We expect a lot of doctors. Even before the current madness started, we knew that they went where the rest of us feared to tread. My GP is quite hands-off; which suits me as I'd rather be told "you'll probably be grand" than that I'd be referred to consultants to be sure to be sure when it was not strictly necessary. I started my desultory and infrequent relationship with him ?12 years ago when I was sent for my post 50 MOT check-up. He checked my prostate per anum with brisk efficiency and a rubber glove. Several years later this invasion was strictly optional in his book because prostate problems were deemed to be picked up from the bloods through a test for abnormally high PSA prostate-specific antigen. He told me once that he finished up as a GP because he was too squeamish for surgery.
How do doctors decide to be doctors and how do they decide what sort of doctor they should be? That question cannot be answered by an anecdote about my GP, it requires data.
Q. Who would be in a position to gather such data?
A. Caroline Elton, a former school teacher who retrained as a psychologist and has been working for 20 years as a sort of careers advisory service form those in, or about to embrace, the medical profession. She has written a book Also Human: the inner lives of doctors which looks at the trials and tribs which doctors have to weather. Even if weathering the storm means beaching the medical career and walking away on terra firma. She has gathered her notes of hundreds of doctors who have been referred to her for counselling or advice about how to cope and/or what to do next.
I will come as little surprise that certain personality types gravitate to certain medical specialities. Women are disproportionately over-represented in girlie roles like Ob&Gyn and paediatrics. Although, here as everywhere, men tend to float to the top. The head of the Dublin maternity hospitals are called The Master of the Rotunda / Holles Street. It wasn't until 2012 that the first female was appointed to such a position: go Dr Rhona Mahony! Contrariwise, women are often to made to feel that they are not natural surgeons, because that's the domain of old white men, and it's particularly difficult for women to crash that particular glass ceiling.
And there's another chapter on how minority medics fare in their white coats. The answer is not very well, but then working class white lads don't progress easily in medicine because they don't fit. Part of the trouble is that medicine is absurdly elitist in its requirements for academic excellence to open the gates into medical school. Academic excellence is strongly correlated with middle class families and/or fee-paying schools. And there is a certain demeanour, accent, facility with a rugger ball that goes with a fancy education. There is a certain amount of ghettoisation after qualification: chavvy doctors do well as GPs in working class districts because, well, empathy.
And what about sex? Every few years you hear about some doctor being "struck off the register" for inappropriate action with their patients. But in training, sex is the elephant in the room. Young men are being confronted by a lot of bare flesh but given no help in dealing with any unwonted erotic eruptions. They are just expected to cope. Too often this pops out as a culture of grotesque sexual humour demeaning to everybody involved. Then again, I suppose they get to build up a more than usual experience of the wonders of human diversity both anatomical and behavioural. Elton seems to suggest that medicine, as a profession, is a long way behind the curve in normalising homosexuality.
We give doctors access to our innermost parts . . . and thoughts. As confession ceases to be normal practice a lot of revelation occurs in surgeries, and indeed doctors recognise that many of their patients present because of a fundamental trouble in the soul, which may be difficult to articulate. Such problems can be treated with 5 minutes and a prescription, but a cure is going to require more empathic engagement - and time - than most over-worked doctors can schedule. Those unresolved cases will surely add to the burden on doctors psychic shoulders. It's a wonder how many of them cope without callusing over entirely.
I've seen things you people wouldn't believe. . . All those moments will be lost in time, like tears in rain. Time to die.