Dis-Organized Medicine

Many physicians share my dismay at the militancy of our professional associations’ alliance with an anti-human ideology. Mainstream medical journals continue to promote anti-scientific, anti-Hippocratic ideas without a shred of nuance and without allowing for dissent or debate among colleagues or constituents. Transgenderism, unfettered abortion license, and racial preferentialism are now the abiding values of our current medical elites. 

In the interest of introducing an alternative viewpoint to their readerships, I submitted the following article to a string of general medical journals, including those representing my specialty. Seeing as all have foreclosed this opportunity to engage in a discussion that is truly inclusive of other viewpoints, I make it available to you, dear reader of Crisis. 

Recently an old friend passing through town stopped by for dinner. As family physicians and contemporaries who have confided in each other through professional and personal events over the years, my friend (I’ll call him Tom) and I reminisced about how much the world—and the practice of medicine—have changed over the years. At one point, the topic of organized medicine and the direction of our specialty societies came up. 

“I haven’t taken seriously anything the mainstream medical organizations have said for several years,” Tom declared with a tone of bitterness. “So many of their viewpoints on social issues are antithetical to why I became a doctor. They’ve ruined medicine by politicizing everything.” 

Tom and I also have in common extensive careers in graduate medical education; he chose to leave academic medicine some years ago in no small part because of the disillusionment he described. I, on the other hand, have persisted in my faculty role despite sharing Tom’s consternation regarding the direction taken by medicine’s thought leaders. 

How would you respond if you felt the institutions leading your profession’s public pronouncements on existential issues contradicted your most deeply held values? If the associations purporting to speak for the principles of the discipline which you have made your professional vocation not only disagreed with the tenets of your worldview, but actually disparaged them?

For many physicians who profess traditional, often religious beliefs, this quandary is a source of profound tension between the personal and professional aspects of their lives. The strain is more problematic when spiritual convictions are the animating force in their work as physicians. 

Policies and position statements of specialty societies that sanction the willful destruction of life at any point along the continuum promote violation of the physician’s Oath. For the many physicians drawn to medicine for its promise to care for people at all ages and stages of development, this creates an untenable conflict. The notion that the physician’s duty to safeguard and protect human life could depend upon the circumstances of the patient’s conception, desirability, or perceived usefulness to others is an abdication of the physician’s sacred calling to protect inherent human dignity.

In a similar way, many physicians see mainstream medicine’s promotion of novel theories of sexuality—which negate an anthropology rooted in the immutable dichotomy of male and female—as a contradiction of medicine’s self-professed adherence to evidence and scientifically knowable truth. Medical societies’ rejection of the binary nature of human sexuality and the promotion of medical interventions that disrupt and destroy the healthy, developing reproductive systems of young people suffering with the pain of psychic conflict is both an exercise in false compassion and a dereliction of professional duty. Many physicians see mainstream medicine’s promotion of novel theories of sexuality as a contradiction of medicine’s self-professed adherence to evidence and scientifically knowable truth.Tweet This

Another battle line on the cultural front is the current emphasis on group identity, often a negation of the rich uniqueness of individuals that ignores the commonalities of human experience. The filtering of all disparity and inequality in our society—the tragic consequences of a fallen world common to all civilizations and cultures throughout human history—through the reductionist lens of race, ethnicity and other group characteristics has become a common theme in medical education and clinical journals. 

Sadly, this perspective downplays the marvelous individuality of human beings. Focusing on collective tribal identities reduces individuals into coarse categories, holding them hostage as hapless victims (or victimizers), and robbing them of their agency as individuals negotiating their own life circumstances. 

Rather than profiling groupings of people (and institutions) as virtuously marginalized or maliciously oppressive, physicians at odds with such type-casting are prone to agree with Soviet dissident Aleksandr Solzhenitsyn’s famous insight that “the line separating good and evil passes not through states, nor between classes, nor between political parties either—but right through every human heart—and through all human hearts.”

Like all venerable institutions, the house of medicine has a storied history. While it has become fashionable to cast aspersions on our forebears because of their perceived defects, we also must recognize that we are indebted to them for handing on the treasure of ideas that are our intellectual inheritance. Many physicians have honored medicine’s humanistic principles throughout their careers, offering continuous and holistic care to people at all stages of life. Today however, the novel position statements of medicine’s legacy institutions on a host of social issues tarnishes the earnest (if imperfect) strivings of our predecessors. 

While not in vogue today, the importance of tradition was perhaps never more clearly articulated than by G.K. Chesterton’s well-known assertion, “Tradition means giving a vote to that most obscure of all classes, our ancestors. It is the democracy of the dead. Tradition refuses to submit to the small and arrogant oligarchy of those who merely happen to be walking about.”

The counterforce to enduring tradition is ephemeral emotion, and medicine is not exempt from the emotion which defines the climate of our current moment. Stepping back from the heat of inflamed passions that fuel today’s social turmoil, leaders of the profession would do well to consider the effects of language when it is wielded to silence or discredit disfavored positions offered in good faith. 

Reflecting on my dinner conversation with Tom, I am saddened to realize that professional ostracization due to his deeply-held beliefs likely contributed to Tom’s decision to leave academic medicine. I know many trainees in his former program would have benefited from his mentorship through the turbulent waves breaking on the bow of our profession. 

My own experience over the years counseling distressed residents at odds with the social stances promulgated by leaders—from national societies down to our local training program—belies the simulacrum of unity projected around these issues. For those physicians and trainees who hold fast to the belief that we can be true to our historical Oath as physicians—which implies caring for our patients with the fiduciary responsibility owed them in service of the truth rather than merely following what is fashionable—the option of practicing and living a double-life is not an acceptable compromise. 

In those moments of unease when feelings of abandonment create dissonance between timeless beliefs and our profession’s new articles of faith, the prayer of Cardinal John Henry Newman offers some solace. 

God has created me to do Him some definite service. He has committed some work to me which He has not committed to another…I shall do good; I shall do His work. I shall be an angel of peace, a preacher of truth in my own place, while not intending it—if I do but keep His commandments. Therefore, I will trust Him. Whatever, wherever I am, I can never be thrown away…He may take away my friends; He may throw me among strangers. He may make me feel desolate, make my spirits sink, hide my future from me—still He knows what He is about.