Doctors’ Most Damaging Hit Piece
With public opinion of medical professionals at an all-time low, an anonymous essay exposing disturbing doctor behavior may have dealt the final blow.
Nobody is perfect. To err is human. Everyone makes mistakes.
There are plenty of ways of saying the same thing, and there is one very good reason for that: because it is true. Most mistakes that people make are relatively benign, but in my line of work (medicine), they can be deadly.
But some mistakes that doctors make aren’t the potentially fatal type. They’re the “What the hell were they thinking” type. Unfortunately these types of medical mistakes are making their way into the public eye with increasing frequency.
Last year, a Fairfax, Virginia, man accidentally recorded a rather insulting conversation between the anesthesiologist and the gastroenterologist performing his colonoscopy. Even though it appeared his actual medical care was fine and there was no physical injury whatsoever, in June, a jury awarded him $500,000 for defamation, medical malpractice, and punitive damages.
It is exactly cases like this that have eroded the esteem of medicine—and of doctors in general. The people who were the most venerable members of society are fast becoming the most vulnerable, and many times we only have ourselves to blame.
Making the problem that much worse, on August 18 the Annals of Internal Medicine published a controversial anonymous essay written by a doctor which details two particularly lascivious stories that shine a dark, ugly light on obstetricians-gynecologists, and indeed on all doctors.
The anonymous doctor describes a medical humanities course that he was proctoring with a number of fourth-year medical students. He asked if any of them had experienced anything unforgivable in their limited experience. One student described a rather salacious OB-GYN saying, “I bet she’s enjoying this” while prepping an anesthetized woman’s genitalia.
The anonymous doctor then related a story of when he himself was a medical student on the OB-GYN service and watched a resident physician treating a woman who had just given birth and was hemorrhaging. After successfully stopping the bleeding and saving the woman’s life, the resident started dancing and singing “La Cucaracha” with his hand still in the woman’s vagina, and he somewhat reluctantly joined in. Only the anesthesiologist yelling “Knock it off, assholes!” made them stop singing and dancing.
The students were reportedly silent after these stories, and the writer finishes the essay with, “I know this is my silence to break.”
Dr. Christine Laine, the journal’s editor-in-chief, states said that in publishing the essay, the Annals of Internal Medicine chose “to publish something that exposes medicine’s dark underbelly.” She admitted that the journal’s editorial team “all agreed that the piece was disgusting and scandalous and could damage the profession’s reputation.” Yet they chose to publish it anyway, hoping that physicians would “refrain from personally acting in such a manner but also call out our colleagues who do.”
Dr. Laine’s hope was that doctors who read the article would reflect on their own careers and improve not only their own behavior, but that of everyone around them. After reading this essay, I sat for several minutes and thought back on my own medical career, including medical school, surgical training, and my subsequent practice. Though I could not recall witnessing any truly vulgar instances, there have no doubt been countless jokes, songs, and dances performed by me, especially after particularly good saves.
Like any other occupation, the majority of doctors are honest, respectful, hardworking people. However, medicine attracts its fair share of sociopaths and jackasses—surgery probably more so. It takes a special (and possibly crazy) type of person to cut open another human being, fiddle with his innards, and put him back together again. The stereotype of The Surgeon With A God Complex exists for a reason—you want your surgeon to think that she can save the world, because sometimes she has to. But there is no reason to believe that the people who act this lewdly will change their behavior one bit just because these shock stories were published. None. Zero.
The bigger problem with Annals publishing this piece is that it further degrades an occupation that has taken a major hit over the past decade, only partially deservedly. Many laypeople will read this article and not realize that these doctors are the exception rather than the rule. Instead, they will get the impression that this is just how doctors are: rude, disrespectful, insulting, demeaning, and misogynistic.
Some may think that knocking doctors down a notch is not necessarily a bad thing, that we’ve become too arrogant. But keep in mind that we are the ones tasked with trying to keep you alive and well. And in addition to the stress of seeing patients and dealing with increasingly massive mountains of paperwork, we’re now living in a world where doctors are rated the same way as restaurants, hotels, and auto parts stores.
I do not believe that doing a happy dance after a tough case is unethical, immoral, disrespectful, or detrimental in any way. Lighthearted behavior in the operating room is a harmless way to blow off steam and ease tension. But keeping those emotions bottled up is harmful to the surgeon. As stressful a job as surgery is, what everyone in the OR wants is a surgeon with as little stress as possible. When I had my appendectomy done, if the surgeon wanted to do a victory lap or make fun of my hair, my name, my nose, or anything else while I was asleep, I would have wholeheartedly approved it if it kept him calm and in control.
Make no mistake, I cannot and will not endorse or otherwise advocate disrespecting a patient at any level of care, whether that patient is awake or not. A certain measure of decorum must always be maintained in every situation, and if doctors are to have the public’s respect, they must show it first. However, asking doctors not to be human is not only unfair, it’s completely unrealistic and unobtainable, like demanding a soccer player not celebrate after scoring a goal. And exposing medical horror stories in this manner is in no way helpful for doctors or patients.