Friday, 18 October 2013

Power and Status

Rather sobering article by a practising medic on a survey revealing the extent to which doctors suffer from mental illness. It seems like an emergency to me. Something requiring thoughtful action. IMHO the situation is exacerbated-if not created- by some long term structural conundrums.

It more or less comes down to this;
Our patients are defined by their illness, while we are defined by our ability to cure their malady.
"Defined" by them, the doctors of course, not by the patients themselves. And isn't it amusing that this describes 'obesity', almost to a tee, except the other way around. The illness is defined by the patient because they are "it". (As we used to say as kids playing tag.)

It's a model that came into being in the era when contagious diseases held sway. For many countries that is still the case of course but as they progress, they too will experience this shift. It's never been as suited to chronic disease, the diseases of ageing and nervous disorders that have come increasingly to the fore. Those require a different model of patient doctor interaction. That's the rub. 

There seems a desire to cling to the increasingly obsolete codes out of a sense of entitlement to the sense of power and status it brings, i.e. "defined by our ability to cure their malady."

This is helping to overwhelm the energies of the medical professions. Instead of using preventative medicine as an avenue to liberate both lay people from our abject passivity and them from being overburdened and drained by it. The docility remains but the responsibility is piling on. When there's little prospect of relief of the burden of that, despite ones efforts, burnout ensues.

Something has to give as some of us know only too well. 

The combination leads to a culture of invasive encroachment that causes as many problems as it solves for both.

We all need to adjust to this new era.The professionals must relinquish control and lay people must step up without having to be dictated to by ill conceived "wellness programs" and the like with their bullshit standard of quackery. Fat people have demonstrated this to an extraordinary extent already.

It's the methodology given to us that let us down, not our sense of responsibility which we followed through with rigourous and sustained action. Efficacy of method is a key point. Standards of scientific endeavour should not drop just because the professionals are in two minds about letting go. That kind of quackery also a sign of the contempt encouraged by the overall passive countenance of lay people and patients, before you consider us being set up even more for failure through an extensive campaign of stigma.

It's not so much that we were consciously set up by others for failure. It's more mixed feelings invoked sabotage. Such an unresolved and overwhelming desire to retain control will not go quietly unless openly addressed and explored. The pushmi-pullyu effect of dumping everything on lay people, but at the same time realizing on some level where the logic of that might lead (not so much voting for Christmas as creating it) meant there was an instinctive inhibition to commit to it. Not sure there was ever that desire, only to relieve themselves of the burden of an issue they could not resolve-and knew it.

If its up to us, then we have to be fully empowered. That means what we do has to be properly and objectively monitored, and the results properly tabulated. No weird denial of reality, because fantasy satisfies the desire for total responsibility with active dis-empowerment. That combination of even lower status than the pathetic norm, plus responsibility far beyond anyone has been a psychological disaster for not only fat people but for the medical profession's chance to graduate from their attitudinal funk. 

The whole direction of research needs to change to facilitate more self/inner directed healing. Leaving the professionals free to deal with more medically complex cases. Yes, that has potential problems. But it's certainly worth trying, this time in a rigourously and properly scientific manner. No quack BS of the "Those who spend more than 5 hours a day on a computer are 15% more likely to be obese" type. This is bollocks and of no earthly use. Even the AMA suggested in its recent repellent decision that research needs to be done, an honest judgment on the worthlessness of the millions spent producing this kind of garbage.

We need actual research into how we can link conscious thought and intent to change the functioning of our bodies, via our nervous systems i.e. our minds. We are at the early stages through using ancient techniques of meditation and more modern imprints of mindfulness-a different awareness of our (major) inner signals and rhythms. And physically through again ancient techniques that can promote the body's self healing capacities.

This shows we are in a way, coming full circle. It could be said that the magic bullet model that was perhaps the real departure, though brilliant, effective and necessary. Great though that is, contagion will always be with us in some forms, it's demands have somewhat distorted the profession and our relationship with ourselves and our bodies. We cannot afford this model in terms of our own health, gaining and sustaining widespread access and healthcare costs.

I don't care what anyone says, drugging our moods, is so not the way to regulate them. Useful though that might be, it's not a long term solution. And some of us just don't want any part of it. There needs to be more catering for that. I'm not saying that from any bullshit bootstrap mentality but from my understanding of how we function.

And when the methods are not working, that has to be properly acknowledged without any rage or violent assault through surgery. People have to become part of this experimentation process. If drugs are not to be at the heart of it. Lay people being part of this kind of large scale natural experiment in public health, can work and be effective and have genuine scientific merit.

It can become another route to advance health and science.

We all have to adapt to it though. As we see in the case of fat people, the public can. But, it doesn't matter how much effort lay people put into their health, if professionals have the power to slander people, deny reality and derail the process. If they dig their heels in, no matter how responsible and honourable you are, ultimately can bring your efforts to naught.

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