Most people think highly of their doctors. They want their physicians to be objective, scientific, detached, and yet caring, compassionate, and sensitive. In short, they want doctors who are more like healing saints than human beings.
It makes sense that people would want this of their doctors. When you are lying on the examination table with the doctor probing your anus, vagina, penis, or other embarrassing organ, you want to believe that the person doing this to you is pure, wholesome, honest, competent, and doing what's best for you. You don't want to think that the doctor is some pervert with a degree and license to abuse.
Well, I'm afraid I have some bad news for you. I've been in medicine, and I know.
Put yourself in the shoes of a doctor. At one time, he or she was just like you, a layperson. They went to kindergarten and grade school and did what they were told, learned how to take examinations and get the expected answers, and as a result made high grades. They kept doing this until they got into medical school. They were selected for their grades and test scores.
For some jobs, applicants need to take personality tests, to give some indication of their character. Are they antisocial, are they honest, would they steal? You would want to know this about employees before giving them a job. Yet, for those applying for the job of doctor, there is no such character testing. Applicants are selected by academic testing. And these people will be trusted with human lives.
Would getting high scores in chemistry or physics or math make you a great doctor? Of course not. Does knowing physiology, anatomy, and biochemistry make you compassionate? They may make you a good physiologist, anatomist, or biochemist, but they have nothing to do with compassion. In fact, since most medical sciences are heavily reliant on cruel animal research, torturing and killing millions of dogs, cats, monkeys, rats, and other animals each year, there is nothing farther from compassion than the field of medicine.
Indeed, medical education is deliberately designed to desensitize laypeople to blood and guts so they can become doctors. Dealing with sick people, some in severe pain, anxious, fearful, helpless, requires a cool head. It is important that doctors keep calm when everyone else is over the edge. In the real world, of course, you need to learn how to be cool and collected in a crisis. Since the medical student is not selected on anything but test scores, the fact is that most students cannot live up to this ideal. If all you had to do with patients was to get their health history in written form and take a test on what drug to give them, it would be no problem for doctors, especially if the tests are multiple choice as they are in medical school and on medical licensing tests.
But medical care requires different skills and personalities than just taking multiple choice tests. That is why medicine has so many specialties for students to choose from. Medical school takes four years to complete. The first two years are textbooks and laboratories. The last two years you get to try different medical specialties for a few weeks to a couple of months, to see what suits your fancy. Some people like the thrill of a crisis. They usually go into emergency medicine. They enjoy the adrenaline rush of a heart attack or car crash. They don't like to see people slowly die from chronic disease and medication side effects. They prefer the medical quicky to long term commitment. Come in, get patched up, and get referred to some other doctor for follow-up.
Others who get a jolt from stress go into surgery. Imagine the rush you feel when you cut open some stranger's chest, blood spurting everywhere, nurses handing you clamps to stop the flow, machines beeping faster to the patient's pulse and respiration, sweat swabbed from your dripping brow by the nurse, the anesthesiologist warning that the patient is going into cardiac arrest, and all the while staying above the fray in your outward demeanor, cracking dirty jokes with the nurses, and talking timeshare resorts with the anesthesiologist. What a job!
For those who prefer being more like the old time doctor, there is family medicine. You get to see kids, parents, pregnant mothers, old people, the whole gamut of humanity, and with all sorts of problems. When the going gets tough, you just send them to some other specialist. People get to trust you and tell you their life secrets. This is medicine lite, a great specialty for laid back people.
I remember a family physician I went to for a check-up on my 30th birthday, at a time in my life before I get into medicine and when I still believed in getting routine check-ups. He did a thorough exam, including a rectal exam to look for prostate enlargement and other signs of inflammation. I didn't expect it. "Pull your pants down and bend over," he told me. He was a tall, blond, handsome doctor, about 6' 4", unmarried, but apparently heterosexual. "Is that really necessary?", I asked. "Yup." So over I bent. He put a little condom on his finger, slipped some vasoline jelly on it, and in it went, as I puckered with displeasure. "How's your sex life?" he asked while pausing inside to get his bearings. "Just fine," I answered, slightly miffed that he didn't even take me out to lunch.
Not long after I had been admitted to medical school. Before I started classes I went to volunteer at a local low income health clinic, hoping to get some more experience. They dressed me in a white lab coat, called me a "student-doctor", and in no time I was doing a pelvic exam on an 18 year old woman. The doctor did the exam first, and then instructed me to feel for the cervix as I uncomfortably slipped my gloved hand inside the strange woman's slightly odoriferous vagina. My layperson days were ending. I was already being given access to peoples' bodies.
