Connect: The Irish Sun called Dr Michael Neary a "womb-butcher" who played "God", writes Eddie Holt
The Irish Independent termed him a "surgeon of shame". The Irish Daily Mail labelled him a "butcher doctor". Yet the report of the Lourdes Hospital Inquiry says he was not an "evil man". Despite their contradictions, both media and legal descriptions of this medical man may be admissible.
Why he performed 20 times more hysterectomies than average remains a mystery. Perhaps he knows; perhaps he doesn't. The public certainly don't. The theory that he feared the sight of blood seems improbable. He was a surgeon! Suggestions he removed wombs because his wife died from uterine cancer in the 1990s are daft because by then most of his "surgery/butchery" was done.
In such legal and ethical matters, focus generally falls on two aspects: motive and result. The results of Dr Neary's behaviour in carrying out 129 hysterectomies between 1974 and 1998 - women left childless or unable to conceive again and suffering the ensuing trauma of such irreversible operations - justify the blunt, if lurid, media descriptions quoted above.
But motive? We simply cannot know. Even if Dr Neary were to give the fullest and frankest interview on the matter, some questions would necessarily remain. We do know, however, that the entire sad episode highlights the excessive deference accorded to medical consultants. Within Ireland's medical hierarchy, consultants are too frequently abetted in considering themselves gods.
The victims' group Patient Focus believes the report shows the "appalling and horrific" way Drogheda's Lourdes hospital was run. "It's a disgrace, an absolutely shocking indictment of the way Irish hospitals are run, of the way doctors can get completely out of order and take over, run the show, be answerable to no one and dictate everything," said the group's chairwoman Sheila O'Connor.
Few doubt that many medical consultants are arrogant. Some, of course, are anything but - learned and skilled people who maintain necessary professional detachment from patients without hauteur, pomposity or pretension. But rivalled for arrogance as a group by perhaps just politicians, barristers and the obscenely wealthy, consultants are often deemed characteristically arrogant.
It may be that in maintaining professional detachment any ensuing lack of human warmth becomes amplified and can be interpreted as arrogance. That's likely. Alternatively, of course, almost every group - powerful or weak, wealthy or poor, skilled or unskilled - contains absurdly pompous people. Few, however, are pandered to with such extreme unction as hospital consultants.
Time was when Catholic bishops had even greater power. After all, they were anointed by God so who were you - you wretch - to dispute their decisions? Now that era has largely passed. But many attitudes have just migrated from traditional religion to specialist medicine - especially as, for even the most esteemed people, the consultant-patient relationship is almost always lop-sided.
It is lop-sided because the consultant knows things the generally fearful patient does not. Furthermore, most people are especially vulnerable when they meet consultants. Frequently their health is failing and they are weak - either physically, mentally or both.
Still, the Neary case ought to concentrate medical minds not just on the appalling management structures (or lack of them) that allowed him produce almost a quarter of a century of dreadful sorrow. It should urge the medical profession to reconsider the way in which it trains doctors. Whether it will or not, however, is unclear because the nature of power is to blame anything but itself.
Doctors - especially consultants - are powerful. Few among them are likely to relish the fact that the case of Michael Neary has catapulted a medical issue into open public debate. The profession regulates itself, after all, and for the most part, medical people - given their specialised knowledge - resent outside "interference". The perennial problem is that power corrupts.
In Britain, RIBA (the Royal Institute of British Architects) is often reconfigured to remind people only half jocosely: "Remember, I'm the Bloody Architect". It appears as if medical schools in this country may substitute "doctor" for "architect" and it may be difficult to get the academic leaders of the profession to change deeply ingrained habits of attitude.
In the 1991 film The Doctor, William Hurt features as Dr Jack MacKee. (It's based on the real life story of Dr Edward Rosenbaum, who wrote an autobiography of his experience titled A Taste of My Own Medicine.) Anyway, Hurt is discovered to have throat cancer and becomes a patient instead of a physician. He gets the alienating medical treatment he had routinely dispensed.
As an exercise in empathy, The Doctor should be seen by all medical people. It does appear, as Judge Maureen Harding Clark's report states that Michael Neary was not an "evil man". Yet he did become a "butcher doctor" and was allowed carry on for far too long because of the status afforded consultants in an Irish Catholic hospital. There's shame for medicine and religion in this one.