Circumspect

*shudder*

That gave me chills, but probably because we see eye to eye on this subject.  I particularly like the " sacrifice satisfied" line, and actually it even seems like it may be a fitting final line w/o the initiation portion.  I like your play on words for the title, as well.  One change I personally would make is omitting the " the" in front of white coat... that way, white coat is an image more so than a person.. just as the other words throughout the poem you convey sensations rather than you saying " the tearing flesh".  Am I making any sense?