The Doctor's Dilemma
BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39293.518796.59 (Published 02 August 2007) Cite this as: BMJ 2007;335:263
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
In 1992 I attended a lecture given by a rising star in the world of
medical politics. Over lunch afterwards an academic administrator friend
asked our lecturer what to do about doctors who “refuse to do what you
want them to do”, to which our lecturer replied immediately and with
vigour, “you should make an example of a few of them”. The identification
of any group of individuals, whether based on ethnicity, culture,
profession or other characteristic for particular treatment (in this case
punishment) is an example of stereotyping in which the attitudes held
about the group are so strong they justify particular action against
individuals of the group on the basis of “group guilt”. This has long been
a dangerous path in human history.
In his review of The Doctors Dilemma by George Bernard Shaw (BMJ
2007, 335,263), Iain McClure tells us that Shaw “had a problem with
doctors”, believing the profession to be in terminal decline and in urgent
need of his linguistic surgery. Shaw’s play is undoubtedly a highly
successful piece of theatre, but do Shaw and his drama really tell us much
about the practice of medicine then or now? Are they truly relevant to
medicine today as Dr McClure suggests? Shaw’s characters are highly
successful in delivering his comedy and satire, but seem to me to lack a
certain earthy reality, so abundant both in Shakespeare’s plays (with whom
Dr McClure links Shaw) and in medical practice. Empathy with human
variability, discomfort and vulnerability, so important in medical
practice are not strong features of Shaw’s work.
Shaw’s childhood revulsion of his father’s alcoholism is
understandable, but his apparent life long unrelenting contempt for him
suggests a personality that might have struggled to achieve the empathy or
compassion needed to understand the practice of medicine. A taste for social
engineering on a grand scale, in contrast to individual social justice may
explain his admiration and defence of Joseph Stalin. It may also underlie
his view that sound public sanitation, good hygiene and vegetarian diets
should replace traditional medicine which he believed to be dangerous
quackery. However, even in the field of public health he was a critic,
attacking for example vaccination against smallpox. But his principal
limitation as a thinker on issues related to medical practice was his well
known deficiency in the area of personal and especially intimate human
relations.
Let us enjoy Shaw’s plays as his contemporary audiences did, but like
them we should regard his stereotyping of doctors and patients as a
dramatic device and decline to be instructed by his brilliant but
disdainful wit.
Competing interests:
None declared
Competing interests: No competing interests
As Ian McClure himself makes clear in the opening line of his
article, George
Bernard Shaw was Irish, not British. Even in the days when Ireland was,
sadly,
part of the United Kingdom, it was the United Kingdom of Great Britain and
Ireland.
Competing interests:
None declared
Competing interests: No competing interests
Re: The Doctor's Dilemma
Professor Sheridan's response to my article (BMJ; 335: 263a) is
informed, elegantly argued and convincing. However, I believe that my
suggestion that Shaw's play is still relevant to doctors today, has value.
Whilst we all probably agree with Professor Sheridan about the desirable
qualities required to practice medicine in theory, we are also only too
well-aware of recent examples of when things have gone wrong in practice.
Doctors are people, subject to their vices, as well as their virtues. Shaw
may have been a flawed human being and, had he chosen to be one, a bad
doctor; but he was a piercing observer of human nature, for which he is
rightly still celebrated.
Competing interests:
None declared
Competing interests: No competing interests