Metaphorigins
Metaphorigins
S3E7 - Palatable Pills & Healthcare Rapport With Wilmer Santos (MScN Student)
Buzzsprout Affiliate Link: https://www.buzzsprout.com/?referrer_id=891796
Connect with guest Wilmer Santos via Instagram: @Wilm2409
Timestamps
- 00:00 - Introduction
- 00:48 - Segment 1: Place-Sea-Bow (Short Story)
- 08:15 - Segment 2: The Origin of "Taste Of Your Own Medicine" (Metaphor History)
- 18:02 - Segment 3: Healthcare Rapport (Communication Topic)
- 27:40 - Segment 4: Talk With Wilmer Santos (Guest Interview)
Description
I seek revenge on the storyteller who gave you, me and many others a “Taste Of Your Own Medicine”. Additionally, I discuss the value of healthcare rapport in establishing effective clinician-patient relationships. I talk about healthcare champions with the inspirationally bright Wilmer Santos (MScN Student), a registered nurse who also researches role models in the healthcare space. Check out the transcript here: https://www.kjbmercurio.com/episode/027.
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To my prestigious family and friends. Near and far. Old and new. This is Kevin Mercurio on the mic. And welcome to the 27th episode of the Metaphorigins podcast.
Now, to show support if you like this sort of content, please make sure to rate and subscribe to the podcast on Apple or Spotify or Google Podcasts or whatever platform you are listening to this on, and follow @metaphorigins on Instagram, that’s @metaphorigins, where I will be posting most of my updates, as well as on my personal website: kjbmercurio.com/metaphorigins. Just a reminder, I will be holding a draw on my 30th episode for the lovely, butterfly-printed, custom Metaphorigins shirt, so stay tuned for that!
Okay. So for today’s episode, I will be talking about an expression that grasps themes of empathy, retribution and Buckley’s cough syrup.
Let’s paint the scenario. It’s the late 18th century. You had just received your licence as a physician in Great Britain, heading to the newly formed United States. Now, if you know anything about history, it’s not a particular honourable time in the US, nor any part of the world for that matter. People’s freedoms were disrespected, and many in the medical practice were crooks with primitive techniques to cure illness. The old physicians of the day were not in tune with the scientific evidence growing around many novel procedures. In contrast to this negligence, you hoped to change the medical field.
You studied your whole life to get to this point. You’ve read the writings of the fathers of medicine, Hippocrates and his oath to “first do no harm”, or the expansion of that oath by Ambrose Paree to “cure occasionally, relieve often, console always.” You’ve carefully investigated the illustrations of the Fabrica by Andreas Vesalius, the transmission of the bubonic plague during the outbreak known as the Black Death in Europe, and the Roman contributions by Gaylen of Pergamon. You understood how the work of these men and their associates allowed medicine to progress to this crucial point, a point often taken for granted by your superiors and counterparts.
Take for example, phlebotomy, or blood letting. Hippocrates and Galen believed that the human body was comprised of four fundamental substances known as humours, “yellow bile, black bile, phlegm and blood.” It is the balance of these four substances that leads to a healthy life. Often, physicians would cut open a vein and remove some of these substances to correct the balance. But you knew it was only blood that was being removed, blood that the body needed to power its system. You would often say, in your characteristic sarcasm, “why, were thy underling bitten by a snake? Because thou must then drain the venom with the river of blood, otherwise you must simply seek rest.”
There was also the usage of mercury. Called quicksilver by alchemists and physicians alike, it is the only metal that is liquid at standard conditions of temperature and pressure. It continues to be used as a remedy for sexually transmitted diseases like syphilis, and would often be promoted as a magical concoction that gives one supreme powers. You would often say, yet again in your sarcastic stature, “have ye forgotten of thy history learned as a boy? The Chinese Emperor Qin Shi Huang (Shin She Wang) bemused when thy drank the immortal elixir of not life, but mercury poisoning?”
Additionally, there was also the barbaric practice of trepanation, in which physicians would burrow holes into the skull to eliminate pressure in one’s head caused by concussions. How often would your peers take their trepans and drill into citizens who complained of headaches or behaved abnormally. Again, in your wise sarcastic words, “oh my, thy patient is now the living figure of what it is to die.”
