"Do No Harm" THE REDUX

I'm rewatching episodes of Lost with an On-line group over this oh-so-grueling hiatus. (4 mos to go YAY!) Last epi we watched was "Do No Harm" a Jack-centric that I think is very telling in determining his make-up and his reservations at a relationship with Kate. He made some MAJOR mistakes with Sarah and has some MAJOR daddy issues. Poor baby!

Here are some thoughts I had while rewatching...

1. Episode name. I assumed that "Do no harm" is a part of the Hippocratic oath. Have always assumed this...and was wrong! LOL It's actually NOT a part of the oath but is a doctrine that MDs are taught in Med School Ethics. Comes from the Latin phrase Primum non nocere "First, Do no harm." The reference I saw is that this is an especially important tenet to follow in emergency medicine or triage (which would be Jack's position with Boone.) This idea promotes the belief that if the risks of suffering of a procedure/treatment outweigh the chance of success then it should not be done. Human acts with good intentions may have unwanted consequences (ie Marrying someone you don't fully love even for the most honorable of reasons can lead said marriage to disintegrate in short order, OR amputating a man's leg as a last ditch chance to save him most likely will only lead him into a far more painful death, OR making a phone call for help that brings about death to those you were trying to save.) I did find interesting that in medical care there are instances in which Primum Non Nocere is not the standard to follow but instead one should follow the credo of Primum Succurrere "First, hasten to help." Primary example would be in treatment of Cancer where the treatments are known to cause suffering but are instituted regularly if there remains any chance of cure and oftentimes just for palliation to extend life. It seems to me that despite the name of the episode Jack is very much instead acting under the credo of Primum Succurrere.

2. Jack's Actions: I found myself wondering if Jack was not behaving just how we would idealize our own Physician acting. That they would do anything to save us...even if they barely know us...even if they don't really like us....even if they have to give their own blood! He is on the edge of insanity almost throughout this episode yet who wouldn't want someone to fight for them or their loved one in that same way (at least until we told them to stop fighting.) Jack was so driven that he would have obviously killed himself had Sun not been there to intervene. Incredible but also curious? We are to assume this has to do with Jack's overdeveloped sense of commitment per his father's words yet many would have this evidencing his "God/hero complex." I don't agree that Jack was trying to save Boone to play hero at all...I think Jack would have done the same thing if it had just been he and Boone on the island and no one would have ever witnessed his actions. I think it's just what they were trying to tell us via Christian and Jack's own words that he is "not good at letting go." Boone's words to Jack, "I'm letting you off the hook. Let me go Jack." seemed to release Jack and deflate him. He had failed yet again...again he didn't have what it takes. To me Jack is committed in EVERY instance b/c he is always fighting against his fathers admonition that he would be a failure and should simply not try.

3. Jack's treatment choices: since the first viewing I've really wondered about his assertion that Locke was at fault b/c he lied about the nature of Boone's injuries. I'd never researched it before but took some time to get a preliminary idea of what he was meaning. The conclusion I've come to is that Jack was right in his view that his line of treatment would have changed had Locke told the truth but ultimately I don't feel that it would have prevented Boone's death. The difference in treatment of a crush/compression injury (such as Boone really sustained in the airplane) versus a fall (vertical deceleration injury) is pretty significant. Jack assumed that Boone had injuries consistent with a fall. The fact that Boone was alive and semi-conscious would be a positive in that immediate survival of the fall improves chances immensely. Fractures and monitoring for CNS injuries (Jack's specialty) would then be the next concerns. Boone's pneumothorax would be less likely with the fall injury but not out of the question and the chest tube was the only treatment appropriate for that. Where the tx's differed began with Jack "setting" the fracture in Boone's leg. Had he known Boone's was a compression injury then he would have known to decompress the pressure (or check for the beginnings of the compartment syndrome that later develops.) He could have made slits in the affected limb to cease the blood from pooling in the limb and avoid the extension of the tissue necrosis prior to amputation being necessary. Since instead he set the fracture and then began giving him blood he worsened the situation which led to the accelerated compartment syndrome in Boone's leg and would necessitate amputation as the only possible course of treatment. So ultimately Locke's lie led to the incorrect treatment which worsened the situation and was a 100% horrible and selfish action on Locke's part. BUT had Jack known Boone's injury was compression in nature I don't think he would have been able to save him without mechanical ventilation once Boone developed respiratory failure. In essence, Locke's lie wasn't causative of Boone's death but to "more harm" to come to Boone because of incorrect treatment. In the end though it was Jack who had to be stopped from causing inappropriate pain to a dying man when he was going to amputate with the cargo door. What a Wow! moment when you realize he is really going to do it...insane! Sun's voice was the one of reason throughout the episode and in her quiet way she told him how wrong he was for doing it to which he employed Locke's line: "Don't tell me what I can't do."

