The Ancients Were More Caustic

This problem of iatrogenics is not new—and doctors have been traditionally the butt of jokes.

Martial in his epigrams gives us an idea of the perceived expert problem in medicine in his time: “I thought that Diaulus was a doctor, not a caretaker—but for him it appears to be the same job” (Nuper erat medicus, nunc est uispillo Diaulus: quod uispillo facit, fecerat et medicus) or “I did not feel ill, Symmache; now I do (after your ministrations).” (Non habui febrem, Symmache, nunc habeo).

The Greek term pharmakon is ambiguous, as it can mean both “poison” and “cure” and has been used as a pun to warn against iatrogenics by the Arab doctor Ruhawi.

An attribution problem arises when the person imputes his positive results to his own skills and his failures to luck. Nicocles, as early as the fourth century B.C., asserts that doctors claimed responsibility for success and blamed failure on nature, or on some external cause. The very same idea was rediscovered by psychologists some twenty-four centuries later, and applied to stockbrokers, doctors, and managers of companies.

According to an ancient anecdote, the Emperor Hadrian continually exclaimed, as he was dying, that it was his doctors who had killed him.

Montaigne, mostly a synthesizer of classical writers, has his Essays replete with anecdotes: A Lacedaemonian was asked what had made him live so long; he answered, “Ignoring medicine.” Montaigne also detected the agency problem, or why the last thing a doctor needs is for you to be healthy: “No doctor derives pleasure from the health of his friends, wrote the ancient Greek satirist, no soldier from the peace of his city, etc.” (Nul médecin ne prent plaisir à la santé de ses amis mesmes, dit l’ancien Comique Grec, ny soldat à la paix de sa ville: ainsi du reste.)