As a generic group, doctors are probably reviled even more than journalists or barristers - yet most of us might admit we know a GP or two who, given a fair wind, might just make it into the kingdom of heaven, which is more than you could say about the wigged ones or the scribblers.
They are odd, doctors. Of all the professions, they are probably the least successful in organising their careers into a sensible, properly rewarded structure, spanning from their first hours in medical school to the minute they hang up their stethoscope and join the queue to see the great GP in his surgery in the sky.
Medical students are put through a hell which is the very opposite of education. Far from their minds being opened, being prompted to engage distant and different horizons, far from their time at university being one of mental liberation and personal discovery, medical students find themselves being funnelled into a witless, brain-sterilising marathon of fact-retention.
Cerebral shoebox
The very first task of medical school is the conversion of the brain from a vital ratiocinative organ for analytical thought and speculation into a machine for storing facts - in other words, a cerebral shoebox containing a vast anatomical index, in which you can find the name of every nerve-ending and every follicle, and also, in an unswept and unvisited corner, a small, withering organ called common humanity.
This is not the fault of the students. It is almost impossible for the spirit of ordinary sensitivity, of optimistic enquiry, of normal ignorant speculation working its way to enlightened conclusion, to survive the Gradgrindery of medical training. Medical students probably work five or ten times harder than art students; and correspondingly, they discover five or ten times less about human nature. That discovery is made in casual college discourse, in unstructured debate, in wide and varied and undisciplined reading. It is the very purposelessness of the liberal arts which give them purpose.
I know a psychiatrist who did her primary medical degree in Cambridge. She is adamant that through her half dozen years studying medicine, neither she nor any of her peers read a novel or a poem or a newspaper. Far from her mind being prodded and poked, being sent in ridiculous wild-goose chases only to return chastened and wiser by far, it was whipped like a chariot-horse in pursuit of a single goal: more facts.
It was made neither sharper nor more humane nor wiser by this experience, merely more technically knowledgeable; and somewhere in the course of this fact-absorption, either imbibed through the daily drip of medical culture or inhaled in the air, moral aloofness, professional arrogance and social superciliousness too often enter the blood. Doctors become a race apart, and within that race apart emerges a separate caste which ultimately will govern the race.
First victims
And the first victims of the rule of that caste are not the stupid, the old, the poor or any of the normal victims of a self-perpetuating oligarchy, but members of their own profession; the apprentices who, having learned the facts, then have to apply them as interns or housemen.
Young doctors are treated abominably. There would very rightly be uproar if supermarkets behaved towards working-class girls from Coolock in the way that the hospital industry behaves towards its young doctors, who are made to work absurd and potentially lethal hours for contemptible financial return. It is as if the life of a young houseman should resemble that of a Cistercian novice in hardship, sleeplessness and penury.
Nor does the misery end with internship. Junior hospital doctors are paid derisory salaries for working monstrously long hours. No wonder that so many of them at the first opportunity scram to foreign shores where they are better paid and most certainly better regarded. The only truly surprising feature of the recent little contretemps at the Mater is that there are any Irish doctors left there at all, and internals (going by the book of course) are not regularly administered for dandruff, athlete's foot and getting your head stuck between park-railings.
And no, it is not a bad thing that foreign doctors are working in the Mater - God knows Irish doctors have been peddling their Hippocratic wares around the world for long enough. But one does wonder at the professional structure at the Mater that a gentleman who spoke little English and with uncertain qualifications could be allowed to work as an unpaid anaesthetist.
Free of charge
I would be suspicious of the merits of anybody who offered to clean floors free of charge, never mind anaesthetising patients for tonsilectomy. Nothing of quality comes free; and cleaning floors is one thing; keeping the customers alive and kicking when the flatlining starts quite another.
Yet out of this world of hardship and slave-labour and cerebral square-bashing emerges a caste of consultants who can often make the most opioniated SC seem like Hughie Green addressing a wheelchaired orphan with two heads. Brusque, contemptuous, supercilious, arrogant, omniscient, given to gazing at their patients with amused disdain over halfmoon spectacles: they are figures of hate familiar to almost anybody who has been in a hospital.
Needless to say, not all consultants are like that - and I say that not just because one day I will need one, but because it is so. Many are hard-working, conscientious and genuinely concerned about their patients; and they will be even more aware than are the rest of us of the preening self-regard of the vastly-paid patrician-physician. That creature does not arise out of an idle hour of thoughtlessness. Decades went into his making. He was forged in a furnace of diseducation, slavelabour, poor pay and institutional abuse, all fired by insufferable arrogance. Pity him. He is merely getting his own back.