You wanted to change these gruesome methods. As someone against conflict and war, you understood that life could be lived with little intervention from thy fellow man. On your voyage to start a life in the US from the Great British Isles, riding the bow of the boat, you contemplate the new science you’ve witnessed emerge over the last decade. Your closest friend, Franz Anton Mesmer, a German physician, had recently put forth his theory of animal magnetism, a force possessed by all living creatures that could help expel the illness out of sick patients. As someone of intellect, you were skeptical at first. It was only by witnessing cures of various severity, despite starting with magnets placed on the affected regions of the sick, eventually Mesmer would simply cast his body’s magnetism towards the patient, who would convulse and contort due the working treatment.
On that voyage, you came up with your idea. An idea that not only would bring you riches in the newly established United States, but actually help people who needed it most. It was to take this animal magnetism you, a healthy person, possess, and formulate that into a medication to consume. In order to do this, you recalled a previous treatment demonstrated from Mesmer in which he would bathe his patients in water possessing metals and magnets. It was obvious that if you could lure out the illness, but you could also lure out your beneficial magnetism as well. Yes, by bathing yourself in your healthy state and collecting the bathwater, feeding this to your ill patients would certainly cure them of disease. Since you thought of this while standing at the frontmost place of the boat, you decided to call your medication, a placebow.
It takes a few months but you’ve accrued enough wealth and patients to test your new placebow. With advice from letters written back and forth with Mesmer, you demonstrate that the new medication has the same effect as his healing touch. You’re beyond happy. More and more patients flock to you, and you gain an almost religious following in your settlement. You founded the Famous Academy of Kindness Everlasting, a medical school dedicated to gentle treatments expanding from your placebow treatment.
Unfortunately, after several years of teaching, you come down with an unknown illness affecting your gut. You are unable to eat anything, just drink copious amounts of water and ale. You write to your friend Mesmer who suggests the following, “have thy tried a taste of your own medicine?”
Of course, why haven’t you thought of that before? You have bottle after bottle of placebow. And wait. Three days have passed and your gut begins to swell. You have more bottles of placebow and wait. Six more days have passed and you begin to feel severe pain. You realize your mistake and say aloud in your sarcastic nonchalant voice, “have ye forgotten your own studies? You cannot drink thy own medicine, for their would be no change in the balance of humours. It is the magnetism of healthy neighbours to which should soothe my gut.”
You then ask your followers at the academy to prepare you their own placebows, to which you drink every single bottle. However, within two days, you develop a fever and the unbearable pain from your gut travels to your head.
In your last ditch effort for sarcastic last words, you say “Quick, fetch me thy drill and trepenate me, for I am dead now.”
Alright let’s try to forget about drinking someone else’s bathwater and instead realize that mesmerism and other phoney medical practices eventually did lead to the theory of the Placebo Effect and how important it is in clinical investigation of new pharmaceuticals. Anyhow, with today’s expression, it is often directed to a foe who has finally received his or her comeuppance for their past actions. But how did the act of medical malpractice become linked to this concept of retribution?
What is the origin to the expression, “a taste of your own medicine”?
*Theme Music*
Most of this information was obtained from many articles discussing its usage and the origin to this expression. All sources will be mentioned in the description.
I want to talk a bit about storytelling. Most stories, the fleshed out ones anyway, will always possess the same elements that create a journey for the reader. Again, in the most typical of stories, a main character will encounter some problem and the story revolves around how the character deals with it. Towards the end of the story, most will either conclude with solving the problem, or not, and the reader is left deciding whether the character has learned something, or if they themselves have grasped some new wisdom.
At the beginning of the story, when the character encounters a problem, there has to be some motive to progress the character into the remainder of the story. If the character chooses, for example, to not do anything about the problem, why did he or she choose to do that? And more likely the case, let’s say the character chooses to solve the problem, why would they choose to put effort into that mission?
Now, as someone listening to this podcast, who dabbles in the fine arts of books, novellas, and fables, can agree that one of the most powerful but frequent motivators for characters to progress through a story is revenge. Countless of literary’s greats have taken the revenge trope as the distinguishing plot device to seed conflict. In terms of novels, there’s Shakespeare’s Hamlet, Stephen King’s Carrie, Alexandre Dumas’ The Count of Monte Cristo, and Emily Bronte’s Wuthering Heights. In cinema, often adapted from written works, there’s characters like Lisbeth Salander in The Girl With The Dragon Tattoo, Clyde Shelton in Law Abiding Citizen and even the complex Arthur Fleck in Joker. Video games utilize this too, like Ellie in the Last of Us, Ezio in Assassin’s Creed II and Venom Snake in Metal Gear Solid 5. These are part of the greatest examples of their craft.
