THE DOCTOR'S BAG BY Keith Souter aka Clay More

2 – THE HIPPOCRATIC OATH

Welcome back to The Doctor's Bag, our monthly look at 19th century medicine, and how aspects of it compare to the profession today. This time we'll take a look at that famous oath that binds all doctors, and has done throughout the millennia - apart from when the actions of various unscrupulous or unethical doctors have demanded that it be updated.

THE OATH

‘I SWEAR by Apollo the physician, and Aesculapius, and Hygieia, and Panacea, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation …….’

A code rather than an oath

Hanging on the office wall of countless frontier doctors, according to western movies and novels, would be a copy of the Hippocratic oath. It may even have been in Latin, for that was the language of medicine for centuries.  In reality, most frontier doctors probably had no such adornment to their surgery wall, on account of the fact that they were probably not medically qualified at all. And those that were may have merely held a diploma qualification that certified that they had attended a series of lectures at some sort of medical college.

No formal educational qualifications were needed to enter a medical school. Indeed,  even the famous Harvard Medical School in 1870 had no written examinations, because apparently most of the students at that time could not write well enough.

But that is not to say that these early doctors did not serve their communities well. Some were superb, while others were at the most, better than nothing.  Still others didn’t stay around too long. Yet all of them would have had an awareness of a code of practice, the Hippocratic code. Basically, it was to do the best for your patient through hell and high water, and not to betray a confidence. That would have been the code that governed their professional life.

The Hippocratic oath

Everyone associates the Hippocratic oath with medicine. It is one of the most popular selections of ancient literature, even though the original Oath is now rarely read or recited. Hippocrates himself almost certainly did not write the original oath, but the work is traditionally included in the Corpus Hippocratum, a collection of medical writings attributed to him, written between the fifth and fourth century, BC.

Aesculapius was the Greek god of healing, and Hygieia and Panacea were his two daughters. Hygieia was the goddess of cleanliness and sanitation, while Panacea was the goddess of Universal remedy. It is said that of the two, he preferred Hygieia.

Nowadays we would agree with that, since ‘hygiene’ is probably one of the most important measures that benefits the health of a community.  And of course, there is no such thing as a panacea – a cure-all!

Hippocrates of Kos (460-370 BC) was an ancient Greek physician, who really brought medicine out of the religio-magical practice of his forefathers and who laid the foundations for the practice of clinical medicine.

Aphorisms

It is generally accepted that we must thank the Classical Greeks for the aphorism, as we know it, that short segment of distilled wisdom that is designed to express a general truth. They are like proverbs and adages; essentially they are rules of thumb. Sometimes they will be discrete packets of wisdom; at other times they are building blocks, which link up with other aphorisms to make a greater whole.

In the Aphorisms of Hippocrates, one of the books of the Hippocratic Corpus that is regarded by philologists as having been genuinely written by Hippocrates himself, the aphorism is seen as an ideal vehicle for passing on the wisdom of experience. In reading these today one can almost imagine the father of western medicine sitting under the famed plane tree on Kos and delivering his nuggets of wisdom to his eager pupils. Indeed, they were an ideal way of handing on the oral tradition of medicine.

 The plane tree on Cos, under which Hippocrates reputedly sat and taught his pupils

The first aphorism of Hippocrates

In this first aphorism, which is often abbreviated to ‘Life is short, the Art is long,’ we see a remarkable piece of advice, which is highly relevant to the practice of any form of medicine.

‘Life is short, and Art long; the crisis fleeting; experience perilous, and decision difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and externals cooperate.’

Hippocrates is telling us that it takes a lifetime to truly learn the art or practice of medicine, and that no one can truly master it. The crisis or opportunities for learning are quickly over, so must be grasped. Experience is not always reliable, so it is important not to base knowledge exclusively upon experience. And finally, judgement is always difficult, because of the complexities of the discipline.

Know a few aphorisms

Doctors in Britain, before the time of any sort of regulation of their practice, could impress by trotting out the odd aphorism in Latin or Greek.  About ninety-five per cent of all medical terms are based on Latin or Greek or a mixture of the two. In general, anatomical terms and the names of micro-oragnisms (which of course were not discovered or known about back in the days of the Civil War and the decade or so after) were derived from Latin. The names of conditions and pathological states, on the other hand, come from the Greek.

