A surgeon scrubbing in for the tenth hour knows something that no amount of medical school can teach: the body on the table is both a biological system and a person with a history, and treating only one of those is a kind of professional failure. The Stoic concept of *oikeiôsis* — developed by Chrysippus and later refined by Hierocles — describes how we naturally extend moral concern outward, from self to family to strangers, in ever-widening circles. What's striking is that this maps almost perfectly onto what the psychiatrist George Engel argued in his 1977 paper introducing the biopsychosocial model: that medicine had narrowed its circle of concern to the biomedical, and was paying a price in both outcomes and meaning. The practical move today is small but real — when you encounter a patient, a colleague in distress, or even a medical decision that feels purely technical, ask whose full circle of concern is being accounted for, and whose is being collapsed.

When you last made a significant medical decision — for yourself, a patient, or a loved one — which layer of the person (biological, psychological, social) did you treat as noise rather than signal?

Drawing from Stoicism / Systems Medicine — Chrysippus & George Engel (synthesized)