Intended for healthcare professionals


Primum non nocere

BMJ 2006; 332 doi: (Published 12 January 2006) Cite this as: BMJ 2006;332:97
  1. Laura Wilkins, medical student (laura.wilkins{at}
  1. Green College, at the Radcliffe Observatory, Oxford

    I was sitting in the outpatients clinic of the cardiology department the other day. A little boy in a wheelchair came in with his father. His father was greeted by the receptionist and whisked off for echocardiography. The little boy stayed in the waiting room and cruised around skilfully in his wheelchair. He had both legs partly encased in plaster with a metal bar between the two holding his legs in a fixed position.

    Pictures of the heart decorated the walls of the waiting room; some were medical images generated from angiograms, but others were far more weird and wonderful, including wood, glass, and metal creations. The little boy was transfixed by them. I struck up a conversation with him about his legs and the content of the pictures. He was very enthusiastic and curious. Just before he left with his father I asked him if he wanted to be a doctor. His response surprised me. “No,” he replied forcefully, “I don't want to hurt people.”

    Of course, he was right. Doctors are traditionally thought of as healers, but I have been surprised on my journey so far through medicine by how much of our time is spent inflicting pain on others with the intention of helping them in the end.


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