            

Most doctors would know this Latin aphorism:

Ubi pus, ibi evacua. Which means, ‘where there is pus, let it out.’ It is a great surgical maxim, especially in pre-antibiotic days.

And, this one:

Res in cardine est. Which means, ‘the next 24hours will tell.’ Again, without modern drugs, often 24 hours could be critical.

Taking the oath

The swearing of the Hippocratic oath is something that is done when you graduate from a university or a medical school. I remember taking my oath, many moons ago, along with my fellow students in our class of 100. It was a proud moment that made one conscious of the long history of oath-taking in our profession.

For several centuries now, doctors upon qualification have taken modified versions of the oath containing the essence of its message.  It is the code by which doctors agree to live by and the fact that doctors take it,  is essential in allowing patients to put their trust in the individual doctor.

There are four main variations:

The Oath of Maimonides written by Moses Maimonides (1135-1204 AD), a rabbi, philosopher and physician in the 12^th century. He was the court physician to Sultan Saladin. Apparently he had declined an invitation to become personal physician to King Richard the Lionheart.

The Declaration of Geneva adopted by the World Medical Association at Geneva in 1948. This arose from the Nuremberg Code formulated in 1949, after the trials in which 23 Nazi doctors were found guilty of breaching the medical code by performing horrific operations on prisoners in concentration camps.

There were other amendments to the Declaration in 1968, 1984, 2005 and 2006, to deal with various issues as they have arisen, including euthanasia, torture of prisoners and so on.

The Oath of Lasagna was written in 1964 by Louis Lasanga, the Dean of Tufts Medical School. It stresses the importance of dealing with patients as human beings, not just as medical cases.  

The Restatement of the Hippocratic oath in 1995. Again, slight variation, which was drawn up by 35 eminent US physicians, the ‘Value of Life Committee. This is the commonest one taken in medical schools today. 

The Oath today

In 1989 a survey was done of 126 US medical schools. It was found that three still used the original Hippocratic oath, 33 used the Declaration of Geneva, 65 used the restatement and 4 used the Oath of Maimonides.

Dr Logan Munro of Wolf Creek

The town doctor of Wolf Creek graduated from Edinburgh University in Scotland in 1853 and took his Hippocratic oath at the graduation ceremony. To him it is a solemn principle that guides him in both his professional and his personal life. And nothing will make him break it! You will find out in the forthcoming Wolf Creek novels 4 and 6.

As is customary, I will be giving away a hardback copy of my book Doctors' Latin - A miscellany of Latin and Greek Medical phrases, to one commenter. It may be useful if you want to decipher his or her handwritten scrawl.

          

Civil War Reenacting: Bayonets

By Matthew Pizzolato

At a civil war reenactment, after we march out of camp and get into position for a battle, the next thing we do is to hurry up and wait.  We always get there early and have nothing to do but stand around.  Of course, the bayonet comes into use then so that we can stack arms, which is the only use we have for one at a reenactment.

During the War, however, the bayonet was the equivalent of a multi-purpose tool.  While it was used on the battlefield, bayonets are generally believed to have caused between 1% - 2% of the wounds suffered during the conflict.

General John Gordon wrote of the bayonet, "The bristling points and the glitter of bayonets were fearful to look upon as they were leveled in front of a charging line, but they were rarely reddened with blood."

Three-sided socket bayonet

There are many different kinds of bayonets, but the one most commonly used by both sides during the War was the three-sided socket bayonet that fit over the end of the Enfield rifle used by the Confederate forces or the Springfield used by the Union. 

Everyday Use

The bayonet saw much more use during the every day life of the soldier.  They were used around camp as an entrenching tools or tent pegs.  Soldiers used them as roasting spits or even meat tenderizers.  Bayonets sometimes saw service as can openers and fire pokers. 

Bayonet attached to rifle

Once darkness fell, soldiers often drove the pointed ends into the ground and placed a candle in the socket end for reading or writing letters home. 

Their use did not end in camp life.  Bayonets have been recovered that were heated over fires and shaped into hooks.  This use was much gorier.  A lot of soldiers of did not like touching bodies, so these "hooks" were used for dragging dead men from the battlefield. 

