I swear by Apollo the physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses as my witnesses, that, according to my ability and judgment, I will keep this oath and this covenant:

 So begins the classical version of the Hippocratic oath 
Each May I listen to a modern version of this oath spoken by the 160 or so students graduating from medical school here at the University of Louisville. It is a very emotional moment, the capstone of a long and difficult journey in becoming a physician. The students stand and are joined in this oath by any physician in the audience wishing to reaffirm their commitment to the profession.

 Though dressed in academic regalia and having had a part in each student's training on their path to becoming a physician, I remain seated with my mouth shut savoring the commitment others are making to the well being and security of their patients. My lack of participation in this solemn occasion is not because I don't agree with the words being spoken or if faced with situation where the dictums of this oath may be relevant in my life I wouldn't try my best to live up to their standards; it is just that my training as a scientist took a far different path from the training of these graduating students, and I simply lack the skills and authority to help patients in the same way as a practicing physician.

 Which brings me to this month's Journal Club article published in the Journal of the American Medical Association as a medical news and perspectives piece [1]. The article is entitled, Exome sequencing comes to the clinic, which seems innocuous enough given the number of times the importance of various types of DNA sequencing technologies have been discussed in this forum as they pertain to gene discovery in DBA. The article, however, takes a dangerous turn in my opinion by suggesting that a patient somehow avail themselves of different resources to obtain exome sequence data and then armed with this information contact a scientist to figure out mechanisms underlying their condition and then (and only then?????) with a clinician determine a diagnosis.

 I can't help but think that the JAMA article blurs the boundaries between work being done under a physician's lead as part of an interdisciplinary group engaged in both clinical practice and research and the idea of a patient directly contacting a researcher to obtain information for a clinical diagnosis.

 As a non-physician scientist, I work with several consortiums of investigators studying various aspects of DBA. Each of these consortiums is led by one or more physicians who act as point persons for interactions with patients and their families.
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