Scene II, in which I clarify my previous statement

My Scibling DrugMonkey brought up a half-valid point. The half that was valid was that none of the medical bloggers spoke out about the surgeon who assaulted a patient. The half that was insane was where this is used as further evidence that doctors are arrogant pricks. Based on this comment and those of the commenters on my blog, some further clarification is needed.

I can’t speak for other doctor-bloggers, but the story of the surgeon who tattooed a patient wasn’t that interesting to me because of its isolated nature. When looking at antivaccine claims, altmed claims, and all manner of woo, we look for patterns of thought and behavior not in individuals but in society and in movements. If it were found that there were a true sub-culture of surgeons doing this to patients, I would probably rant for days about it.

That being said, there are certain aspects of the incident which seem to confuse our readers.

First, we as doctors are entrusted with the physical and emotional facts, secrets, and foibles of our patients. This creates a vulnerability in our patients (and in ourselves, but more on this another time). Violation of this vulnerability is the greatest of immoral acts in our profession, whether it is telling of their secret affairs, doing inappropriate exams, or making marks on their bodies.

The incident in which a surgeon apparently put a washable tattoo under the pantie-line of a patient is a gross violation of trust, physical integrity, and is attached to a whole lot of issues regarding power, violation, and abuse. A vulnerable woman (she was under anesthesia) awakes to find a mark on a private part of her body for no good reason.

It may or may not be hyperbole to call this an act of violence, but either way, this idiot should not be practicing medicine. These behaviors aren’t usually isolated, so investigation may show a pattern.

But back to the other issue. A doctor committing an act of violence doesn’t really illustrate much about the profession as a whole. It doesn’t illustrate much of anything except that there is an asshole out there committing violent acts, and as he is a member of my profession, his acts are related to it.

The days of systematic pathologic paternalism on the part of doctors is long gone. It may linger in places, but it’s just not part of the culture anymore. Doctors are authorities. We know things that others do not, and use that knowledge to help people. We have an unequal part in the doctor-patient relationship which is potentially (but rarely) abused. To level this relationship senselessly, to claim that doctors have no different skills or knowledge than others, is to abandon our responsibility to our patients.