Combat Use

When they were used in combat, it was primarily as a weapon of intimidation or of desperation, if the regiment was out of ammunition.  Not many men would withstand a bayonet charge. 

The most popular bayonet charge of the War would probably be the one made by the 20^th Maine at Gettysburg on Little Round Top, but occurrences like that were few and far between.

Matthew Pizzolato's short stories have been published online and in print. He writes Western fiction featuring his antihero character, Wesley Quaid, that can be found in his story collection, The Wanted Man and the novella Outlaw.  

Matthew is the editor and webmaster of The Western Online, a magazine dedicated to everything Western and can be contacted via his personal website: www.matthew-pizzolato.com or he can be found on Twitter @mattpizzolato. 

Western Comics Focus: Jeff Mariotte

Presented by TROY D. SMITH


Jeff Mariotte, it seems, has done it all. In addition to his own creations, such as WITCH SEASON and ZOMBIE COP, he has written prose and comics for licensed characters in multiple genres: STAR TREK, CSI, BUFFY THE VAMPIRE SLAYER, ANGEL, CONAN, and many more. (In fact, he wrote the CRIMINAL MINDS book I gave to my wife a couple of Valentines ago- we are, in many ways, a sick and twisted couple.)

Jeff is also no slouch in the western department. Two years ago, Western Fictioneers enlisted a panel of experts to vote on the GREATEST WESTERN COMICS OF ALL TIME. He served as one of those judges, and despite the fact he declined to vote for his own works, two of his series made it into the Top 20: DESPERADOES at #6, and GRAVESLINGER at #14.

Here's what we had to say about DESPERADOES at the time:

Desperadoes is a Weird Western title that has been released periodically since 1997 as a succession of miniseries and one-shots (five to date.) Each story has been written by Jeff Mariotte, and the title has been illustrated by various artists, including John Cassaday and John Severin. Originally published by Homage Comics, it has since moved to IDW Publishing.

The “desperadoes” in question are former Texas Ranger Gideon Brood, ex-slave and buffalo soldier Jerome Alexander Betts, Pinkerton detective Race Kennedy, schoolmarm-turned-prostitute Abby DeGrazia, and (beginning in the third installment) roguish gunfighter Clay Parkhurst. Their adventures take place in a realistic Western setting which has a way of turning rather strange: they have encountered zombies, ghosts, and a vicious serial killer with magic powers. The resultant combination of Western adventure and atmospheric horror has garnered wide praise.



You can catch up on the whole saga in the 500 page DESPERADOES OMNIBUS:

Jeff has graciously agreed to join us today and answer a few questions...

1. Why do you think the Weird Western genre has found such an audience the last several years?

That’s an interesting question to ponder, and if I knew the answer, I could probably capitalize on it in some way. My first take is that weird everything is popular these days. Look at the whole urban fantasy genre, which essentially takes tropes from many different genres—mysteries, thrillers, romances, etc.—and adds monsters. I suspect that contemporary American pop culture has reached a point at which the traditional genres were maybe feeling a little tired—and maybe a little over-examined, since they had become acceptable topics for academia—and needed a shot of something new. In the short-attention-span world that is comics fandom, my series Desperadoes might have come along a little too soon. I’m not saying it was the first weird western comic, because it wasn’t by a long shot. But when it debuted there were precious few western comics on the stands. Jonah Hex hadn’t even been around for a while. Now that 15 years have passed since the first issue, weird westerns are everywhere and the people reading them don’t necessarily even remember that Desperadoes ever existed.

2. Which of the Desperadoes characters did you most enjoy writing for?

I love all of them (and intentionally answered in the present tense, because I don’t want to close the door on writing them again). I really enjoyed doing the narration in Race Kennedy’s voice, because it was all so alien to him and he could react to everything he saw, in ways that people more accustomed to the setting wouldn’t. But Race is dead, so I don’t get to write him anymore. Gideon Brood is the most me, in a lot of ways, and I love the way he turns a phrase. But I can’t leave out Abby DeGrazia or Jerome Alexander Betts or Clay Parkhurst, either. So I’ll have to take the easy trail and just say, whichever one I’m writing at any given moment.

