breaking a great vow

Yesterday, my neighbor Joe, school books under his arm, crossed the street for a chat. Joe, at 60 or better, is taking classes at a local college in order to be certified (or some similar bureaucratic name) to counsel elderly people.

Joe had just come from a class in which the teacher posed a hypothetical problem. I don't much like what-if discussions, but the day was sunny and the conversation was pleasant, so I listened.

Problem: A patient is consulting with his psychologist, a person charged with keeping patient information confidential. The patient says he is HIV positive and has not told his female partner. In addition, he has another female sex partner and hasn't told her either. And to top things off, the patient says he is planning a trip to Florida for "Spring Break" festivities -- a time for a lot of drinking and love-making ... and the patient is not planning on telling any of his hoped-for bed companions that he is HIV positive.

The shrink tries to redirect the patient's thinking, but the patient remains unconvinced: He will go on enjoying his sex and he will not tell anyone.

HIV (human immunodeficiency virus) is not invariably fatal, but it can be fatal and it stands a good chance of sickening the carrier in a variety of other ways. Hence, the patient is saying he is willing to kill, or at any rate harm, others in pursuit of his between-the-sheets gratification... and he won't reconsider.

What should the psychologist do, Joe's teacher asked? A vow of confidentiality is central to the relationship with any patient and yet if others are all but assured of getting harmed, what should the shrink do ... break the confidentiality vow and tell, perhaps, the cops who might enforce the various laws that forbid the harming of others, or maintain the confidential relationship with the patient?

Joe said the teacher promised to revisit the question later in the course. It was not resolved during yesterday's class. (And in the meantime, I cannot help remembering author and wit Dorothy Parker's approximate observation, "Why do we expect others to keep our secrets when we can't even keep them ourselves?")

Vows are interesting things. Some are great, some are small, but each contains within it something that is viewed with varying degrees of seriousness. Buddhists make vows -- don't kill, lie, cheat, steal, etc. Married couples take vows. Members of the security and military forces make vows. People make contractual vows when they buy a car. And "I'll meet you for dinner at 7 o'clock" is a vow as well.

The seriousness of a vow is entirely up to the one who makes it. Some vows are worth dying for and some are just self-serving hot air. But as far as I can figure out, a vow is something to take so that you can learn from breaking it. Not that all vows are necessarily broken, but a vow-maker who is not prepared for that eventuality needs to grow up... which may account for the sloppiness with which some people take their vows ... and the inane and inhuman inflexibility that others may exhibit.

I'd like to think (vow) that I would not kill ... and yet I had beef stew for dinner last night. Am I not party to the killing of a cow? (And I am not about to get into a pissing match with vegetarians who consume the food that might otherwise nourish the peaceable cow I ate last night.)

I'd like to think (vow) that I would not lie ... and yet what are the words written on this blog if not politely-cloaked lies that cannot hope to accurately convey reality?

And the laundry list goes on and on: I vow and life snickers, "Yes, dear -- do your best."

But my vows do have some usefulness in that they bring my attention to things and call for my taking responsibility. And that's the best I can come up with: Pay attention and take responsibility ... things work better that way. Sloppiness is too sloppy and inflexibility is too inflexible.

Pay attention and take responsibility.