In the XII book of the Aeneid,1 in the fight against king Turnus and the Rutuli, Aeneas is wounded in battle and is taken away from the field, with the tip of an arrow buried in his thigh. He agonizes, not so much for the pain, but because he wants to return to war. Amidst a crowd of fellow soldiers in despair, an old surgeon, Iapiges, comes to his aid; he is skilled and equipped with a prototype of surgical pliers (Figure). With few strokes, Virgil sketches an extraordinary biography of this ancient physician: “Iapiges, son of Iasus, on whom Apollo, captured by ardent love, wanted to bestow his own arts, his gifts, prophecy, the zither and the fast arrows. He, in order to defer the demise of his dying father, preferred the knowledge of the power of herbs and their use in healing and to practice, inglorious, the quiet art.”
Iapiges is experienced, and profuses all his talents in trying to remove the metal fragment from Aeneas's thigh to provide healing. Yet, he does not succeed: a superior might, Venus, the mother of Aeneas, intervenes by secretly adding miraculous remedies to Iapiges’ potion. I am tempted to interpret this as the metaphor of basic science advancing practice. As we have witnessed, COVID-19 can be relieved by medical arts, but can only be cured, or prevented, by science. But let us not divert from our main character, the old surgeon.
Iapiges was a man loved by Apollo, who wanted to bestow upon him the mastery of music and performing arts, and the celebrity that goes with it. Indeed, Apollo has a broad portfolio from which to choose his gifts to men: he is god of music, poetry, art, archery, medicine and, in general, of knowledge and science. This, of course, is another metaphor. What is the deep meaning of being loved by Apollo in the classic world? It means being endowed with exceptional natural talents. Borrowing from the ancient Greek, we can deduce that Iapiges was polùtles, “he of many skills and talents,” which is how Homer defines Ulysses. Thus, at the time of choosing his profession, Iapiges must have been an intelligent, curious, open-minded, perceptive, sensitive, quick-witted, empathic, dexterous, and hard-working young man. He would have excelled in anything he pursued. He could have been a star.
For very personal reasons, ie, to assist his ailing father, Iapiges declined the offer of stardom, and asked Apollo to be granted the art of medicine instead. Notably, Virgil defines it an “in-glorius” choice. This must not be intended in the sense of disgraceful, of course. What he means is that the medical profession is not associated with glory, but rather a gift to be spent discretely, far from the spotlight.
This is quite extraordinary, counterintuitive at first sight. Is it because physicians were poorly appreciated in ancient times? Not likely. In various forms, medics have always been esteemed members of societies throughout the ages. Then, what is Virgil telling us from the distant past that may still prove true and topical? Exactly what he says: that medicine is an inglorious art. It attracts women and men of talent, well suited to succeed in careers more likely to bring celebrity, who choose to take their gifts along a more obscure path. Medical practice may be incredibly rewarding, but does not come with notoriety. Fame should be neither its prime driver nor its most coveted prize. The true essence of medicine, its pristine value, lies at a private, individual, and confidential level of human interaction. Its innumerable achievements in everyday practice remain unknown to the masses, and so they should be.
Not that there is anything wrong with well-deserved fame. Illustrious physicians provide invaluable inspiration to younger colleagues. It is important to celebrate those who excel, so that they may earn notoriety and attract other women and men loved by Apollo to follow suit. However, neither glory nor public acclaim are at the core of our trade: they are not connatural to our profession. Too often, in these digital times of instant fame (coupled with instant oblivion), we are tempted to forget: physicians are at their greatest when they are gloriously inglorious.
Corresponding Author: Iacopo Olivotto, MD, Cardiomyopathy Unit, Careggi University Hospital, University of Florence, Florence, Italy 50134 (iacopo.olivotto@unifi.it).
Published Online: January 26, 2022. doi:10.1001/jamacardio.2021.5701
Conflict of Interest Disclosures: None reported.
Additional Contributions: To the memory of my father, who chose to serve science rather than fame.
1.Virgil. The Aeneid of Virgil. Bantam Books; 1981.