3. Who influenced you as a writer?

My influences are many and varied, and include such unlikely bedfellows as Stephen King and William Goldman, Ed Abbey and Wallace Stegner, Ross Macdonald and Thomas Gifford. In terms of western writers, I can specifically point to a contemporary young adult Western by Gordon D. Shirreffs, called Mystery of the Haunted Mine, which I read in the 5th or 6th grade, and which combined Western elements with mystery/thriller elements and even supernatural elements (or at least the suggestion of them) in a way that marks the path I’ve taken in my career more concretely, I think, than any other book. Likewise, a 1952 Western by Clay Fisher, War Bonnet, was formative in how I thought about western fiction (and Clay Parkhurst of Desperadoes owes more than a small debt to Fisher). I’ve enjoyed several of his other books, too, especially those written under the name Will Henry. And under his real name of Henry Allen, I’ve had a lot of fun watching the cartoons he created alongside director Tex Avery. I’ve read and enjoyed a lot of other western authors, but those two are the ones who bear the most burden for making me the writer I am today. I guess I have to call out one more influence—Roy Rogers. Not that he wrote the comics himself, but he was my childhood hero, and I read everything I could with his name on it. The first comics I can remember ever having in my hands were Roy Rogers comics, so that’s what set me on the road I’m still traveling.

4. You've worked on a lot of licensed properties (as have many of our Western Fictioneers members)... if you could pick one pre-existing western character to write about, from comics, movies, literature, or television, who would it be?

I’ve been so fortunate to be able to work with a lot of the great western characters, including Zorro, Jonah Hex, El Diablo, Bat Lash, Scalphunter, and more. I’ve even been able to do comics and fiction based on the popular weird western game Deadlands. I’m envious of John Ostrander, though, in that he got to play with the Marvel Comics pantheon, including the Rawhide Kid, the Two-Gun Kid, and more. Those guys would be a blast to work with. And I once had an opportunity to do something with the Lone Ranger, but it came up at a bad time and I had to pass. So that’s who I’ll stick with—if somebody wants me to write a Lone Ranger novel or comic (the real one—I can’t say I’m impressed with what I’ve seen of the new movie), I’m there.

5. You work in a lot of genres (and often blend them)... is there anything in a western, besides the obvious setting factors, that requires an approach different from other stories?

I think what defines a western is different from what defines any other genre. It probably falls under the “setting” category, but it’s more complex than that. After all, there are plenty of novels written about the American southeast, but they’re not called “southerns.”

A western, unique among literary genres to my knowledge, is defined by place. Whether it’s historical or contemporary, it first has to be set in what’s known as the West. That setting has to be more than just window-dressing; it has to matter to the story. The characters have to be affected by the setting, and ideally to affect it in return. Whether or not they really notice it, the writer should be aware of it. It helps if the writer actually knows it, from ground level. Finally, people who have been shaped by the West aren’t quite like anybody else, and that’s got to come through in the characterization. Any or all of those things can be faked, but I think in those instances the work itself suffers. To be a western and to be good, they’ve got to be as true and as real as the landscape and the people and the clear, big sky overhead.

6. You were on our panel a couple of years ago that voted on the greatest all-time western comics (and Desperadoes placed 6th on the list, even though you abstained from voting for it!)... do you remember what some of your picks were?

I don’t specifically recall what I picked, but I’d imagine that a number of my picks wound up on the list. I’m sure I would have chosen Jonah Hex and Bat Lash and The Kents and the various Marvel Kids. I probably would have picked Roy Rogers, too. And I can’t tell you how greatly honored I am that Desperadoes wound up on there—and so highly placed—and also that Graveslinger, which I wrote with my good friend and saddle pard Shannon Eric Denton, wound up so high on the runners-up list. It really is one of the nicest compliments I’ve ever received.

7. Tell us about your newest release, and anything coming down the pike you are excited about.

My new book—releasing today [Feb 26], if all goes as planned—is Season of the Wolf. It’s not a western, per se, but it’s a supernatural thriller set in a small Rocky Mountains town in Colorado. Besides a western setting, it has some of those elements I mentioned earlier: the landscape matters, the flora and (especially, as you might guess from the title) the fauna are literally fundamental to the story. Most of the people in the book are real westerners, and they’d be familiar to anybody who reads western fiction. It’s contemporary, but with threads reaching back 10,000 years. It is, I like to think, suspenseful and fast-paced and scary, and just when you think you know who/what the villain is (or are), there are some curveballs coming. Season of the Wolf is published by a prestigious small press called DarkFuse, in limited edition hardcover (already sold out), trade paperback, and ebook, so if you don’t see it in a bookstore near you, ask for it—they can order it.