Our expression today is often one uttered at the final leg of these character’s journeys of revenge. Sometimes they succeed, like (spoiler alert) Arther Fleck killing Murray Franklin and completing his character arc, or fail, like Clyde Shelton detonating the bomb that kills himself (but perhaps he realized the desired change in the final moments of his life). To have a taste of your own medicine, to give someone a taste of their own medicine, is defined by the Cambridge dictionary as “to treat someone as badly as they have treated you”. Sticking with games, there are awards given to players who, in Minecraft, feed poison to the Witch, or in Dead Space, kill a slasher necromorph with another slasher’s claw, in each case awards dubitabley titled with “Taste of Your Own Medicine”. It seems that death, like most revenge stories, is the ultimate price for ones previous actions.
A taste of one’s own medicine is often attributed to the malpractice of doctors or those promoting treatments backed by little evidence, like the short story early this episode. One example is the annual Fish Prasadom in Hyderabad, India, in which people with asthma or other respiratory conditions come to receive a live mural fish stuffed with medicinal yellow paste (ingredients kept secret of course). One family, the Baithini Goud family, have been administering the fish medicine since 1845, and claim the the cure is scientific. Other examples include many homeopathic medicines. James Randi, probably one of history’s most famous skeptics, once took a “lethal dose” of homeopathic sleeping pills and proceeded to give a TED talk about how fraudulent these products are (what a legend).
But perhaps the point of having a taste of your own medicine, or giving someone else a taste of their own medicine, leads you to learn something, like most stories do for their readers. Like the Chinese philosopher Confucius once said, “Before you embark on a journey of revenge, dig two graves.” Again centred around death, I believe this can be attributed metaphorically, in that the person seeking revenge for the shitty medicine will change just as much as the person who provided that shitty the medicine. In fact, scholars have used this expression to introduce relevant topics of psychoanalysis and human relationships. In an 2019 article published in Psychology Today, Dr. Leon Seltzer, a clinical psychologist, discusses the advantages and disadvantages of giving someone a taste of their own medicine. In short, he recommends to ask ourselves the following two questions when debating on this opportunity: 1) Are you certain that the person who hurt you actually meant to? And 2) Will your giving them a taste of their own medicine help or harm the relationship? If you can’t answer these questions, is it really worth it to prescribe said medicine?
Oh no, I’ve tangented again. Let’s get to the origin at hand. Who gave who a taste of what and why? Now this one was a bit difficult as my usual sources had very little reference material. In a stack exchange forum, user Sven Yargs addresses different records of its use tracing all the way back to the early 1800s. Since most medical interventions at the time were physically terrible and often dubious, Yargs “found it natural to equate a doctor being forced to take his own medicine with a person having had done unto him or her some unpleasant thing that he or she had previously done unto others.” He also references that in the Oxford English Dictionary of Idioms, author John Ayto states, “The idea of taking or receiving your own medicine has been in metaphorical use since the mid 19th century.”
Going earlier than the 19th century, this expression is often attributed to the Greek fabulist Aesop. You might know him from Aesop’s fables, often read to kids as bedtime stories. One such Aesop fable that was referenced was the Fox and the Crane. To summarize, these two animals are friends. One day the fox thought it would be funny to feed the hungry crane some soup in a flat plate, and therefore could just barely wet the tip of its beak. To get the fox to have a “taste of its own medicine” one day the crane feeds the hungry fox some fish in a long narrow jar.
Another such fable by Aesop equates well with the theme of medicine, called the Cobbler Turned Doctor. This one is short so I will read it in full:
Unable to make a living by his trade, a cobbler, rendered desperate by poverty, began to practice medicine in a town in which he was not known. He sold a drug that he claimed was an antidote to all poisons, and obtained a great name for himself by long-winded puffs and advertisements.
He happened to fall sick of a serious illness, on which the governor of the town determined to test his skill. For this purpose he called for a cup and, while filling it with water, pretended to mix poison with the cobbler's antidote and commanded him to drink it, on the promise of a reward.
The cobbler, under the fear of death, confessed that he had no knowledge of medicine and was only made famous by the stupid clamors of the crowd. At this the governor called a public assembly and thus addressed the citizens; "Of what folly have you been guilty? You have not hesitated to entrust your heads to a man whom no one would employ to make even the shoes for their feet."
