Tell 'em what I took, man!

Reflections of a repatriated ex-patriot

Saturday, May 09, 2009

The Caduceus and the Rod of Asclepius

In going over the user guide documentation for the Computer-Aided Dispatch software which is the cornerstone of the company for which I now work, I came across an image which represents a symbolic metaphor for the dissonance of current medical practice in the United States-- two symbols, in fact, embedded with all the potent intrigue of a Dan Brown novel. In studying the software's map module, which can be used to locate an organization’s vehicle posts, medical facilities, and patient pick-up and drop-off locations I was presented with an idea that made me pause and reflect.

When an emergency call taker gets a call from an injured, wounded, or sick individual, she must find out, among other things, where the incident is taking place—the ambulance’s pick-up location—and enter that information into the application’s user interface. If the call taker maps the location, and sends it to a dispatcher, the dispatcher will see the pick-up location marked on a map in the symbol of a "Caduceus." I noticed that the symbol looked slightly different than what I had seen on the sides of ambulances when doing general research about Emergency Medical Services—the six pointed "Star of Life." In the center of the Star of Life exists the Rod of Asclepius—what I had thought to be the ancient Greek symbol for medicine. I came to ask myself the question: what’s the difference-- other than the presence of an extra snake and pair of wings in the Caduceus and their absence in the Rod of Asclepius—between the two symbols? Naturally, I looked them up in Wikipedia and came to find a symbolic inconsistency representative of perhaps the greatest controversy in the medical profession today:

The rod of Asclepius (sometimes also spelled Asklepios or Aesculapius), also known as the asklepian, is an ancient symbol associated with astrology, the Greek god Asclepius and with healing. It consists of a serpent entwined around a staff. The name of the symbol derives from its early and widespread association with Asclepius, the son of Apollo, who was a practitioner of medicine in ancient Greek mythology. His attributes, the snake and the staff, sometimes depicted separately in antiquity, are combined in this symbol.

That was pretty much what I had expected. Why then was a Caduceus used instead of the Rod of Asclepius in the map module of the software I now support? I did some more research on Wikipedia and came across the following:

The caduceus is sometimes used as a symbol for medicine or doctors (instead of the rod of Asclepius) even though the symbol has no connection with Hippocrates and any association with healing arts is something of a stretch; as the symbol of the god Hermes, its singularly inappropriate connotations of theft, deception, and death, as well as the confusion of commerce and medicine in a single symbol, have provided fodder for academic humor.

“The confusion of commerce and medicine:” how very appropriate to the ongoing war between patients, insurance companies, HMOs and government. All of the connotations embedded by the two symbols were evoked in my thoughts in a sudden flash: The insistence of putting a monetary value on medical care to the detriment of the patient; the alarming number of bankruptcies in this country as a result of the inability of individuals to pay their medical bills; the election campaign discussions about the government’s role in health care and health care as an economic industry; Michael Moore’s Sicko; the ambivalence in the role I provide at this new job: am I promoting the saving of lives by helping to ensure that dispatchers are able to use the software efficiently in getting ambulances out on scene to help patients, or am I making life worse for the sick by providing an arsenal of data which can be used by the organizations to justify billing the sick into oblivion—all of these thoughts represented themselves in those two symbols.

Even though I’m now far removed from the analysis of literary symbolism during my days as an English major, the weight of the connotations carried by those two symbols just makes me say "WOW!”