It is early Sunday morning—there’s the rare kind of quiet today that feels borrowed. My daughter is still asleep beside my wife, and the house is hushed in that golden stillness. I find myself flipping through the paper copy of The Rheumatologist’s “Best of 2024” supplement that had arrived earlier in the week—I just wanted a brief escape from medical records (and even more so, from studying).
Half-skimming, half-unwinding, I stumbled on an article titled The 7 virtues of rheumatology. It wasn’t a clinical update or policy piece. Instead, it was something more personal—almost philosophical. The author began by referencing Dr. R. A. Asher’s “The Seven Sins of Medicine,” a 1949 essay I hadn’t thought of since med school. Curious, I looked it up.
It was startling in its honesty. Asher listed sins we all recognize: cruelty, bad manners, overspecialization, the love of the rare, envy, sloth, and stupidity—not as dramatic moral failings, but as quiet habits that erode the soul of our profession. The virtues offered in response felt like a balm—not lofty ideals, but practical compass points we too often overlook.
I thought of someone I’d seen recently—Mrs. K, one of our long-standing patients at the rheumatology clinic. Her lupus and kidney disease were stable. Her joints were quiet. But her eyes were tired in a way I couldn’t ignore. Her husband, terminally ill and fully dependent, now required constant care. She was his only caregiver. And she was exhausted. She spoke softly—about lifting, bathing, feeding—and then, more quietly, about the fear of losing her beloved. I realized she wasn’t just fatigued. She was disappearing under the weight of it all.
We went through the motions: medication refills, lab orders. But what she needed most was a space to be seen—not as a caregiver or a diagnosis, but as a person on the edge of heartbreak. She needed a space to be simply human.
As I returned to the article, I understood why those virtues resonated so deeply:
- Clarity over obscurity
- Compassion over cruelty
- Good manners over bad manners
- A holistic perspective over overspecialization
- Appreciation of the common over the love of the rare
- Thoughtfulness over commonplace stupidity
- Diligence over sloth
Rheumatology, as a specialty, quietly demands these virtues from us. It teaches us that complexity isn’t always in the serologies, but in the stories. That clinical ambiguity is not a flaw, but a feature. And that healing sometimes begins before we even speak—when we simply listen.
Still, as I finished the piece and set the journal down, it struck me that these reflections aren’t just about rheumatology. They’re about being a physician. The sins Dr. Asher named, and the virtues our field aspires to, apply just as much to the intensivist rounding in the ICU, or the primary care doctor managing diabetes and loneliness in tandem.
Maybe that’s the quiet brilliance of both pieces: They challenge us not just to diagnose, but to care well. To protect ourselves from callousness not with protocols, but with intentionality. To remember that good medicine is as much about moral clarity as clinical skill.
As the morning sun grows brighter and the street noises begin to rise, I feel a sense of renewal. In a time of mounting pressure, increasing burnout, and impossible schedules, these reminders—that how we show up matters—feel like the most important kind of continuing education.
And I silently hope and pray that more of us rediscover the soul of what we do as physicians.
Syed Ahmad Moosa is a rheumatology fellow.
