[Never admit that you are wrong]

Medicine has always occupied an often uncomfortable space between science and belief. I remember when I started medical school the Dean of the medical school welcomed us to the main lecture hall. He told us how wonderful it was that we had chosen to become doctors, and waffled on for a bit about how we were the chosen few. He finished his speech with these words, which etched themselves into my brain… ‘Welcome to the brotherhood.’

Of course the parallels between medicine and religion have always been obvious to anyone who has eyes to see. The patient consultation as confessional. The use of long latin words that the patient cannot understand. The rituals and incantations of medicine have clear parallels with religion. Or would that be the other way round. You could go on and on.

It is easy to understand why many aspects of medicine and religion mirror each other. Particularly if we look at one very important aspect of religion. Namely, protection against terrible things happening to you. Humans, once they became aware of their mortality, very rapidly felt the need for protection against an unpredictable and dangerous world. Earthquakes, storms, crop failures, plagues, early death… that type of thing.

Very early on, religious leaders realised the power and status you could command if you claimed to be able to understand why such terrible things happened. And, more importantly, how to stop them. Build a big temple, pray to a god, don’t shave your hair, sacrifice a pig, don’t eat pigs…. give the priests lots of money, and suchlike. The people, in turn, were extremely eager to do these ‘right’ things in order to feel a sense of protection, a removal of fear.

Of course, none of this actually stopped anything. But when terrible things still occurred it was because you (you sinner) didn’t pray in the right way, or someone else (a heretic) was deliberately praying the wrong way and causing bad things to happen. ‘Find the heretic in our midst and burn them.’ Or whatever. A good idea not to have ginger hair or a club foot at such times.

Over time, a million and one reasons were developed by clever priests to explain why, despite all the incantations, gifts, temples built, and sacrifices, bad things were not prevented. However, there was one reason that could never be countenanced. Namely that the priests were completely wrong, and had no idea what they were talking about. For, if the priests were wrong then…well then, terrible things just happened and there was nothing you could do to stop them.

How frightening is that. Thus, it was not just were the priests desperate to keep their power that kept their religion going, the people were equally desperate to believe that the priests knew what they were doing. It could be described as a conspiracy of the willing. ‘I will protect you. Yes, you will protect me.’

It was usually only when plagues and earthquakes and lack of rain and suchlike went on for a prolonged period of time that the people rose up against the priesthood and bashed their skulls in. Usually to be replaced by the ‘new model priesthood’, with another bunch of newly discovered incantations. ‘The absolutely new true truth is revealed,’ rpt.

Then, luckily, along came science and we started to learn what caused bad things to happen in the first place. Earthquakes weren’t due to the displeasure of Gods. Infections were caused by viruses and bacteria and suchlike. More and more that used to be unknown, and terrifying, became explained and, at least in some cases, controlled.

As science advanced, and became the best way to explain the physical world medicine, which used to be a branch of the priesthood, moved towards becoming more scientific. However, one of the primary social drivers behind medicine remained ‘this is how the world works, and we can protect you from it’.

Thus, although in many ways, medicine became more scientific, it maintained of the key social functions previously carried out by religion. ‘We can stop bad things happening to you. You do not need to be frightened. If you do as we say’

This form of mutual dependency works extremely well when the medical profession really does know how to stop things happening, and the medical leaders know exactly what they are doing. However, there is a heavy price to be paid for establishing yourself in the position of ‘certainty’. A position of belief requirement.

Primarily, it becomes extremely difficult for you, or the rest of the brotherhood, to admit that you don’t know something? Or that things you have been telling people, or doing, are in fact useless or wrong. Because if you start doing that, you fear you may lose your hard won authority, control and respect. Equally, if patients no longer believe, or trust in you, or your advice, what then? Fear stalks the land. Metaphorical skull crushing looms.

This is why, if you are a patient who feels that your treatment has not worked as you were told it would, or should, you will not find an eager audience for your complaints within the medical profession. Equally if you question or refuse the sacrament, sorry treatment, your doctor is likely to become very angry with you.

Additionally, if a doctor cannot discover what is causing your symptoms, or they have no tests to diagnose you, you are likely to be told that there is nothing actually wrong with you. The medical profession cannot easily admit to ignorance. In such situations, the only explanation that can be countenanced is that ‘you are making it up.’ Unexplained symptoms become ‘somatisation’. Side effects from drugs, such as statins, are due to ‘nocebo’ effects.

A million reasons will be found as to why the treatment has not worked in your case. Or why you got worse. The only explanation that cannot be allowed is that the doctors are completely wrong, and do not know what they are talking about.

If you find a whole group of patients who feel that their condition is not being treated well, and you band together to get the medical profession to think again, you will run up against a brick wall. You will simply be written off as cranks, and dismissed. The priesthood does not take kindly to being exposed as wrong.

See under, treating thyroid patients like children.