It is most notably the case that to give someone a “taste of their own medicine” is derived from one of these fables by Aesop. And its through these stories that we learn valuable lessons about ourselves, given life through the personified actions of fictional characters, characters in fables, movies or even video games. So before you exact revenge on your nemesis, take a pause and ask yourself, “what illness am I really trying to cure?”.
*Theme Music*
For my communication segment, I would like to talk about an interesting concept, at least to me, which is more relevant now then at any point in my lifetime. The concept has always been important, whether you were infected with a respiratory virus, housing out-of-control cancerous cells, or just a simple headache, that encouraged you to seek the counsel of medical professionals. And that topic, is healthcare rapport.
There’s something really interesting about healthcare that I personally don’t hear much about during its discussion. Sure, there’s the vast collection of knowledge leading to correct diagnoses, educated prognoses, biochemical breakthroughs and pharmaceutical innovations. Yet, I’ve always been curious about the act of healthcare itself, its methods of delivery to different people composing the general population. And this is often attributed, collectively, to how the body works and its known and unknown ways of being influenced.
I’ve mentioned the Placebo Effect earlier this episode, because it truly is a fascinating phenomenon. Simplified, the body can be tricked into undergoing chemical processes for relieving symptoms of disease like pain, but overall do not impact the progression of the disease. In fact, by taking what you believe to be a pharmaceutical that was, say, a sugar pill or some inert electrolytic solution, your body may react positively as if the disease has been cured. This is why many clinical trials for novel pharmaceuticals, including vaccines, include placebo controls in the study to see whether the new drug actually does better than someone who received nothing valuable.
Now let me tie that to the topic of this segment, which of course, has to do with communication. How often do you have chit chats with your general practitioner when visiting them for a checkup? Or when, if you have to stay at the hospital, your nurse is checking your vitals in the morning? Perhaps about an update on the most controversial news story of that day, or how your kid is getting along in her courses, or for my dentist, asking how my soccer team is doing this season (note, I am not part of a soccer team). Even the attempt for general conversation seems to be a critical part of every sort of medical related encounter. It’s possible they don’t say anything, but how weird would a colonoscopy or a visit to the gynaecologist be without the bare minimum of small talk. This aforementioned level of communication with healthcare providers has impact on medicine without any external chemical added, or procedure performed, just like the Placebo Effect.
This topic goes by many names. I’ve dubbed it healthcare rapport, but it has also been called the doctor-patient relationship or doctor-patient communication, but certainly can be extended to all healthcare professionals. If you think about the very core of healthcare, people are entrusting complete strangers with their lives, especially in emergency situations. Think about that for a second. These people aren’t elected, there’s no track record of their history for treating patients the public can ultimately review prior to seeking their counsel, other than perhaps from known referrals. This relationship between patient and healthcare provider is assumed to begin with trust and respect right at the very start. The healthcare worker trusts you to reveal any information that could inform them of how to best treat you, and you trust the healthcare worker due to their medical training to fulfil their duties in saving lives.
Is that true though? How many times have you not been completely honest to your doctor? Delayed the admittance of being sexually active until the word penis stopped making you snicker? In fact, one 2020 survey conduced by the US Life Insurance Company TermLife2Go asked 500 people about whether they lie to their doctors about specific things that would aid the doctor in providing them with top medical care. In summary, 46% lied about smoking habits, 43% lied about exercise routines, 38% lied about drinking habits and 29% lied about their sexual partners. Further, men tended to lie more about alcohol consumption, while women tended to lie more about sex.
But is that the fault of the patient, or the doctor? Is it to be assumed that the prestige which comes with years of work to become a healthcare professional comes with trust from the general public, and the comfort of sharing intimate details of their lives? How relevant has this question become now, as the entire world is inundated with viral transmission and forced to wear personal protective equipment (or PPE), hindering yet another portion of that doctor-patient communication. National Committees, like those a part of Ireland’s Health Services, have given healthcare providers with instructional guides on building communication skills while using PPE, including recommendations involving setting up the environment, eye contact, taking your time to explain concepts and extended listening. Even talking about vaccines might be a difficult topic to discuss without full trust among the two parties, as patients have every right to be skeptical of these novel medicines, and doctors have every right to feel overwhelmed with keeping up with the medical literature.
