Tea at Trianon: The Lost Vocation of Medicine: From Calling to Commodity

John Wilson Croker on Marie-Antoinette

"We have followed the history of Marie Antoinette with the greatest diligence and scrupulosity. We have lived in those times. We have talked with some of her friends and some of her enemies; we have read, certainly not all, but hundreds of the libels written against her; and we have, in short, examined her life with– if we may be allowed to say so of ourselves– something of the accuracy of contemporaries, the diligence of inquirers, and the impartiality of historians, all combined; and we feel it our duty to declare, in as a solemn a manner as literature admits of, our well-matured opinion that every reproach against the morals of the queen was a gross calumny– that she was, as we have said, one of the purest of human beings."

~from History of the Guillotine by John Wilson Croker, 1844

Edmund Burke on Marie-Antoinette

"It is now sixteen or seventeen years since I saw the queen of France, then dauphiness, at Versailles; and surely there never lighted on this orb, which she hardly seemed to touch, a more delightful vision. I saw her just above the horizon, decorating and cheering the elevated sphere she had just begun to move in, glittering like a morning star full of life and splendor and joy. Oh, what a revolution....Little did I dream that I should have lived to see such disasters fall upon her, in a nation of gallant men, in a nation of men of honor and of cavaliers! I thought ten thousand swords must have leaped from their scabbards, to avenge even a look which threatened her with insult. But the age of chivalry is gone; that of sophisters, economists, and calculators has succeeded...."

~Edmund Burke, October 1790

Monday, October 6, 2025

The Lost Vocation of Medicine: From Calling to Commodity

From Brownstone Institute:

A patient’s trust was not a transaction—it was a gift, a profound act of vulnerability. To be allowed into that sacred space was to be given a responsibility greater than anything I had known. We did not speak in the language of “compliance metrics” or “quality indicators.” We spoke of healing, of service, of devotion. Medicine was not a career. It was a vocation, a purpose, a life anchored in something deeper than self.

Over the years, however, something shifted. What was once a vocation has been stripped of its soul. It has been rebranded, reframed, and reduced until it barely resembles the profession I entered with such hope. Medicine today is a business enterprise. Patients are consumers, doctors are “providers,” and healing has been crowded out by billing codes, liability fears, and the suffocating weight of bureaucracy. The vocation has been replaced by a job, and a job can always be abandoned. That is what haunts me most.

The decline of vocation did not happen overnight. It was gradual, almost imperceptible at first, like a slow leak in the hull of a ship. Administrators multiplied until they outnumbered physicians. Insurance companies dictated what treatments were permissible, not based on medical judgment but on actuarial tables. Pharmaceutical firms turned research into marketing, blurring the line between scientific discovery and sales strategy. Hospitals transformed into corporations with CEOs, branding departments, and profit margins to defend. The physician’s desk became a computer terminal, and the patient was no longer a soul in need of healing but a data point to be coded and billed. Even the language betrayed the transformation: patients became “units of care,” outcomes became “deliverables,” and clinical judgment was rebranded as “adherence to protocol.”