The Psychopathocene Age (Australian Doctor 17 August 2012)

August 17, 2012 § Leave a comment

“We’re all going to die.” My new patient had a fine goatee and looked agitated. Her words lingered in the air as she sat down. I cast a wary eye at her and said: “Of course.”

She bristled. “No, I don’t mean it like that! I mean I’ll be dead, you’ll be dead, lots of people will be dead within a week.”

She was desperate to communicate but her eyes were maelstroms of anguish. I didn’t want to be sucked into the vortex and couldn’t hold her gaze for more than a few seconds.

We talked. Even before the tears started it became obvious she was mad, not bad; psychotic, not psychopathic.

Perhaps she’d have done better if she was a psychopath.

My employee number at one workplace is 007. James Bond is emotionally defective; as are many of humanity’s leaders, heroes and zeroes.

Most psychopaths aren’t powerful but perhaps most powerful people have a psychopathic spectrum disorder (a spectrum disorder that, to my surprise, garners only three hits on Google; or now maybe four). How else could politicians and industrial leaders risk an unliveable planet from climate change for pathetic short-term aggrandisement? Geologically we might live in the Psychopathocene, not the Anthropocene, Age.

A study last year suggested 4% of CEOs are psychopathic. The true percentage has got to be higher. Intelligent psychopaths don’t give themselves away by honestly answering questionnaires.

A current Parliamentary committee has heard one in four Australians have experienced or seen workplace bullying. This figure also seems remarkably conservative.

Large institutions such as hospitals — and, for that matter, parliaments — are surely the natural home of bullies and psychopaths. Most doctors have probably encountered assorted narcissistic surgeons, patient-abusing psychiatrists, nurse-savaging physicians, vicious control-freak midwives who make obstetricians look normal, weird women-hating gynaecologists (not all with testosterone encephalopathy) and administrators who get emotional about numbers and not people.

I’ve been there, done that. Worked with them all.

Of course, not every renowned paediatrician gets charged with waterboarding their 11-year-old daughter; and many a life is saved by psychopathic surgeons. There are indeed circumstances where I’d prefer to entrust my mangled body to a heartless technician rather than a sensitive soul. But there are no circumstances where I’d prefer the emotionally stunted technicians to control the health system.

I recall working as night resident in Campbelltown Hospital in the aftermath of the 1980s NSW doctors’ strike.  The hospital still had no orthopaedic cover and none of the 17 or so other public hospitals I rang that night had an orthopaedic bed. I had a patient with a nasty compound leg fracture who had spent hours trapped in a car before being rescued. He then spent many more hours in casualty while I tried to find an orthopod to treat him.

Are you already better off than almost everyone on the planet yet self-righteously prepared to hurt people to get more? Let’s hope not.

But enough nostalgia.

I should see my psychotic patient again this afternoon. That is, if we are both still alive.

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