Yesterday, a mutual posted about toxicity among our medical elders. The story involved an SR being made to kneel down and raise his hands in front of house officers and medical students because of some perceived mistake.
When I read it, I found it deeply disturbing.
One thing many people do not understand is that hierarchy in medicine is, to some extent, necessary. Medicine is built on experience. A consultant with decades of experience is not on the same level as a registrar. A registrar is not on the same level as a house officer. A house officer is not on the same level as a medical student.
There must be hierarchy.
Patients' lives depend on it.
Experience matters.
But hierarchy is not the same thing as humiliation.
Those are two completely different things.
There is nothing educational about making an adult kneel down and raise his hands in public. There is nothing professional about humiliating somebody before people younger than him.
The first thing many medical students forget is that these are not children.
An SR is not a child.
A registrar is not a child.
Many of these people are married. Some have wives, husbands, and children. Some are fathers of two or three children. Some are mothers raising families while simultaneously enduring the rigors of residency.
There is something profoundly dehumanizing about telling a grown man or woman with a family to kneel before people who may be younger than them by many years.
Whatever correction is being made could be made without stripping someone of their dignity.
And I think these things persist for one simple reason:
People allow them.
More importantly, many of the people doing them had them done to them.
Human beings are strange in this regard.
Many people who suffer abuse do not seek to end it. They seek to inherit it.
"When I was a registrar, they did this to me."
"When I was an SR, they treated me worse."
"So why should you be spared?"
Sometimes they even justify it to themselves:
"I am not even doing half of what was done to me."
The cycle continues.
The abused become abusers.
The humiliated become humiliators.
The victims become custodians of the same system that wounded them.
From my own interest in human behavior and psychology, I have noticed something frightening: many people endure suffering not merely because they have no choice, but because they secretly view the suffering as an investment.
An investment in future power.
They tell themselves:
"When I become a consultant, my turn will come."
That is a dangerous mentality.
For now, I like to tell myself that perhaps social media exaggerates some of these stories. I have not entered clinical rotations yet. Residency is still years away for me. So perhaps Twitter amplifies these incidents because outrage spreads faster online.
I genuinely hope so.
I hope reality is kinder than the stories.
But if these things truly happen as often as people claim, then something must change.
Personally, I am a person who guards his dignity carefully.
I can sacrifice many things.
My dignity is not one of them.
As long as I live and breathe, I do not believe any human being should be treated like an object.
I am not saying this as a threat.
Violence solves little.
But structures solve much.
If systems create abuse, then systems can restrain abuse.
That is why medicine needs structures that protect juniors from mistreatment by seniors.
We need formal reporting systems.
We need accountability.
We need records.
We need institutions willing to investigate complaints fairly.
And yes, when people repeatedly abuse power, there should be naming and shaming within professional boundaries.
Consultants or senior doctors who repeatedly humiliate people, degrade them, or abuse their authority should not be protected simply because of seniority.
Authority without accountability eventually becomes tyranny.
Medicine is difficult enough already.