Awakenings

I have taken a break over the past months while doing some more formal writing and (partially) recovering from illness. I ended up missing a whole lot of deadlines. The picture of Sisyphus sleeping is reproduced with kind permission of artist Michael Bergt.

I also spent some time thinking about the way we discuss malfunctioning systems in medicine.

During my break, I received some interesting documents about various cases I have been exploring. I received two amazing documents about UK medical regulators. These tell a story of corrupt organizations that are more interested in a surreal brand of public relations and self-protection than in any form of honesty. I received a few documents about myself.

Some of these documents made me angry. I have been wondering whether there is a type of discussion that is not legitimate. The internet is a scary place. Is it reasonable to embarrass individuals in positions of authority when those individuals have not (by any reasonable standards) behaved appropriately? I have generally tried to avoid embarrassing individuals, even though I have had ample reason and opportunity to do so.

Some of the documents I have are about other scandals that have already been ignored for many years. In many of these cases, both perpetrators and accusers have already suffered greatly. These are not individuals who are now in positions of any great authority.

The Bruce Hall affair

One such case is that involving Professor Bruce Hall in Australia. The scandal involving Hall resulted in the destruction of several careers. It has never been properly and openly addressed or discussed. The lessons have not been learned. Almost two years ago, I attempted to find out what happened. I began communicating with three very angry complainants, a journalist, several onlookers and Professor Hall himself. My questioning precipitated a trail of events which conveyed more about what might have happened than was conveyed by any of the conflicting reports. I was left with an immense feeling of sadness, not only for the students and staff who had raised problems, but also for Professor Hall himself.

Those students and staff wanted accountability, honesty and transparency. There was nothing that suggested to me that this was the intent of any of those in charge. Professor Hall was tired and apparently ill. He wanted to get on with doing good science. The real villains, it seemed to me, were not Hall or his wife, but rather the University of New South Wales and two medical journals who had behaved abominably. I ended up not discussing it at the time.

A document about myself

I also received a document about myself. This was an item of correspondence between two rather powerful individuals. It seems that my own refusal to go along quietly with attempts to manipulate the scientific method and the scientific record might imply that I am mentally ill. This kind of assertion is unfortunately a regular feature in many similar scandals. The person who wrote that letter should have known better. He failed to ask any of the obvious questions. He failed to stand up for what was right. He was someone I respected as a scientist. Indeed, he was someone who respected me (until I started asking the wrong type of question about the activities of his friends). I found this letter far more depressing than any of the futile and damning attempts by various authorities to cover-up what happened.

Is it worth discussing these things?

I think it probably is.

But it is hard to find a voice that conveys an attempt to learn (and teach) about malfunctioning systems - without also appearing to have a vindictive wish to inflict damage.

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Comments on: Awakenings

 

Anonymous Anonymous said ... (August 23, 2008) : 

Dear Aubrey, I hope you are feeling better and am sorry to hear you've been sick.
I cannot begin to describe how much your post affected me and could have been my own words. I am at a similar loss. In support, Sandy

 

Blogger Daniel Goldberg said ... (August 25, 2008) : 

Aubrey,

I hope you are recovering, and I am very glad to see you blogging again.

As for your specific questions, they are extraordinarily difficult ones. I tend to be something of a militant regarding the value of open discourse, and so I would love to know more about the events you mention in this post. One possibility is that, as powerful as it can be, the blog format may not be the best for airing your knowledge and concerns.

I understand you may be a bit sour on many professional journals, but perhaps some publications related to professional or research ethics would be appropriate.

I'd be glad to suggest some, if you think it would help.

 

Blogger Stephany said ... (August 26, 2008) : 

Dear Aubrey,

I'm glad to see you back and that you are feeling better.

Stephany

 

Blogger MedInformaticsMD said ... (August 28, 2008) : 

Is it reasonable to embarrass individuals in positions of authority when those individuals have not (by any reasonable standards) behaved appropriately?

Aubrey,

My early medical mentor, pioneering cardiothoracic surgeon Victor P. Satinsky, M.D. (inventor of the Satinsky clamp and other surgical tools and techniques used to this day) was very direct on this issue.

His opinion was thus:

The best remedy to injustice is public embarrassment.

He once suggested to his students that we openly picket a shop that failed to deliver our white coats, write letters about the owner to the news media. etc.

It seems that my own refusal to go along quietly with attempts to manipulate the scientific method and the scientific record might imply that I am mentally ill.

This is not an uncommon attack by scoundrels on those who speak and act ethically; one should remember, however, that this is also a common feature of totalitarians, e.g, the punitive psychiatric hospital or Psikhushka. It's actually a tactic of political warfare.

If it were me who discovered such a letter, public embarrassment would be my remedy of choice (and/or legal action, although I understand that's more difficult on your side of the pond).

See the end of my post here for an example of my response to experiencing this type of defamatory political attack.

 

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