A few days ago, in the #SaatchiBill stream on Twitter, I saw this conversation:
Sounds fairly conclusive, doesn’t it, but this conversation jogged my memory, and thanks to the permanent nature of Twitter’s archive, I was able to find this earlier mention of the problem from January:
So whereas in January there were two docs known to Malcolm who supported it but wouldn’t speak out publicly to say so, that distinction has now gone and the clear implication is that the silence simply means that there is no support among doctors.
Just two doctors is a meagre boast anyway isn’t it? Except not necessarily, because even I know two doctors on Twitter who support it and are quiet about it, and I’m not even a doctor myself. So two for me and two for Malcolm makes four, and I’d be willing to bet we aren’t the only ones who know a couple …
One doctor who is very noticeably quiet about his support of medical innovation is former LDN advocate Tom Gilhooly, who is (at least was) part of a small but growing (at least was) group who have welcomed the sterling results from use of this safe, non-toxic drug, and prescribed it for autoimmune conditions on the NHS. In the GMC Tribunal report of his innovative prescribing, which I’ve read, Paul Williams stated that this wish to help patients was a character trait needing restraint, and which is “still present today”. This is why Dr Gilhooly must now wear a hair shirt and bite his lip.
Framed in the very language of care, this statement from the Tribunal hearing surgically excises the beating heart of his most likely motivation for being a doctor in the first place, to care for others, and even suggests that as his notion of “helping” is flawed, it now therefore warrants redefinition.
The inference that his caring can’t be trusted, is the very essence of paternalism. Can’t be co-opted more like.
Although the actual innovation fight is clearly about who controls medicine, the terms of battle have been clearly chosen to offset and counter the fact that Saatchi’s Bill is about empowering the patient as a genuinely equal partner in their own care, able to bring something to the table, not merely to decide whether to submit to “reasonable alternative or variant treatments” as per the much vaunted ruling on Montgomery v Lanarkshre Health Board. Although that judgement examined the changing nature of doctor/patient relationships in some detail, it stopped short of Saatchi territory (possibly due to irrelevance, as the case was about negligence concerning known risks, not innovation), and does not specifically recognise that patient autonomy may mean that patients may approach doctors with treatment requests that the MD has not even heard of, but could still be willing to look at with an open mind.
No argument can honestly rebut the one that is at the base of this idea, which principle is upheld in the above judgement, that medical doctoring doesn’t encompass the derogatory meaning of “fiddling about with” at all, but is a service performed with and for the benefit of patients, who are equal human beings.
Nevertheless the Gilhooly headline tells us clearly that battle has been joined, and that the chosen battleground is “caring”.
And this ground will be familiar to all who have been following. The slick medical innovation Bill explainer talks about empowering people to think and act for themselves in tandem with their doctor, while the anti-Saatchi brigade bleat about how dangerous it will be because patients won’t be able to litigate against bad doctors and quacks, as if that’s just piss-easy now.
Although both sides are using rhetoric about caring, the suing argument of the status quo totally ignores the very group of people the bill is actually aimed at, those who wish to take responsibility for their own choices, presupposing instead that patients are too stupid to genuinely mean that, or to think for themselves, and therefore will inevitably screw up and need to sue.
Like all paternalistic bullshit it is also utterly devoid of sincerity as we shall see.
I was talking to another doctor last week about the Tom Gilhooly affair. He was pretty cross with Gilhooly, as I’m sure a lot of people are. But it may (or may not really) surprise you to learn that his reason for being angry was that he felt Gilhooly should have shown more bloody backbone. Why spend all those years advocating for a safe natural and cheap immunobooster if you’re not even going to rebut the GMC Tribunal’s fallacy that LDN is dangerous in pregnancy by citing Phil Boyle’s studies and results, just because your balls are in a vice?