SEASON OF THE WOLF

Beyond that...well, there is one more Desperadoes story done, story and art. It’s a very cool crossover, and we’re just waiting for a few more pieces to fall into place before it’s published. So there’s something else to look forward to. I’ve long thought about writing a novel about those folks, as well. With the current weird western boom, this just might be the time to do it.


Many thanks to Jeff for joining us today... check out his work, you'll love it as much as I do.

Troy D. Smith

Review Roundup: From the Table to the Grave

 

Cooking Wild & Wonderful
By L.J. Martin
Wolfpack Publishing, March 2011
$11.95 paperback, ISBN 188533933X
$3.99 Kindle, ASIN B004UICW36
166 pages

One of the primary reasons folks read western novels is a desire to live, vicariously, an adventure populated by larger-than-life characters attempting to tame a wild land. Imagine a cookbook that delivers a similar experience.

L.J. Martin’s Cooking Wild & Wonderful is a delight—not only because Martin’s recipes please the palate, but also because his writing entertains. This is a cookbook people will want to read, not just prop up in the kitchen during meal preparation. Much more than a collection of how-to’s, Cooking Wild & Wonderful is a cultural reference that evokes the spirit and flavor of the West.

Martin takes cooks and wannabe-cooks by the hand and fairly yanks them into a philosophy of food—and in a much broader sense, life—that is charming and liberating, awash with color and brimming with adventure. Game recipes comprise a very small part of the mix; instead, the “wild” in the title refers more to abandoning supposed rules and taking risks. Risk is relative here, though, because Martin’s chatty, colloquial voice is nothing if not encouraging. Although one definitely gets the impression Martin would be as at home in a chef’s kitchen as on the trail, his recipes and advice are easy to follow, from simple fare with uniquely flavorful twists to multi-course gourmet meals.

No matter how tasty the food, however, the flavor of the text, replete with stories of real-life cowboys and country folk, is what sets the book apart.

The Handsomest Man in the Country
By Nancy Radke
Bedrock Distribution LLC, November 2012
$0.99 Kindle, ASIN B00A7GCFGY
103 pages

Orphaned by the Civil War, an 18-year-old girl from the hills of Kentucky heads west on a wagon train, only to discover the devils she knew at home may have been preferable to the devils in disguise she encounters along the trail.

Despite a couple of formatting, word-choice, and punctuation glitches, The Handsomest Man in the Country is an excellent read, mostly because author Nancy Radke nailed an unusual—and unusually charming—character voice. (The writing could use a substantial infusion of commas, but even that perceived shortcoming fades into insignificance behind the sheer enjoyment of the reading experience.)

Marketed as a sweet romance (no harsh language or sex), the story follows the standard romance protocol only in that it ends on a happily-ever-after note. Don’t expect to find overwrought musing about romantic love on these pages. The characters are much too busy surviving to moon over each other.

Handsomest Man is told in first-person, which represents a significant risk for the author. The music of the hills is in the way Apalachian people think and speak. Attempting to render such a distinctive patois in prose without losing readers is challenging, but Radke did an admirable job. Little of the language is presented in dialect (phonetic spelling, elisions like dropped Gs, etc.), but the sentence structure, word choices, and rhythm of the writing all evoke the color and flavor of the unsophisticated, hardscrabble, pragmatic attitude of the area.

Writers often are cautioned about using dialect, because it can be tiresome to read. Radke's novella demonstrates how smoothly and respectfully dialect can be suggested without resorting to trickery or parody.

Joshua’s Voice
By Charlie Steel
From the anthology Six-Guns and Slay Bells: A Creepy Cowboy Christmas
Western Fictioneers, October 2012
4,800 words

For the Love of a Woman
By Charlie Steel
From Rope and Wire Western Short Stories, 2010
3,850 words

Charlie Steel’s two short stories are quick, easy reads. Though very different in tone, each presents more character study than adventure.

