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ORWELLIAN SICKSPEAK
P C M. D.:
How Political Correctness Is Corrupting Medicine by
Sally Satel, M. D.
Review by
Mark Webster
Surprisingly, the best anti-PC books I’ve read this year have
been by a repressed minority – Women!
Dr. Sally Satel is a practicing psychiatrist and a lecturer at the
Yale University School of Medicine. Her
book demonstrates how the bad ideas of political correctness have burdened
the practice of medicine in public health, mental health, nursing, health
education, drug treatment, and psychological counseling.
Before touching on some of the examples of political practice in
medicine, I would like to quibble with Dr. Satel’s clever title.
The term “PC” is so overused it is meaningless.
Although Dr. Satel never actually defines the term, I define the
term to mean a “strategy used by collectivists to silence speech which
would which would presumably hurt the heightened political sensibilities
of political subgroups in whose name the collectivists wish to speak.” I would prefer the term “Orwellian” from the author
George Orwell whose novels Animal Farm and 1984 demonstrate
how the “newspeak” and “doublespeak” of an ever changing political
orthodoxy diminishes language
and common sense.
The term “Neo-Orwellian” appears on page 228 of this 233 page
book in a chapter entitled “Therapy for Victims.”
Dr. Satel discusses three forms of therapies: trauma based
treatment of adult patients with “memories” of abuse in childhood,
oppressed based therapies, and multicultural counseling.
A common strain of political bacteria runs through all the
therapies: “You are a victim. Your
illness is caused by power imbalances.
Your cure is political action.”
Here is a simple example of how a bad medical idea infects us all
very quickly. Recently, a
Harvard psychiatrist has argued racism should be classified as mental
illness. When Atlanta
Braves’ pitcher John Rocker made disparaging remarks about certain New
Yorkers, baseball commissioner Bud Selig ordered Rocker to undergo
psychiatric evaluation before returning to play.
Dr. Satel describes the incident as “Neo-Orwellian” because it
medicalizes a boorish comment. She
approvingly quotes columnist Charles Krautheimer’s statement: ”John
Rocker is a jerk, but jerk is not a medical diagnosis.”
Not yet.
Dr. Satel begins the book by surveying four eras of public
policy in American medicine: 1) the sanitation era of the late 1800’s
which emphasized cleanliness to prevent typhoid, tuberculosis, and yellow
fever; 2) the biological era of the first half of the twentieth century in
which scientific advancements stopped polio, smallpox, and diptheria;
3)the lifestyle period of the
1970’s which stressed exercise and diet as a way to prevent disease; and
4) the politically correct era which puts ideology before patients.
In an unfortunate pun, she calls the practitioners of politically
correct medicine “indoctrinologists” who see malign social forces,
such as racism, sexism, and “classism,” and corrupt institutions, such
as patriarchal medicine, biased doctors, and authoritarian psychiatry as
the cause for every measurable health disparity.
Take breast cancer, for example.
Dr. Satel destroys the myth of women as victims of patriarchal
medicine who are second-class citizens in the world of medical treatment.
She demonstrates the death rate from breast cancer had been
declining since the mid-1980’s. Greater
incidence of less advanced stages of the disease had created the false
notion that more women had fatal breast cancer.
In addition, women represented 62% of more than six million
participants in NIH funded research in 1997.
Ever since 1985, the year the National Cancer Institute (NCI) began
keeping figures, breast cancer research has received more funding than any
other form of cancer research. Women
also spend more time going to doctors than men do.
Geriatric medicine is largely the treatment of aging females.
Dr. Satel demonstrates heart disease, not breast cancer, is the
biggest killer of women.
In 1997 the NIH concluded women over 40 should seek their
doctor’s advice and then decide whether to get an annual mammogram.
Congress rejected that suggestion and passed a resolution 98-0 to
force the NCI to recommend annual regular mammograms for women over 40.
Ironically this demonstrates that the government thinks it knows
more than women do. In
other words, women aren’t able to decide for themselves.
By the way, Dr. Satel shows the evidence of invasive breast cancer
is less than the incidence of invasive prostate cancer, yet breast cancer
research received five times as much funding as research for prostate
cancer in 1997 and three times as much in 1999.
Don’t worry. The activist Men’s Health Network is lobbying Congress for
parity in funding.
Let’s consider condom use. How
could that be political? Well,
the theory of “social production of disease” argues racism and sexism
contribute to disease. This
led one epidemiologist from Harvard to explain away unprotected sex among
minorities this way: ”Seeking sanctuary from racial hatred through
sexual connection as a way to enhance self-esteem…may offer rewards so
compelling condom use becomes less of a priority.”
But what about the health of the partner?
The Harvard doctor doesn’t say.
Last, can the certification of health counselors become political?
It can when multicultural counseling requires only gays counsel
gays, women women, and so on.
Multicultural counseling started out as a humane idea.
In the 1970’s San Francisco General Hospital (SFGH) created a
specialty ward for Asians in order to improve counseling services to
non-English speaking patients. It
was successful. A similar program for Spanish speaking patients was started.
It, too, was successful. Then
victim politics replaced language barriers as a rationale for the special
treatment. African-Americans, gays and women demanded special units
because the “indoctrinologists” believed each subgroup had special
experiences that could only be addressed by a similarly situated
counselor. SFGH created
a Cultural Competence and Diversity Program to address these needs.
Now each new patient admitted for psychiatric treatment is assigned
to a treatment team specializing in African-Americans,
gays/lesbians/bisexuals, women, and HIV positive individuals.
The only patients who don’t have a team are white male
heterosexuals. As could be
predicted, problems arose between staff and residents.
What about the patients they were supposed to treat?
Most were so psychotic they were oblivious to the identity politics
of their counselors.
Dr. Satel also discusses “crack moms” and nurses who practice
“therapeutic touch.” The
silliness is sad because innocent people are harmed.
What then is to be done? Dr.
Satel suggests governments pull the plug on the funding for PC medicine.
Group based preferences that lower academic standards at medical
and nursing schools should be stopped.
While discrimination and bias should be eliminated, they are not
the cause of differences in health outcomes.
Improved access to medical services, good health practices, and
personal attitude can close the gap and inoculate M.D.s from PC.
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