Some guys would have been envious, I suppose, so long as pus doesn't turn you off. Imagine what type of guys become gynecologists. They get to tell women to strip for them all day long, all types of women. They then get to stick their fingers inside their vaginas, anuses, and feel their breasts. They want their patients to feel they are experts on women, even though they are only men and never had a period, wore a bra, or had some strange guy probe their vaginas.
Of course, there is a down side to this specialty. What would it do to your sense of women to have to examine pusy, smelly, diseased vaginas everyday? When your wife gets amorous, do you reflexively reach for your glove and lubricant?
While most gynecologists are men, urologists are not mostly women. Women are willing to have a strange doctor probe their genitalia. But most men would feel strange to have a woman doctor probe their penises. Of course, it feels strange having a man probe your penis, too. What kind of man gets attracted to urology and a lifetime specialty of dealing with penile and prostate problems?
The same can be asked of proctologists. Imagine, as a medical student, if you would find it exciting to work with rectums and colons. What would it do to your sense of humanity to see butts all day long, year after year?
As you can see, it could be difficult to make a choice of specialty. If you are really an idealistic person and came to medicine to end suffering, you are in for some disappointment and grief. I know a rheumatologist who could no longer cope with seeing her patients slowly die, unable to do much to alleviate their suffering. She decided to change specialties and become an anesthesiologist, so all her patients would be unconscious and she wouldn't have to get to know them personally.
Those medical students who fit no other mold and are slightly strange themselves usually become psychiatrists, escaping the blood and guts by seeking the mind. Psychiatrists who are themselves a basket case often feel great emotional relief and increased self-esteem by simply listening to other peoples' problems all day long, making psychiatry very therapeutic for the doctor. This is an especially attractive specialty for medical students who enjoy LSD or peyote and stayed high through most of their basic sciences training. They can really get into peoples' twisted fantasies and hallucinations. But beware of the power hungry shrink. They can call you crazy, lock you up, and keep you drugged out of your mind for the rest of your life, if they want to.
Indeed, doctors have all sorts of powers over the public. They are licensed to practice on people with drugs and surgery. As a doctor, you can accidentally kill a patient, or make it look accidental, and get away with it if you can show that it was standard medical procedure. And you can even bill the deceased patient's estate for services. Now that's power. This power is attractive to some people, which is why they became doctors in the first place. Of course, as in politics, anyone attracted to power is precisely the kind of person that shouldn't get it. People growing up wanting to be called "Doctor" all the time and have the power, money, and prestige our culture gives to the medical profession are not necessarily the best people to treat patients fairly, sensitively, and with the patient's interests foremost in mind. These doctors do not serve their patient's health needs. The patients serve their doctor's power needs.
Along with the power of medicine comes the money. Above all else, medicine is a business. It is in the business of treating disease, which means the doctor makes out best when you are sick, not when you are well. This puts the doctor, like the auto mechanic, invested in you breaking down. It means the doctor is invested in sickness and treatment, and is the enemy of health and prevention. If you went to medical school to help heal humanity, this sad fact about the basic, underlying financial impetus of medicine may be enough to make you quit the profession. It made me quit. It made me also realize that if you want to be healthy, you need to stop doing things that make you sick, including going to doctors.
So the next time you are being probed, keep in mind that the person doing the probing is no different from anyone else. They are not necessarily saints who vow poverty to treat the sick and help prevent disease. They are not necessarily unbiased, objective, mature people who can distance their personal feelings from their work. They are just regular people who have been given a license to practice on you. They have the same perversions, biases, stupidity, self-interest, and petty lives as the rest of humanity, but are attracted to the lucrative and powerful business of disease.
Say, "Ah!"
Sydney Ross Singer is a medical anthropologist and director of the Institute for the Study of Culturogenic Disease, located in Hawaii. His unique form of applied medical anthropology searches for the cultural/lifestyle causes of disease. His working assumption is that our bodies were made to be healthy, but our culture and the attitudes and behaviors it instills in us can get in the way of health. By eliminating these causes, the body is allowed to heal. Since most diseases of our time are caused by our culture/lifestyle, this approach has resulted in many original discoveries into the cause, and cure, of many common diseases. It also makes prevention possible by eliminating adverse lifestyle practices. Sydney works with his co-researcher and wife, Soma Grismaijer, and is the author of several groundbreaking health books.