This isn’t a novel concept, that communication between the healthcare provider and the patient has as much to do with good medical practice as a medical intervention. Academics have encouraged and outlined the reasons for having good healthcare rapport. One 1995 paper often referenced published in the Social Science and Medicine Journal terms the specific behaviours that occur during a consultation: cure-oriented vs care-oriented behavior, verbal vs non-verbal behavior, privacy behavior, high vs low controlling behavior, and medical vs everyday language vocabularies. Healthcare providers are now encouraged more and more to be aware of balancing these behaviours correctly, and may vary depending on the patient they treat. If not properly balanced, these could lead to major problems. Discussed in a 2010 review of this topic published in the Oschsner Journal, these problems include the deterioration of doctor’s communication skills, an increase in avoidance behaviour (or steering clear of discussions that stressed the doctor), or resistance by patients altogether.
A lot of research is centred around the experience of the patient, like customers of a business. But the difference with healthcare is that patients are not consumers of a product sold by healthcare salespeople. Healthcare providers are the second half of that life-changing relationship. Throughout my research on this topic, there was one review that spoke briefly on the perspective from the healthcare professional. Published in 2011 in the Journal of Pediatric Hematology/Oncology, authors state, “we need to realize that we health professionals are human beings too and sooner or later we will all have to deal with existential issues too such as death and fear of the unknown. We need to have in mind that we are not something different from what our patient is.”
How much that statement kind of hits you in the gut, right? News stories of healthcare workers in tears as they witness day after day, person after person dying of COVID-19 after being intubated with a respirator for weeks. We always expect a level of calm and almost nonchalant reaction in situations that normally require a gasp or at least a tear. Yet, as mentioned in a great Tedx Talk by Dr. Daniel Wozniczka on Millenials in the US Medical Field, “every single year in America, we lose anywhere between 300 and 400 doctors who take their own life. That’s a doctor a day on average. That’s an entire graduating medical school class, gone, every year. ”
This, this is the reality we live in, a relationship we are all a part of that borders life and death for both the patient and the healthcare provider. This relationship goes beyond trust assumed from the very get go; its the development of a bond between two equals for various amounts of time, one who is living to understand medical advice and the other who is living to provide medical advice. Both of which can learn to communicate effectively such that the rapport between the two expands from health to lifestyle to life in general.
I end on one final experience I had that eternalized healthcare rapport as a topic I find extremely valuable to think about. On a family vacation in my teenage years, we travelled from Canada to visit my Aunt in Germany for her birthday who, unbeknownst to us, would soon die of cancer. A month long vacation that started with her full of life, ended with her practically immobile in a hospital bed. Towards the end of that month, my brother and I saw her one last time in the hospital, in which the doctor had informed her that this is likely the last time she will see us again. The saddest moment I have ever experienced first-hand is seeing her struggle to hug my brother one last time, and I was furious at the doctor for informing her of that. But it wasn’t until thinking about it over the years which balanced this moment as somehow also one of the happiest moments I have ever experienced, that it was their brutal honesty that gave life to my immobile aunt one final time with us being present. It is that level of trusting communication, that level of healthcare rapport, between two people we could all learn from to strengthen the relationships in our lives.
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For today’s episode, I’ll be interviewing someone currently working the midst of the healthcare fiasco society has found itself in over the last year, and also studies the intricacies of leadership roles, or champions, within that space.
He completed his Bachelor of Science in Nursing in 2015 at the University of Ottawa. He has been a registered nurse for about six years on a general and hepatobiliary surgery floor. Currently, he’s in the second year of his Master of Science in Nursing and a research assistant at the University of Ottawa.
Please welcome the inspirationally bright, Wilmer Santos.
*Theme Music*
*INTERVIEW*
And thank you for listening to this episode of the Metaphorigins podcast. For another update, I’ve passed my first exam to bring me that much closer to the certification required for animal research. This topic is understandably one of concern by the public, and even for me, as I questioned the ethics behind whether this pertains to the category of “for the greater good.” I will probably explore this topic a bit more in later seasons. More updates will be given via bits and pieces throughout the season, so stay tuned, and hope you enjoy this one-of-a-kind perspective (literally). Remember to follow the Instagram page for visual updates as well as to be entered into the draw for the custom, butterfly-printed Metaphorigins shirt which will be given out on the 30th episode. Until then, stay skeptical but curious.
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