Letter writing isn’t my forte, and thus neither is open-letter writing. But I can’t not respond to the bevy of whiney, whingey Western medical doctors who are complaining about their working conditions in Western hospitals, among other complaints, amid the COVID19 pandemic. And in this post, when I reference “Western” anything, I obviously mean capitalistic and patriarchal, and all capitalistic and patriarchal eminations and penumbras arising therefrom. In this post, I am responding to this article, which is only the most recent I’ve seen (but perhaps the only one I actually read) written by these clowns who seem to believe that the risks and fallout from practicing capitalistic, patriarchal medicine should be shared amongst the community, you see, while the rewards of working in a top-tier (read: apex predator) capitalistic patriarchal field, including money, power, status, invincibility and the like, should be theirs to savor alone. #fuckoff
This particular article, that I was actually moved to read, was written by a medical resident and woman of color which are probably the only reasons I read it, already knowing what she was likely to say, but giving her a chance. Residents are barely even doctors, having just graduated from medical school and having not even taken their exams yet. They are not even fully licensed to practice medicine and are also known as doctors-in-training, student doctors, or interns, mkay, fucking interns, yet practicing medicine without a license on a largely uneducated, naive public anyway, a public who thinks that anyone wearing a white jacket automatically knows what the fuck they are talking about and more importantly, what they are doing, physically doing with their hands and directing others to do.
By comparison, lawyers do their internships including a provisional kinda-sorta license-to-practice-while-closely-supervised-by-a-real-lawyer while they are still in law school and before they graduate, and are not licensed to practice law until they take and pass both the bar exam and the so-called “character and fitness” exam, as well as passing the character and fitness background check which deeply probes into every metaphorical orifice including criminal, financial, academic and personal. Prospective attorneys must have several already-licensed attorneys write letters of recommendation to the bar examiners vouching for the applicant, which is no small feat for an autistic, generational white trash candidate like myself, nor is the disallowance of any negative financial or criminal history easily overcome for some people. As I was preparing my credentials to become licensed, I remember being very concerned about parking tickets. Parking tickets.
Clearly, this attorney “vetting” process is selective, in that it selects-out the chronically poor and marginalized: not people who get parking tickets, but people who are unable to pay or timely pay their parking tickets before those tickets turn into something worse, and people in whatever many ways are unable to finesse their way out of trouble generally. Also selected-out are those unable to convince “personal attorney references” that they are fit to practice law (read: educated white people like them and will put their own reputations on the line for them by personally recommending, in writing, that they be licensed). And obviously, people who didn’t finish and/or do well in college, or who flubbed the entrance exams, for whatever reason, are generally excluded as well. Use your imagination to recognize who that would (and would not) be, while recognizing that these people, and more importantly these “types” or classes of people are excluded from practicing or even seriously studying the law for a reason. That’s important.
Anyway, I gave this naive baby/barely a doctor a chance, I gave this woman, who is by definition not (quite) an apex-predator a chance to say something, anything, that was interesting, or insightful, and/or something I could respect. Literally anything! If she even said one thing that was interesting or thoughtful I would’ve been extremely happy, as that happens so rarely in general. Particularly doctors are generally self-interested, milquetoast and authoritarian, hence whatever they say bores me to tears. As did this woman bore me to fucking tears. But what she is saying is timely, and her concerns and general message are taking up a lot of real estate in the cultural conversation surrounding the medical response to the global pandemic known as COVID19.
So I will take a few moments to respond, to her and everyone, from my perspective as an attorney and whatever else I am, and particularly as someone at least as educated as she is (I have a terminal degree in my field, as she has in hers) who is (therefore demonstrably) at least as intelligent, at least as accomplished, has at least as much student debt as does this woman who thinks that she deserves hazard pay, student loan forgiveness and a shitload of other goodies just for showing up to fucking work and doing what she did, in fact, sign up to do: providing medical care to patients in a capitalist, patriarchal Western medical setting within a larger capitalist, patriarchal global context/culture. If she thought that wasn’t going to be a hellacious nightmare she must not have thought about it too deeply, but the vetting process for medical professionals, similarly to the process for vetting attorneys, selects for certain characteristics innit.
And after that, it funnels these same “certain” people into and through a career track that specifically prohibits them from coming to or acting on certain conclusions if they want to remain in the profession. Conclusions like: making money off the backs of sick and dying people creates unresolvable conflicts of interest. And, authoritarianism — when applied to thinking beings — violates natural law because it is thought-terminating by definition. Unresolvable. By definition. Get it? This woman may as well have written an op-ed in the Huffington Post complaining that tangerines are too tangerine-y. Or not apple-y enough.
