The accumulation of spam e-mails in my ‘‘bulk’’ folder is laced with all sorts of raunchy solicitations, yet I have learned to read through the list before accidentally deleting an important e-mail. Last week, while performing this obtuse responsibility, I discovered an invitation to my 25th medical school reunion. I couldn’t believe that time has gone by so quickly. Out came the medical school yearbook, and along with it a bunch of memories. It is obvious now that I could never have predicted the path taken, both in training and as a radiation oncologist. And there, on the back page of the yearbook, was a copy of the Hippocratic Oath I had taken some 25 years ago. I was dumbstruck that I had forgotten the language, although not the concept: ‘‘I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.’’