Abstract
My piece acknowledges the existence of “bad doctors” and medical malpractice and abuse in healthcare systems, especially in mental health treatment. While it is optimal for there to be a high level of trust between the patient and doctor, I present this piece to encourage readers to exercise caution when taking advice from or agreeing to certain procedures, treatments, or drugs from healthcare professionals. Health consumers can benefit from doing their own research on procedures or treatments, especially new ones that may not be backed by substantial scientific evidence or proven to be ethical, or consulting multiple professional opinions before making a final decision. In our post-industrial society, where the “next new thing” and innovation are prized, doctors may be incentivized by profit or fame rather than the wellbeing of their patients, such as my character. With that being said, certain traits of individuals who practice medicine can especially exhibit these qualities, such as megalomaniacs. My character, a megalomaniac, holds an extremely high opinion of himself, too high almost, to the point that he thinks he can do no wrong and has a false sense of self-invincibility. While he does not necessarily intend to hurt his patients, his belief that his intellect and capabilities are above others is what inspires his actions, as well as causes his neglect and ignorance of the harm his patients and staff are suffering as a result of his actions. I was particularly inspired by the Netflix show “Ratched” I happened to stumble upon one afternoon when browsing. It is loosely based on the character from the 1962 novel “One Flew Over the Cuckoo’s Nest” about a “bad nurse”, who abuses her power over patients in a mental institution. Both the show and the book seek to understand motivations behind psychiatric abuse of patients, which is what I am trying to imitate with these journal entries. While it is smart for health consumers to be cautious about the procedures or treatments they receive in all areas of their health, I particularly chose to hone in on mental illness. This is because even though the rates are increasing both in America and around the world, there is still a substantial amount of work needed to be done toward destigmatizing mental illness, to allow for conversations on improving treatment and decreasing rates. In addition to the main message, I wanted to pepper in other fundamental flaws in the medical system and psychiatry in particular, such as racism, sexism, criminal malingering, and heterosexism, in which some factors, such as race, sex, and sexuality adds even more stigma, further prompting potential abuse from psychiatrists. Finally, I explore how physicians find ways to continue practicing after they’ve been disgraced. In deciding how I wanted to portray my messages, I considered many forms: comic, short story, narrative, but decided that day-to-day journal entries of a megalomaniac psychiatrist would best help readers to understand the motives behind psychiatric abuse.
TRANSCRIPTION
May 5, 1932
Well, I am in the last stages of finalizing my research and preparation on what will most likely be the greatest psychiatric breakthrough known to mankind. As all competent psychiatrists should know, all insanity stems from purely biological causes, not mental. And my patients are deserving only of the correct treatment – none of that neurological explanation bushwa! I am ecstatic to finally be seeing my years of research come to fruition in the preliminary rounds of lobotomies I will be performing in the upcoming weeks; I have just refined the leucotome, a needle-like instrument with a retractable wire loop that will be simply inserted above the eyeball through the orbit of the eye and tapped into the frontal lobe of the brain to cure all kinds of emotional instabilities. Some of the staff at Hopkins objects to this, claiming it to be “unethical”, but I will pay them no mind, for they are merely laborers under my direction. It’s actually quite funny, my staff retaliating against Adolf Meyer’s protege, who, must I remind you, also has a medical degree from Harvard and a string of papers published in the world’s leading medical journals such as New York Medical Journal, Psychiatric Bulletin, Archives of Neurology and Psychiatry, Journal of Nervous and Mental Disease.
Ah, I have been dreaming of this since my days in medical school – I can already picture the headlines: “Young Doctor Cures Mental Instability with Simple Procedure.” Since I was a child, I always had an inkling I was destined for greatness, and this is just the beginning. I better hurry along now – I must prepare the material I will be presenting to a number of hospitals on my trip down south pretty soon. I invited myself over to the Norristown State Hospital Hospital in Pennsylvania and Georgia’s Milledgeville State Hospital to demonstrate the lobotomy and encourage their staff to follow in my footsteps; say, aren’t they lucky, having the privilege to hear directly from me and witness what will soon be a psychiatric treatment practiced worldwide?
Until next time…
May 25, 1932
7:30 am
I am back from my trip down south and feeling more rejuvenated than ever! I think the staff over at the hospitals I visited really learned a great deal from me, and I’m sure they appreciated it, as they should. Anyhow, today’s the day – my first lobotomies! Of course, my first couple of test cases will be on the patients in the black ward; as madness is a primitive feature predominantly found in black persons, this would be of the greatest service to them. Well, I’ll be off now! These lobotomies won’t perform themselves…
9:15 pm
An exhausting day indeed, but successful nonetheless. Oh, how I wish more people could have witnessed how seamlessly I performed those lobotomies! My hands are tired; I performed at least fifty today, with each taking me less than 10 minutes, and with exceptional results! The patients flinched not even once, due to my extraordinary coordination and perfect execution. I was so confident after my first couple of trials on the black patients that I invited the staff to the operating room to watch me perform lobotomies on my white patients. But the most disturbing thing in the room was not the lobotomy itself, no, it was the sight of several of the female nurses vomiting – how disgraceful! Of course, I can only attribute this to females being both physically and mentally weaker than us. Thank goodness I wasn’t born female then! If I were, I don’t think the lobotomy technique would have ever even existed!
