From the Editor

Who Am I?

By Louis L. Constan, MD

At the climatic end of the first act of “Les Misérables,” the blockbuster musical based on the best-selling historical novel, Jean Valjean sings about a turning point in his life. You see, he, as a young man, had been branded as a criminal and spent 19 years in prison for stealing a loaf of bread. After his release, even as he is hounded by Javert, a lawman determined to return him to prison, he strives to live a life of altruism and self-sacrifice. Still, Valjean largely accepts the notion that he is, at heart, a criminal. Finally, at a dramatic turning point, as he sings “Who am I?”, he begins to realize that he has self-worth; that society’s, and Javert’s assessment of him is wrong. That he is a valuable person, blessed by God. I thought of Valjean recently as our SCMS Board did some introspection by asking, not “Who am I?” but “Who are we?” and came up with a set of Mission/ Vision/Values (more later on that). I also thought of Valjean as I learned that the attorney general of the State of Indiana asked Indiana’s Board of Medicine to revoke the license of a particular Indiana physician. This Ob-Gyn, who had aborted a ten-year-old rape victim (which is strictly permitted by Indiana law…but unpopular in certain quarters) was called on the carpet for a minor reporting error over that very necessary medical procedure. According to the top law enforcement official of Indiana, she deserved to lose her license over this. Extreme? Certainly, and we can easily recognize that attorney general as a modern-day Javert bent on imposing simplistic views of morality on a physician who was providing a needed service to a suffering patient. Clearly, we doctors live in tumultuous times. That Ob-Gyn surely asked herself “Who am I?” as she put the welfare of her patient first and stood up to the most powerful law enforcement official in her state. And “Who are we?” is no less an important question to ask ourselves as we confront a plethora of challenges to our ability to practice our profession. I need not list these challenges but will do so anyway: • The impugning of medical science and evidence-based treatments • The appalling ignorance of those who are allowed to decide how we can practice medicine • The outright threats to doctors who stand up to those who spread misinformation about viruses, viral treatments and vaccinations • The underfunding and belittling of the role of important institutions such as the FDA, the CDC and NIH • The laws in some states that forbid doctors from giving complete information to patients Benjamin Franklin, after he signed the Declaration of Independence, warned that: “We must all hang together, or assuredly, we shall all hang separately.” While not as hallowed a document as the Declaration, our Mission/Vision/ Values does serve a vital role. It answers important questions. We, as a medical society, are a diverse group of individuals. Some independent and some employed. Academic and community physicians. Multiple specialties. But what holds us together? What drives us, what dreams do we dream, what values do we hold dear? Mission/Vision/Values attempts to answer those questions. Over the next few months, I will be presenting commentary on those Mission/Vision/Values. Our Board worked hard on this document and we are in their debt. We, individually, may not agree with every single word, phrase, or punctuation mark; but it is important for all of us to wrestle with its content. We may be asked about them. We may be challenged by those who do not value the doctor/patient relationship; who do not believe we can be trusted to make ethical decisions; who give a social media posting as much weight as a doubleblind study. Armed with this document, we will be better able to stand up and defend our values; to answer the question “Who are we?”

Benjamin Franklin, after he signed the Declaration of Independence, warned that: “We must all hang together, or assuredly, we shall all hang separately.”