Gilhooly should have told the GMC that he had a right to prescribe according to his judgement and that this is the priviledge and responsibility of having a medical license, said my doctor friend. Clearly doctors, with this tremendous power, must not be co-opted, and should as individuals work hard to remain fiercely independent and committed to their original motive for service, only thus can they counter the ever present and inevitable risk of becoming a tool in the potentially unlimited arsenal of control of, for example, a neo-liberal corporate state.
It’s a truism that you don’t need a steel cable to tie up a puppy, and Gilhooly had previously been a vocal advocate of LDN for some years. So if even he can’t maintain that independent position, just because he’s been made to publicly express shame for being a decent human being, it’s hardly surprising all those other doctors are quiet about supporting medical innovation, is it?
There’s only one reason someone would do an extreme volte-face like Tom Gilhooly’s, and it’s that thing the Dalai Lama hates most.
Gilhooly’s stone face says he ain’t gonna cry, but he’s apparently not going to speak up for LDN anymore either; job done.
The necessity for his lack of emotion may however be somewhat explained by “The Crying Game”, Dr Rita Pal’s petition update shortly before World Mental Health day 2015. “Never cry in the presence of officialdom”, she says “tears imply weakness. This may not be so but that is how it is interpreted.”
Crying “is also interpreted by authorities like the GMC and others as people who cannot cope or have some kind of mental health issue”, continues Dr Pal.
Dr Pal certainly knows what she is talking about, for despite Franciscan rhetoric, speaking up about corruption, or just disagreeing with powerful lobby groups who don’t like it, is a really dangerous thing to do, especially for your mental health, and it’s getting more dangerous by the minute.
The battleground of caring and empowerment is really hotting up, but as it’s not the real battle, it doesn’t have to be taken seriously. For example Sarah Wollaston quite often comments that she hasn’t seen any real evidence of fear of legal action. But I’ve provided some and she won’t see or hear that, which kind of proves the point. To be fair, Sarah did promise she’d take my POV to parliament, but I don’t know if she did because she won’t engage with me over it, and hasn’t even provided a counter argument. She just appears to ignore the evidence and then claims not to have seen any.
Call me old fashioned but not advancing a counter argument doesn’t do much to convince me that mine’s rubbish: it’s blindingly obvious that the politest of disagreement is simply not possible with people who studiously refuse to engage.
If anyone wants to see the reality about the actual loss to patients in Gilhooly’s public humiliation however, they need look no further than the sad comments under the Glasgow Herald report on Gilhooly which I urge you to read.
Caring down to patients, caring onto, or caring at patients, is not the same as caring for them, listening to them, and standing up for them as a public servant.
But having done all that in spades herself, Dr Pal was nevertheless targeted with mental health smearing by the actual GMC: an org exposing move if ever there was one.
In the ensuing legal action, Judge Harris commented, “For myself I don’t really see why somebody complaining about the behaviour of doctors or the GMC, if that is what they are doing, why that should raise a question about their mental stability, unless anybody who wishes to criticise “the party” is automatically showing themselves to be mentally unstable because they don’t agree with the point of view put forward on behalf of the GMC or the party […] It is like a totalitarian regime: anybody who criticises it is said to be prima facie mentally ill – what used to happen in Russia.”
And I’m loving the past tense and geography there, because I now have to disclose, as I did in my first and very widely read article on the subject, “When Doctors Throw Their Hands in the Air”, that this too has happened to me as a patient advocate.
When our family tried to access LDN for our dying mum, her GP reacted in a violently frightened manner about losing her job, shrieking loudly, throwing her hands into the air and terrifying my poor mum out of her wits. In spite of the fact that the GP was only effectively being asked to rubber stamp it, because we had already accessed the actual drug elsewhere, she still put her legal fears before the welfare of the patient, (perhaps intuiting the possibility that she might be taken to a tribunal and pathologised for caring too much).
The other doctor I happened to talk to following that meeting, and who advised me to go back and insist on getting the LDN, wasn’t personally known to me, apart from one meeting for about an hour, occasioned solely by our mutual campaigning about Steiner education (about which our family subsequently achieved a Landmark Human Rights Settlement about the notorious unchecked bullying, a fiercely contested subject lopsidedly reported on Newsnight.)