On another note, I was so jolly after the surgeries, walking myself over to the break room to reward myself with a cookie (my favorite, chocolate chip, of course) when I heard strange noises coming from one of the patient’s rooms in the male ward. The door was slightly ajar, so I took a peek inside and to my horror, two of the younger male patients (somewhere around 16 years of age) were performing fellatio. I was so disgusted I immediately ordered for them to undergo electric shock therapy, another revolutionary technique invented. The methodology is foolproof: show pansies pictures of both men and women undressing and shocking them when they are aroused at the same-sex photograph, and refraining from shocking them when they are aroused at the opposite sex photograph, encouraging heterosexuality. I will have them undergo electric shock therapy as many times as needed until all the gay is completely shocked out of them. I simply refuse to tolerate letting such people with evil morals roam the hospital under my watch.
Note to self: ask nurses to start recording sexual orientation in daily rounds starting tomorrow
Until next time…
June 13, 1932
Quite the unusual day awaited me today. Recently, we took in the most notorious murderer in town – the man who went on a killing rampage over at Roland Park Elementary? He is a self-proclaimed schizophrenic, so the state has put him under my care as he awaits his trial. I had a one-on-one meeting with him in my office today to determine his diagnosis – I must admit, by the looks of it, he doesn’t seem like a man capable of what he had done, so naturally, I wasn’t the least bit scared – and of course, I couldn’t imagine anybody dare to hurt an esteemed man like myself. But here is the strangest part of all: when I asked him questions about his feelings and such, he answered with statements seemingly straight out of a textbook. It was almost as if he had studied the symptoms of schizophrenia, in order that I might diagnose him with it right then and there, deeming him eligible for psychiatric treatment. But lucky for me and not so luckily for him, I am not one of those wandoughty, chowderhead doctors. He may think himself clever by faking schizophrenia to avoid jail time, but with all my years of experience, he can’t fool me. I didn’t make the final call today yet; much more poking and prodding will be done until I find out this evil man’s intentions.
Until next time…
June 26, 1932
Allow me to pour all my frustration into you. My staff pesters me all the time nowadays – I’m thinking I might have to do my treatments on THEM if they keep this up! What in the world are they pestering me about, you ask? The “high mortality rates” we’re seeing in our patients after I perform my treatments on them, that is. Sometimes, I don’t even know why I hired them – ninny hammers, the whole lot of ‘em! Do they not realize that this is a normal and essential part of every experimental process in medicine and the sciences? In addition, the deaths can very much be attributed to the mental illness the patients already had, not a result of my treatments; in other words, they were bound to die either way. And the mentally impaired have lower vitality and quality of life, so aren’t their deaths quite a good thing, a burden off the shoulders for both the insane and their families? It is as if the staff chooses to overlook my successes and focus on the deaths instead, which I find quite disrespectful. Have they forgotten the over 1,000 patients that have been discharged from this hospital in much better health and vitality than when they came? The patients who had previously wrestled with insanity all their lives instantly cured by my life-altering treatments, resulting in complete changes in disposition, complaining no longer of mood disturbances, vomiting, nausea, or fluctuating emotions. One would be hard put to find another physician capable of such miracles as myself.
Until next time.
July 6, 1932
Lawsuits seem to be the only word I ever hear these days! The reason they are trying to sue me is just absurd. I did nothing wrong – I am only doing my job in helping rid the world of lunatics! I have definitely heard of these types of cases before though. What’s that saying again, the one about how people only try to sabotage your successes because they are jealous? Yes, I do believe that is exactly what is happening here. They are only trying to sue me for their own enrichment – they want me to stop practicing only so they can get their hands on my research and discoveries. And by they, I mean the government, media, and the industry. As far as I can tell, the only cases of fraud are their carefully concocted stories about me, riddled with fake data on the mortality rates of my patients. They are all out to get me, but this is understandably only out of their jealousy; I do feel sorry they feel they have to stoop so low. Simply put, taking away my medical license would be equivalent to no less than halting psychiatric innovation. I am not too worried, however, as I am in the process of creating a plan of action to fight back. On top of hiring the best lawyers Baltimore has, I am in the process of writing a book detailing my findings as well as exposing the oafishness of the government, media, and industry in attempting to revoke my license; my book is already in the talks with Oxford University Press for publishing, so stay tuned.
Until next time…
REFERENCES
Deer, Brian. The Doctor Who Fooled the World: Science, Deception, and the War on Vaccines. Baltimore, MD: Johns Hopkins University Press, 2020.
Racism and Psychiatry: Contemporary Issues and Interventions. Germany: Springer International Publishing, 2018.
Scull, Andrew. Madhouse: A Tragic Tale of Megalomania and Modern Medicine. New Haven, CT: Yale University Press, 2007.
Smith, Glenn, Annie Bartlett, and Michael King. “Treatments of Homosexuality in Britain since the 1950s—an Oral History: The Experience of Patients.” BMJ 328, no. 7437 (2004): 427. doi:10.1136/bmj.328.427.37984.442419.ee.
Tan, Sy, and A. Yip. “António Egas Moniz (1874–1955): Lobotomy Pioneer and Nobel Laureate.” Singapore Medical Journal 55, no. 4 (2014). doi:10.11622/smedj.2014048.