Negotiating society often defies the idealistic logicalisms of medical training. And I have realised that society is unable to afford the incorruptible physician.
Curing the sick requires no more than a well grounded training, but to please and engage society requires greater leaps and often over uncharted ruggedness.
The historical chronicle of medical practice over time reveals how society, though constantly clamouring for nobility within its medical corps, constantly shoots itself in the foot and exports, sometimes wholesale, the inanities within its own ranks into the fabric of the medical fraternity with consequences, which it turns around to criticise.
Often, compromises of virtues have simple beginnings. But once the innocence of virginity is lost, what can follow is no longer predictable: restrained use of the new avenue or licentious indulgence in the new possibilities that the innocence of the newly minted doctor is first put to strain when he is besieged time and again by members of society, high or low, to write sickness certificates for anything other than sickness.
Perhaps all they want is a chill, or escape from court and law schedules, as well as an extended recovery from a tiring holiday. And the only thing to do is apply pressure on the doctor, until then, an innocent hatchling who has been trained to exercise this immense declarative power only for the right reason.
He is now torn between a right training and a wrong ‘re-training’ by the hypocritic world he faces. He is soon taught how to place a spin on truth; learning to refrain from calling a spade a spade merely to suit whims.
They come requesting that he couch their illnesses in anything other than what they really are ; magnify to enhance pending claims or minify to qualify for jobs.
To refuse to oblige is to court unpopularity and sometimes where it may hurt. The naive healer is not infrequently persuaded to doctor the bills, falsifying the figures for what is effectively an insurance fraud. The insurance company themselves are sometimes hand in gloves with acolyte doctors they have managed to suck into their fold, retraining them but only in their own image
They abandon ethics finagling diagnosis and treatment protocols aimed only at maximizing corporate profits for insurance moguls. Then the shameless sick who enjoyed the best of a doctor’s care only to avoid paying the bills, forces the doctor to recast himself and to harden his approach to care or even adulterate it.
Society often drags doctors into its day to day battle arenas: running to the doctor to be excused reporting to duty just to avoid a boss or colleague or an assignment.
Sometimes such requests come from heavyweights, heavy enough to intimidate the average doctor out of his innocence.
The transformation of the medical corps into a criminal enterprise gets more treacherous over time and with society’s propensity for the ludicrous. Doctors are being seduced by society to become accomplices to illegal organ harvesting, organ theft and organ sales.
The story has been told of war prisoners in the Kosovo Serbian conflict stripped of organs using pressure groups to persuade doctors to take organs from captives for different purposes.
Similar stories surround death row felons in China where society persuades its doctors to tear a path into the bodies of these felons to yank out precious organs.
Between the 1980s and 1990s, dead Israeli prisoners were reported to be stripped of corneas, heart valves, skins and bones in the Israeli-Palestinian conflict, by a peculiar collusion between the society and its criminalised medical corps, against every professional protocol these doctors received during their medical training.
Governments and otherwise reputable organisations can sometimes seek, in their zealotry, to induce unwholesome practices in hapless doctors within their reach.
A doctor is trained to save life, not take it. But somewhere along the line, segments of society ‘retrain’ him to take life either by inflicting such last act without which death would not have occured (euthanasia) or assisting the victim in inflicting that last act himself (assisted suicide).
All through the day, justices sit on their high benches criminalising abortions while bishops shout themselves hoarse immoralising it; and then at night, a whisper comes through from same judge or bishop begging the doctor to spare them the embarrassment of their lone daughter found to be pregnant just before her fifth form exam in high school.
In whose image does he mould: the judge on the bench, the bishop on the pulpit or the whispering hypocrites creeping in the cover of night to make abortionist of him or the parliamentarian who is just as duplicitous?
How many of these heavyweights can a conscientious doctor turn down before his life becomes miserable. How incorruptible can he remain!
Society has almost succeeded in retraining a whole new school of doctors committed to expedient duplicities when it suits. When a set of lawyers smelt fortune taking a vaccine manufacturing company to court, they seduced an unsuspecting British surgeon to convert to fraud.
In the world of elite sports, doctors are daily besieged by society surrogates to try illegal means of boosting performances to merit undeserved trophies.
How many doctors, faced with the corrupting onslaught from power magnates, heavy handed employers, rich brazen athletes, military dictatorships or sledge-hammer politicians can say no to corruptly extending a sick certificate by a day or a week, spinning health reports on a prime minister/presidents, obliging special and dangerous prescriptions, or facilitating governments in what is essentially murder plots?
The challenge is if society can stop frowning at the physician who refuses to play ball, anytime anywhere on that pitch or frowns at him only cos he is not playing our part of the pitch.
•Fadipe is a former professor of clinical surgery in the West Indies. He wrote in via email@example.com