In Joshua’s Voice, the sole survivor of an ill-fated westward wagon trek grows from helpless child to savvy wilderness dweller with the help of a mysterious, omniscient presence that, by revealing itself, endangers the fabric of the cosmos. Sometimes harsh, sometimes amusing, and sometimes tender—but never creepy—the story evokes comparisons to the Star Trek episode “Metamorphosis,” though Joshua’s Companion remains invisible. By the time Joshua discovers his destiny, readers will mourn the Voice’s sacrifice. (A review of the entire Six-Guns and Slay Bells anthology is forthcoming.)

For the Love of a Woman observes a husband and wife as they struggle to keep their farm and their marriage together. Tangled in daily-life struggles as they are, the pair have forgotten the language of love and seem able to interact only by hurting one another in little ways. Though they try to recapture the spark that first drew them together, life’s disappointments always seem to interfere. The arrival of an orphan train changes the dynamic of their relationship in ways that warm the heart. The story was a second-place winner in Rope and Wire’s 2010 short-story contest and is available as a free read on Steel’s website, CharlieSteel.net.


Kathleen Rice Adams is a Texan, a voracious reader, a professional journalist, and a novelist in training. She purchased Cooking Wild & Wonderful and The Handsomest Man in the Country, and received review copies of Joshua’s Voice and For the Love of a Woman from the author. Her opinions are her own and are neither endorsed nor necessarily supported by Western Fictioneers or individual members of the organization.

The dean of western short story writers

Cheryl told me to blog about a short story. To me, when someone says “Western short story,” one man’s name comes to mind.

* * *

He came to ride for her pa’s ranch, a tall slim man, quiet yet strong, and he always meant what he said. That was new to Ellis, and it wasn’t long before she fell in love with the cowboy and wanted to marry him.

She knew her father, maybe better than he knew himself. The cowboy wanted to ask for her hand, but she said her father would never allow them to marry. But they did. And they settled down on a little spread he’d bought with money he’d saved up from when he rode as a scout for the Army. Just an adobe hut with a simple ramada. Just thirty yearlings to start with. Just somewhere hard work and patience could build a place for a family to live in peace. Just a place.

Then the old man rode in with a rifle across the saddlebows and five men at his back. He’d not married until forty and the girl was his only child. Not a girl to marry a ne’er-do-well cowboy who was more like a redskin than a white man. Not that. She’d marry a man capable of building further on what her father had already built. She would. She surely would.

“Where is he?”

“He’s at the stock tank,” she said, “but he’ll come in now.”

“Whether he does or not,” the old man said, “you’re coming home with me.”

“I’m married now, Pa.”

“Don’t talk foolish.”

“Married in Willson. By a priest.”

“We’ll talk about that at home.”

“I am home!”

“Girl, this isn’t going to be a public debate.”

“Then why did you bring an audience?”

The man’s name that came to mind when Cheryl said “Short story?”

   

Elmore Leonard, of course. You know him for 3:10 to Yuma. Valdez is Coming was also a short story to begin with. Originally, this story was entitled The Waiting Man, but in the collection of Elmore Leonard’s short stories, the title is Moment of Vengeance.

How many stories have you read where the protagonist goes in with both fists slamming into those who oppose him, or where he jerks out a Colt SSA .45 and blasts baddies to oblivion, or where he leads them out into the desert where they die a terrible death of thirst? So many. So many.

But this one is different. As the title says, there’s a moment of revenge. It comes because the man Ellis chose to be her mate was patient. He held no disrespect for her father. He was rough with a couple of riders while he was being patient, but never on camera.

Then the old man came after him with shotgun across his lap. They talked. Then talked some more. Her man was patient.

“I’m anxious to see my wife,” the man said.

The old man’s face came up, out of the shadow, deep-lined and solemn, but the hard tightness was gone from his jaw. He shifted his weight and came down off the saddle, and on the ground, he handed the shotgun to her husband. “This damn thing’s getting too heavy to hold,” he said.

You’ll have to go find the story if you want to know what finally happened. But it wouldn’t matter what Elmore Leonard short story you picked up to read. He's the dean, and it’d be a good one.