I appreciate Dr. Fins’s letter and agree that the keynote address can help shape the ultimate message of a White Coat Ceremony. However, I speculate that no address can speak quite as loudly as the actual ritual that pointedly frames the entire event. The Gold Foundation1 and others2 have specifically highlighted the power of ritual in explaining the basis for the White Coat Ceremony, and on this point I fully agree; hence my critique.
Framing, I believe, is a key issue regarding the White Coat Ceremony. By the very structure of the ceremony, even the most genuinely humanistic values are being transferred from physician to student, along with the white coat, as part of a medical tradition, rather than as a universal message. For that moment, that narrow framework may well be inescapable. Thus an address that touches on broad and transcendent themes may actually be chaining them to professional parochialism rather than overcoming it.
Last, I call attention to Dr. Fins’s own chosen terminology. In his words, Dr. Dave Rogers “deployed his professionalism in the service of universal humanistic goods and goals.” I confess that I still don’t know what professionalism adds to this discussion. Why can’t we just say about Dr. Rogers that his professional role never overshadowed his more basic commitments to human decency and dignity? Similarly, rather than “aspire to a brand of professionalism that makes medicine’s humanistic reach felt more broadly in society,” I am more comfortable simply suggesting that doctors be doctors second and humans first.
Judah L. Goldberg, MD, MBE
Resident, Department of Emergency Medicine, New York Hospital Queens, Flushing, New York; (firstname.lastname@example.org).
1 Arnold P. Gold Foundation Web site. Available at: (http://www.humanism-in-medicine.org
). Accessed October 23, 2008.
2 Glick SM. White coat ceremonies—Another commentary. J Med Ethics. 2003;29:367–368.