Witness to War: An American Doctor in El Salvador

It is unusual for a physician— merely by discharging his daily duties—to be able to practice his morality as well as his medicine, to live the ancient injunction to "first, do no harm." Most of us, despite our protestations of humane intent early in the process of medical education, gradually succumb to more tangible rewards. For physicians with more than a superficial commitment to concepts like altruism, compassion, social justice, and equality, this disengagement from important personal beliefs—at least on a daily basis—is an acutely painful process. The system of medical status and success makes it easy to justify inactivity on issues of broader social or moral concern, since medicine usurps—if permitted—ever increasing amounts of time, energy, and effort. As students, we can attempt to placate a guilty conscience by insisting that the time spent in study may make us more able to help others in the future. As practicing