Demonization of Doctors: #jesuisasur

in Life Beyond Medicine by

The Durga Puja is not just a religious ceremony for Bengalis. To them, it is a cultural extravaganza, a carnival, and a riot of happiness that knows no caste, creed, color, religion or political affiliations. So, naturally, this has become an extremely lucrative opportunity to be exploited for economic gains by multiple stakeholders. The norm of the day are opulent arrangements, and thematic celebrations, where the idol, the pandal and all other arrangements are made in sync. While this provides for a spectacle worth observing, to the social scientist, this is also an expression of the way society thinks and looks at issues plaguing them everyday.

One such theme has caused a bit of an uproar. In a Durga Puja arrangement in Central Kolkata (Md. Ali Park), the idol depicts a doctor, dressed in white apron and flaunting a stethoscope, as the Asura, the demon that is slayed by the Goddess. The image has, expectedly, gone viral on WhatsApp groups and local social media. Healthcare professionals have come out strongly condemning such an arrangement. In response to this caustic backlash, the puja organizers have, allegedly, hung a poster around the neck of the Asura-like doctor, which reads: “in condemnation of fake doctors and with respect to qualified ones”. Latest trends in WhatsApp groups are lauding the state’s Chief Minister for pressuring the puja organizers to take down the offensive idol.

There has been a host of reactions for this idol and based on the media coverage generated by this news, the puja in question is going to be a success (which is usually measured in terms of footfalls per day). In a world where “no publicity is bad publicity” is the key mantra, the organizers have hit the jackpot as an outcome of this controversy. Now everyone will be interested in seeing the idol where the doctors were depicted as demons.

This demonization of the medical profession is something that goes way deeper than an idol or a religious sentiment. This is, in fact, a major concern for medical professionals from all disciplines. Considering these pujas as the proverbial mirror that reflects social values and opinions, the thought that depicting doctors, as the enemy would be a unique selling point, indicates a malady running deep in people’s mindsets today. The arguments along the lines of “doctors themselves are responsible for their fall from grace” are tired and clichéd. Yes, there are black sheep – isn’t that true for all professions?

Today, we have an environment where medical professionals work under the constant threat of physical harm and injury, where every day heartbreaking news of lynching of doctors, manhandling of female healthcare workers trickles in on WhatsApp and Facebook, and doctors continue to bear the brunt of the responsibility of the failures of a poorly funded healthcare system that is stretched too thin trying to cover too many priorities. While this picture is true for doctors working across India, in West Bengal, the portrayal of doctors as a form of class enemies is probably the strongest. The Md. Ali Park puja this year is disturbing, but at the same time, it is the symptom of the way the common man has started to lose faith in the public healthcare system; and as doctors are the face of the system, they bear the onus and face the reactions.

So where do we go from here? The affirmative action taken by the authorities to take down the offending idol is welcome. Perhaps it is indicative of a will to work towards building a safer workplace environment for healthcare professionals of all disciplines, and at all levels. Or perhaps it is just a response to the spontaneous agitation which gained a lot of momentum on social media. Whatever be it, there remains a lot of soul searching that needs to be done by doctors and patients alike.

This demonization of doctors, in both the literal and figurative sense, is a reflection of the deterioration in the doctor-patient relationship, which used to be sacrosanct. The era of precision medicine, and personal medicine makes healthcare today sound intimate and customized for the individual, but truth be told, doctors hardly know their patients anymore. Gone is the era of the family physician, who was basically an unspoken member of the patient’s family – he would know when the kids were malingering and how often the elders were neglecting to adhere to their prescriptions. With the rise of super-specialty care, medicine today gets more and more delinked. The same patient is under the care of a phalanx of doctors, many of whom are not linked to each other in taking care of the patient. The government hospitals, which always function under sub-optimal resources and support, are, predictably, manned by overworked staff, who are usually underpaid and undervalued. Naturally, despite humongous efforts, they fail to provide the time and attention each patient deserves – because doing so might mean failing to address several more patients. As the diagnostic arsenal gets more and more tools added to it, in tune with Abraham Verghese’s lamentations, we see how medicine is taking the clinical touch away from the business of patient care.

It is all too easy to picture the puja committee which proposed or approved this ill thought out enterprise as the real demons in this whole fiasco, but it would be an oversimplification of the process at work. In fact, in my eyes, they have done nothing wrong – in poor taste, for sure, but strictly speaking, they were catering to their target, providing the consumers with a product that they were expecting, or were likely to appreciate. What I do have issues with, however, is the ease with which this transition has happened. Once considered next to God, doctors today lie at the feet of the Goddess of power and righteousness, begging for salvation as her trident rends his heart. The irony is that most doctors do not want to be treated either as a God or a Demon; we want to be treated as a fallible human being. When considered next to Gods by our patients, we, as doctors, are being set up to fail. It is impossible to live up to the standards of divinity that is imposed on our frail and fallible selves. But, at the same time, we are not all money-oriented, heartless monsters who do not care for their patients and only looks at the cash lining their wallet. Unfortunately, public perception, the fickle mistress that it is, keeps vacillating and keeps swinging us from one extreme to the other. One day we are heroes because we restarted a child’s heart and brought her back to life. The next, we are demons because we failed to save someone’s ailing grandfather who suffered a massive stroke. This cycle of putting us on and off the pedestal, this continuous, vicious, unpredictable transformative process does more harm to the doctor-patient relationship than we can actually account for. And it is this continuous transformation that we need to stop – and for that to happen, we need to bolster the healthcare system, raise people’s confidence in public health facilities, make healthcare quality oriented instead of quantity oriented and above all, provide a safe and healthy workplace environment to those professionals who have to deal with the responsibility of other peoples’ lives in their hands.

We need to remove the Damocles’ Sword that dangles above the head of each and every doctor today, and we need to do it together.

Skeptic Oslerphile, Scientist at the Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases. Interests include: Emerging Infections, Public Health, Antimicrobial Resistance, One Health and Zoonoses, Diarrheal Diseases, Medical Education, Medical History, Open Access, Healthcare Social Media and Health2.0. Opinions are my own!

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