While I am not interested in responding line by line to this inane opinion-piece by a naive baby/doctor, in this article, she complains about what she calls the “deep, chronic wounds suffered by doctors during medical training” that even loan forgiveness and hazard pay, while they would “help resident doctors” would not heal. Here she is talking about what others have discussed and characterized as “inhumane” conditions under which doctors, medical students and student doctors work and learn, examples of which abound on primetime television showing various hazing rituals endemic to the profession. It does seem a bit opportunistic (and disingenuous) to hijack the COVID19 discussion and reroute it into a more general discussion of what many student doctors experience in medical school, or doctors in medical practice generally, but what are doctors and student doctors if not disingenuous opportunists afterall?
What she does not seem to grok is that this system is not broken, but is working exactly as intended: the ritualistic abuse doled out to student doctors works as a filter and effectively filters out (for example) the chronically ill, who have intimate, firsthand experience with complex health concerns and Western medical providers but who cannot tolerate extreme physical and/or mental stress, including 24- to 48-hour working shifts. Abusive learning and working conditions would also serve to remove those who have a moral or other objection not to simply being abused, but to abuse itself. And would filter-in those who believe or act as if abuse can be a legitimate means to an end. Doesn’t it?
Whereas student doctors who object to abuse and are willing to act on that objection would self-select out of the medical field, which has been written about before. In this 2 year old post, I wrote about and provided external links to the discussion of disaffected doctor suicides, where doctors themselves have been discussing this problem of selection and self-selection without recognizing it for what it was: incontrovertible evidence that the Western medical field purposely excludes practitioners who object to abuse, including torturing and killing live animals in medical school “labs” via vivisection and experimentation; harming patients via iatrogenic illness and injury (aka medication side effects, surgical complications and medical mistakes); and providing ritualistic medically futile care like hopeless resuscitation attempts and so-called end of life care that prolongs the dying process and often serves interests other than those of the patient, including family members and society at large.
Medical students and practicing doctors who can not (or can no longer) tolerate the abusive norms of their field choose to exit, often by committing suicide. What we are left with — those who are not selected or self-selected out of the medical field — either have no objections, or choose not to act on their objections to individual and systemic abuse including interpersonal violence for reasons often related to money and status, and those are the ones providing care, and teaching the next generations of doctors. And on it goes. That is my response to this baby/doctor’s complaints and the thrust of her essay which does not really address the specific circumstances of the COVID19 pandemic at all: if you truly objected to abuse, and were willing to act on your convictions you would not be practicing medicine at all. You obviously have no such objection, or you are a disingenuous coward for not acting on your alleged objection, so fuck off.
But since she also mentions the idea of society rewarding Western medical providers under the current circumstances of a global pandemic, including hazard pay, student debt forgiveness and the like, and since this perspective is gaining steam, I will take this opportunity to throw some cold water on that shit by making a parallel between the “heroic doctor” and the “blue lives matter” perspectives, where pretty much all thinking people dismiss the “blue lives matter” cops but coddle the heroic doctors, regarding these groups differently for no obvious reason. The parallel is a bit complicated, but it is absolutely there to be noticed: “blue lives matter” suggests that police officers — to whom the cultural elite outsource their most direct violence to protect their own interests — can and should shift the risks and burdens of their profession onto society at large by (for example) shooting first and asking questions later, in order to avoid becoming harmed themselves. They believe that, even though they are rewarded with a salary, power, status and the other goodies that go along with being a cop, they should not have to also shoulder the risk of having to deal with “potential criminals” (ie. private citizens, people) without disabling them first.
That this proposed and actual risk-avoidance/burden-shifting makes these cops and pro-cops tyrants and assholes has not been lost on progressive, allegedly thinking people and there has been some pushback against Blue Lives Matter which is seen as overreaching, racist and ignorant, which it is. It is also hopelessly and wrongfully derivative of legitimate civil rights movements that object to exactly what these moronic cops and pro-cops are trying to do: to hoard the gains amongst an elite few while spreading the costs among the many, including the less powerful and those who can least afford it.
Where doctors in the age of COVID19 seem to think that they deserve a doctor’s salary, virtually unassailable social status and whatnot while their neighbors and communities absorb the costs of both their medical educations and any personal risk these doctors are taking as part and parcel to providing medical care under conditions of capitalism and patriarchy, which conditions rather necessarily include overpopulation, poverty, a permanent underclass of the chronically ill and injured, overburdened to nonexistant social services and the like. Even the very concept of massive “hospitals” where contagious people congregate with the uninfected would only exist under a capitalist patriarchy, where maximizing profits and controlling people, among other things, are prioritized no matter their negative effects on anyone’s health: as an anecdote, last time I went to Urgent Care, and exposed myself to actual sick people, I ended up sick for 2 months myself despite initially presenting with an earache.
Patients know this arrangement is far from health promoting, but Western doctors stopped making housecalls, where contagious people stay home and don’t infect their communities, a long time ago. Doctors exposing themselves to literal hoardes of contagious masses in a frantic hospital (clinical) setting, which isn’t good for anyone except the owners of the hospitals and those even above them, and being obedient corporate stooges and elitest patriarchal enforcers is largely why doctors get paid enormous salaries in the first place, but now they want us to subsidize their educations and publically-fund their so-called hazard pay too.