Nevertheless, in court as a witness on related issues, this doctor, who is also a Senior Mental Health Academic at Plymouth University, actually claimed that he had developed “concerns” about my mental health during that phone call about the LDN, because of me “expressing crossness with the medical profession” following the GP’s behaviour towards my dying mother!
Plymouth University
But hang on, didn’t I just say that anti-Saatchi’s main thrust is that they want people to be able to not just criticise but actually sue bad doctors and quacks? And don’t they say that doctors are already completely free to prescribe off-label, ergo she was at fault? Yet you’ll hopefully notice the total lack of concern that this GP was so ignorant she didn’t even know she was needlessly abusing a dying patient in defence of her job.
Strobe-effect goalposts anyone?
Its really not that hard to expose the fakery of the caring battleground; if you prescribe LDN (for example), or ask for it, or reasonably criticise the “medical profession”, there has to be something wrong with you, like being deficient in caring or mentally ill.
The details of the Plymouth Academic’s testimony are hardly relevant to the point, although it’s worth noting the extraordinary number of contradictions in what he claimed, but the basis (and purpose) of his “concern” was very clearly to pathologise completely normal distress at appalling GP behaviour, and even grief itself, if that’s what it took.
Of course in court, in contradiction to his witness statement, he had to appear to acknowledge the effect of the violent outburst of the GP on us, the frustration caused by her trenchant ignorance, and even condescendingly a smidgin of distress on my part as my mother was about to drop dead, but it was certainly much, much more important to limit any concession to ordinary normal human feelings, and to artfully dig in his concerned heels about “crossness with the medical profession”.
You think?
What another great example of how the offended persona of “the medical profession” can be used strategically to beef up any outrageous claim, just like the depersonalising one that everybody agrees about medical innovation.
Continually citing all the “orgs” that endorse the “no legal fears” rubbish, including “patients’ orgs”, conveniently (and transparently) side-steps the obvious fact that they’re just full of individual people who desperately need to hang on to their jobs.
In fact aren’t “orgs” often the exact things that Pal’s warning whistleblowers not to cry in front of?
The offended persona-org tactic could just as easily be referred to as the “wide-mouthed frog manoeuvre”; an efficient means of intimidating naughty independent-thinking doctors from expressing their point of view. After all, who on earth wants to have the whole of the medical profession ranged against them?
“Always remember” cautions Pal “that authorities will try to break your spirit, your mind and your heart. To allow them to do so would be to allow them to win.”
OK Pal, got it. So whatever they do to you when you speak out, or are marked out, you mustn’t ever let them see you cry: I guess all this is what is meant by ‘no legal fears’.
In the crucial fight for control of what is put into people, on the bloody battleground of caring, watch who is caring down to, caring at, or caring onto patients, watch who is whispering behind their hands, who contradicts themselves, and above all, watch whose eyes are cold.
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Personal Disclosure
If a doctor writes something untrue about you on your medical record you still cannot erase it. THAT is the absolutely incredible and totally unwarranted power they have. If you know for a fact, as I do, that you’re being targeted by abuse at a high level, that dossiers are being compiled on you for the “authorities”, as if you were some fucking dissident, you obviously cannot afford to do nothing about it, and that’s why I have to tell YOU ALL about it, and make sure that the disclosed evidence of four years (so far) of copious networked and co-ordinated cyber-stalking, disability abuse and vicious mental health smearing is on my mental health medical file, something I never even had at all, until I needed to get there first.
AG
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Main Image sourced from www.szamon.com’s article “Before The Salem Witch Trials: European Witch Finding”
Photo of Dr Tom Gilhooly sourced from Herald Scotland
Photo of the Kremlin sourced from Raymond Cunningham’s Flickr
featured, Medical Innovation Bill, mental health, Saatchi Bill, World Mental Health Day
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