Friday, May 6, 2005

Satire of Doctors and Medicine: An Appropriate Therapeutic Potion?

I think that the medical profession is deserving of satire. Doctors are looked to for help with personal illness. Any personal illness is loaded with uncertainty even if it is more or less trivial. "Can I get over this cough to go the the concert tomorrow?" "Does this runny nose mean I am going to have a permanent allergy?" "What does this cough and runny nose mean? Do I have pneumonia?" And with these concerns and even more deadly questions including those regarding death itself, we go to the doctor for that help we need. But the doctor is still a mysterious entity even and perhaps even moreso in this age of consumerism. Consumers no long take the physician for granted as they did over 50 years ago. Do we all know who can become a doctor? What does it take to become a doctor? Do doctors follow any rules? Do they have ethics? What are the ethics? Are they trained for "bedside manner"? How do they make their money? Do they order things or schedule repeat visits to make more money? What is the doctor thinking about when the doctor asks those personal questions or examines me? Are they interested in me or some other interest? ..and so on.

Satire (the use of ridicule, sarcasm, irony, etc. to expose, attack, or deride vices, follies, etc.) is a way to nervously express the uncertainties one faces when confronted with a personal illness and their personal physician. I have found a great article on medical satire in the British Medical Journal 1994;309:1714-1718 (24 December)titled "Dr Doubledose: a taste of one's own medicine" by Roy Porter. (Note: the link to the full article may be available only to those who subscribe or who have institutional library permission.)

As an example, from the article, of the concerns of those in the 18th century when "doctors were taunted with caring only for their fees" is the satiric verse of 1714 by Bernard Mandeville, himself a practitioner within "The Fable of the Bees".

"Physicians valued Fame and Wealth
Above the drooping Patient's Health,
Or their own Skill: The greatest Part
Study'd, instead of Rules of Art,
Gave pensive Looks, and dull Behaviour;
To gain th' Apothecary's Favour,
The Praise of Mid-wives, Priests and all,
That served at Birth, or Funeral."

Another example of satire of doctors is in the "The New Yorker Book of Doctor *(*and psychiatrist) Cartoons" published by Alfred A. Knopf 2003. Actually, a number of the cartoons are literally a satire of patients since I guess as patients we also deserve a bit of mockery. What has all of this got to do with medical ethics? I think satire also reflects the ethical misbehavior of physicians or the misinformation about the ethics of the profession as received by patients. In either case, there is a need for improvement. In conclusion, it may be that writing and reading satire of doctors and medicine provides us all with a therapeutic potion for what concerns ails us when we get sick. What do you think? ..Maurice.

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