teaches that sometimes the demands of hospitality can be a challenge and that we must be up to it. While I have never been asked to get naked in its pursuit, more than once I have been caught with my pants down.

Live and learn. You can make mistakes about who you let into your life, but you must above all learn from them.


Groove of the Day 

Listen to Roxy Music performing “India”

2 Responses to “primum non nocere”

  1. 1 Belinda
    May 2, 2013 at 10:56 am

    Appreciate this post. Let me try it out.

  2. 2 Rose
    May 2, 2013 at 11:07 am

    I’ve listened to this a dozen or more times and still find it delightful and sooooo original in concept. We realize that we don’t need to listen to outside authorities; we are not guided by our internal authority.

    It’s more than just doing the right things or being involved in a good opportunity.

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