4. Jack should never have/did not want to marry Sarah. Sarah didn't really love Jack...she loved Jack's heroics. Her speech to him was VERY telling. She never once mentioned love just told what a hero he was and that he was "the most committed man [she'd] ever known." Yikes! Not the prose you want to hear your beloved spouting about you with regard to reasoning for marriage. Jack's face indicated a realization that neither of them was really in the marriage for the right reasons and he threw out a net to his father hoping to be "let off the hook." But instead his father offered more bad advice and pushed Jack into a doomed marriage not unlike his own only with the infidelity coming in reverse. Jack cared about Sarah without question but only married her as he suspected because "he was the one who saved her" which conveniently was the reason she married him. I think in his drunken rant to Kate in SNBH Kate had become Sarah in his mind and this statement to Kate was actually meant for Sarah...but never voiced. Again it's Jack's mistaken notion that he "earns" love not simply is given it from those around him. Jack's vows to Sarah in the wedding were sad in discussing his writers block in writing the vows, expressing his fear of failure in being a good father and husband --the same questions he still has when he proposes to Kate. He says that he didn't fix Sarah but that she fixed him but this doesn't ring true at all since he proceeds to sabotage his marriage through immersing himself in work and ultimately fails as miserably as he'd feared he would.
"The Watch" mobisode comes into play here since it was set during jack's wedding. To refresh... Christian gives Jack the watch that his father had given him on the day of his wedding. The watch was tainted in that Christian's father didn't approve of Margo. Why then is he passing it on to Jack? Jack wants to know if Christian is subtlely trying to say something about Sarah but again he isn't let off the hook and Christian expresses approval. Jack is marrying a woman that his father approves of but isn't the right one for him. The same watch appears in SNBH..it's the one he checks the time on at the bedside table. Don't know if this means anything but ya never know in Lost!

5. Hadn't noticed before that Jack's best man Mark Silverman is the same boy that he protects from the school yard bully in White Rabbit. Another example of commitment...once Jack commits to you, he's yours for life!

6. Symbols of Lost: duality was big in this episode. First the yin/yang on jack's shirt in the beginning. Then the strong juxtaposition of Jack's failure with Kate's success; Birth with Death; the shot of Claire cradling Aaron faded into Jack cradling a near-death Boone. And what I consider to be the theme song of Lost (not that it makes is definitively so but humor me!!!) is played in the scene which begins with the group admiring Aaron happily and leads to Jack telling Shannon of Boone's death. A beautiful, haunting melody M. Giacchino titled appropriately "Life and Death"---the ultimate theme of existence, no!

7. Little random thoughts: Kate knows that Clarie was giving the baby up for adoption and Claire actually said "I didn't want the baby." Kate's notion that Aaron belonged to all of them. Relevant dialogue in retrospect.

Boone's last words never realized: "Tell Shannon...I" Why was he not allowed to even express a last thought? Are we to assume he was going to tell Jack he loved Shannon and this wasn't important to hear since we knew this already or was there something relevant he was going to say? I wasn't ever a fan of the character but it was nice to see him die gracefully and with courage. He always wanted to be heroic and he did die heroically in the end.

Locke/Jack feud takes residence in this episode. Prior to this they had seemed to have grudging respect for the other.

That's it. I admittedly watch through these >> (Jack-tinted glasses) so take it with a grain of salt!