“Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. The opposite of love is not hate, it’s indifference.”
– Elie Wiesel
This piece is written for World Mental Health Day (10 October 2019)
There is a longstanding conspiracy of silence within the medical profession – doctors are not allowed to admit their mistakes or speak about their personal struggles in public. Any public admission of personal difficulties is considered a sign of weakness and a disgrace to the profession. In my medical training, I have seen numerous instances in which this culture has brought only harm to both doctors and patients.
A brilliant colleague of mine passed away recently from suicide. Nobody saw it coming. In the highly competitive environment in medical training, it is difficult to speak about our struggles with mental illness at work. After all, our training performance is evaluated by our direct supervisors as well as our peers through peer evaluation. Any admission of weakness only breeds distrust and raises doubts about our competencies. With the 120 hour work weeks, the rampancy of hospital staff abuse and the rigid demands of medical training, most of us have in one way or another felt a sense of resentment against the system and hopelessness about our prospects. Due to the demands of work, we work to the bone and often neglect ourselves and our families. Yet, silence about our personal grievances is the mandate so it must be adhered to like the medical oath.
Furthermore, any admission of medical errors is often regarded as contemptible in the profession. After all, did we not enter the profession promising to strive for high standards and achieve perfection? Medical errors are extremely costly; medico-legal wars are waged and careers are ended overnight due to the smallest of errors. Junior doctors find it difficult to admit their mistakes because this may ruin their career portfolios. Senior doctors find it even more difficult to admit their mistakes because this may damage their established reputation and pride. Due to this culture of silence, mistakes are often covered up or spoken about surreptitiously and the culture is further propagated. Ultimately, both patients and doctors suffer as a consequence.
We can do better as a profession. This veil of silence must be broken. Awareness about each others’ difficulties is powerful and allows us to help and complement each other in constructive ways. We have to acknowledge that beneath our carefully put together public image as doctors, we are in all ways as fallible as every other human being. We all have our shadows to deal with and repressing this aspect of ourselves is extremely dangerous to both doctors and patients. As Gandhi said, “Silence becomes cowardice when occasion demands speaking out the whole truth and acting accordingly.” Together, we can start the right conversations and create a safe environment for speaking up for ourselves and for each other in the workplace.
p.s. Leave a comment if this resonated with you. I love to hear your stories!
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Nice post. Bob