I have had a major insight into something, as yet to be defined, regarding doctors: people hate them. Doctors, as a species, are not loved, respected or admired: they are despised. I have been in the attack mode with physicians for some time and I finally realized that nobody is defending them. Nobody likes them. You do not go to a physician because you want to: you go to him, like the dentist, because you have to. The difference between the physician and the dentist is that the dentist knows this, so he goes out and buys season tickets to the symphony and takes his wife to dinner. He has a job and understands that it is neither a lifestyle nor an identity; it’s just a well-paid, interesting job.
Likewise, I know a psychologist who raises kids, Dalmatians and roses. Other than the fact that the Dalmatians are pretty stupid, it’s a nice life and he enjoys it. He chose not to become a physician. His uncle and his mentor were both psychiatrists and they told him that to achieve what he wanted in the way of helping people, he did not need to go to medical school. Some time after he was firmly and successfully established in practice, he amused himself by taking a computer survey on how to choose the right career.
It was one of those things that asks a million questions like “Rank order your preferences: (1) collecting seashells; (2) purchasing medieval religious paintings; (3) picking your nose, or (4) masturbating.” The program purports to choose the ideal career for you. Psychology was what was chosen for him, thus proving that he understood himself as well as did a machine. The report said that psychiatry was not for him because (a) he could tolerate seven years of academic preparation but not eleven, and (b) he was not sufficiently motivated by money.
Recently the psychologist attended a conference where the keynote speaker was an exceptionally wise physician who defined “doctor” as “A person who worked hard in school.” The psychologist has taken to repeating this definition on a weekly basis because it has captured for him something that he only had understood intuitively. The difference between him and a physician is not about the moral quality of providing humane care or the intellectual ability to achieve. He simply did not want to work that hard at career preparation. He wanted to have a whole life of children, stupid dogs and pretty flowers.
In his early career days he often plaintively pointed out that he, too, was a doctor and was worthy of the status given to physicians. He identified with physicians, knowing that he could have been one if he wanted to—he just didn’t want to. Now he and his wife, also a psychologist, are middle-aged, and have acquired standard middle-aged medical diseases: one difficult and frightening, two chronic and potentially dangerous, several stupid and irritating. This has given them extensive experience with physicians and the psychologist no longer chooses to identify with them. Instead, he has succinctly summed up the contemporary American perception of physicians: doctors are assholes. They are a breed, a species, a collective, not individuals. You have human relationships with your mother, stepson and housepainter but your relationship with your physician is that of human to asshole.
The psychologist is now, informally and unofficially, running a continuing workshop on “How to Manipulate Your Asshole.” An excerpt from this was demonstrated one day when he decided to come to a doctor’s appointment with me. I needed to receive medical care but was refusing to because I had not rid myself of the infantile belief that doctors are human beings; therefore, I was not free to manipulate my asshole. I asked the psychologist if it made any difference if you went to the doctor alone or with someone else.
“Are you kidding me?” he howled. He leaped up, grabbed a chair, planted it firmly and sat down on it with his arms crossed while saying, “When my wife was pregnant we went to her obstetrician appointments like this in order to get our questions answered.”
What he had done was set the chair in front of the door to prevent the doctor from leaving the room. Lesson One completed.