Uncommon in poets, artists, and priests, apathy is curiously common in physicians, who should care but do not. Its genesis resides not in the long arduous years of training when sleepless nights and callous superiors might be imagined to inflict the disease, but rather after, when one might have assumed that income, family, independence, and authority might have conferred some immunity. In physicians, apathy is especially egregious. Its nature is such that it conceals from the afflicted its very presence, and so the diseased assumes the arrogant air of one above it all, detached, removed, objective, the deserving object of pride. There is a necessity about it, a noblesse oblige—it becomes prized therefore, and so can grow, metastasize, and supplant proper function, as would a cancer. At the highest levels, the brain becomes addled. Ignorance is confused with iconoclasm, banality with prosaism. The victim ceases to read. He has already arrived. He spurns learning. He has enjoyed the finest training. Journals, research, new studies, recent advances he views as unproven, faddish, vagarious, maggoty. At the more mundane level of daily functioning, he becomes slipshod, slapdash, and derelict, yet he sees this as an efficiency born of experience. Morning rounds become perfunctory, a facade, evening rounds, forsaken. That which is missed, or worse, ignored, is deemed irrelevant, inconsequential. His patients do poorly, but only because, in his view, he is saddled with such difficult cases. Requests for consultation are an intrusion; students’ needs, burdensome, impeditive, onerous. To the unimpassioned observer, it should not be surprising that those in the advanced stages of the disease exhibit a frantic, sometimes comical (occasionally outrageous) pursuit of reviviscence. Hence the red Ferrari, the lavish home, the enervating hobby, the mistress, the extravagant vacation, and conspicuous consumption of many descriptions. If these desperate measures do not in themselves advance the primary disease process, they do invariably prove unsuccessful at alleviating its symptoms and usually complicate the victim’s disease state. Despite the energy and money expended, despite the time consumed and distractions pursued, the ennui remains. Things become all important.Money and the means to it replace Profession and the pride in it. The apathy-afflicted physician senses, perhaps for the first time in the course of the illness, that he is trapped, and he may become angry, bitter, and vengeful at this realization. He will believe these emotions are justified, and he may even act out against those around him who, he believes, have caused his unhappiness. This is stage IV disease. Its pain at this point is fierce, though often masked by denial, distraction, and strength of personality. But death of the spirit is always painful, even if unrecognized. Seeing such pain, such complex affliction, a friend or colleague is tempted to “throw” a cure at Dr LaCombe is a cardiologist in Augusta, Me. THE ART AND THE CALLING