Of Memory, Power and Medical Hierarchy

“The struggle of man against power is the struggle of memory against forgetting.” Milan Kundera

Bullying. The dominance, the arrogance, the vanity of it all. Think of the medical student who has no other response than to keep his head low. You are always on the line. You have to make the right impressions, or at least avoid making the wrong ones.

What mostly baffles me is that most, if not all consultants must have been irked, piqued, offended, disgusted, even exasperated while they were bullied as medical students. So why is it that some still end up as irritating as they are? Wondering what on earth fuels the vicious circle, I came up with two hypotheses.

Memory in different colours

“Life is not what one lived, but what one remembers and how one remembers it in order to recount it.” Gabriel Garcia Marquez

Do memories of these wrongs merely dissolve into a fast receding past? Memories, of course decay. Does the mind simply reconstruct the past in an overly positive light and people forget that they ever suffered these same wrongs? Nostalgia is always in the business of cleaning off the bad and indelibly printing the good in our memory. Or does time, the slow passage of time, simply dull their sensibilities, even reverse all they had held to be true?

The distracting slings and arrows of middle age may contribute to the loss of youthful idealism. It’s so easy to consider these changes in perspective an advantage of thinning hair; the gradual mellowing down and placidity that is often confused with wisdom.

Does relativism just take over? What is right or wrong anyway? Isn’t that all we’ve been fed with in medical school? That is the old-time tradition of medical practice. End of story. Or is it the savage case of the oppressed becoming the oppressor as he takes what he has suffered out on someone else?

Power calls to power

“Power calls to power, and the brutality of power…evokes a conspiratorial craving for the phenomenon of success.” Wole Soyinka

I noticed a particularly interesting, though surprising trend while editing my class’s final year book — a greater proportion of my classmates, usually the most brilliant, who considered themselves likely to end up in academic medicine filled in the names of the most tyrannical consultants in the hospital as their most admired teachers. It was a rude awakening for me.

Wole Soyinka once suggested that one of the reasons why despots find it easy to remain in power is “the self-willed ignorance of brilliant men who bend their skills and intelligence to ensuring the continuity of power by rationalizing and even applauding the crudest barbarities of power.”

Although it might ordinarily have sounded far-fetched, this seems the most plausible explanation I could place my mind on. Such affinity, as Soyinka cites, is in close parallel to the love a slave girl has for her master, clearly shows that power indeed calls to power. This perverse identification with power figures may, in reality, be self-identification. The viewpoint that validates and justifies the activities of power may, in turn, affirm the existence of the student.

Eternal vigilance

“Eternal vigilance is the price of liberty.”
John Philpot Curran

Medical practice will continue to be steeped in a quasi-terrorist quagmire that thrives on the fear of failure or loss of professional recognition until we all choose to combat this criminal hierarchy, first and foremost, individually. The way out lies in developing a critical awareness of what goes on around us everyday, and learning to constantly interrogate our own individual motives and feelings.

To keep our memory intact, my simple suggestion is that we resolve to keep written records of such events as we pass through medical school. This is the only way these events can remain pure in our memories and ensure we never repeat them. And if you’ve not yet suspected, that is exactly what I was trying to achieve by writing this article – taking notes.

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