COOPER: The doctor will not see you now

Woke-ism has now come for the physicians and scientists, with predictable consequences. For some reason they are surprised and annoyed.The National Post a couple of weeks ago published an alarming story by Leigh Revers, an associate professor of biotechnology at the University of Toronto’s Mississauga campus. He has a Ph.D from Oxford in chemistry and trained at the famed Dyson Perrins lab in Oxford as a molecular biologist. He has done work on the role of enzymes in the development of disease at SickKids Hospital in downtown Toronto and research on how toxins exploit aspects of cancer. He is also a biotech entrepreneur, as are so many university professors who work in high-tech fields.In a word, Revers has pretty good academic creds.His job, he said, is to be a “gatekeeper” for the aspirations of pre-med students. That is, they take his courses to qualify for medical school. Revers has no time for those who think that a new cohort of Canadian physicians should be qualified to practice medicine because of their command of ancestral healing or Indigenous TK, ie “traditional knowledge.” Revers supports MRIs over TK.He sees himself as an advocate of free enquiry and recourse to evidence, which he described as “the walled city of reason” based on “enlightenment values.”For a political scientist, such a self-description is based on a massive simplification of European intellectual history. But he’s an organic chemist, so let it pass. Besides, the threat he sees applies to history and political science as much as chemistry or approving students to go to med-school.His story of wokeism recounted events during a 90-miunute faculty town hall meeting a week earlier. It showed that “even the scientists” had become captive to an “irrational and incoherent ideology” that “seeks to correct every single structural imbalance in authoritarian fashion,” chiefly by “policing speech.”One further self-characterization. Scientists, Revers said, are “timid creatures in the public square.” They just want to make useful discoveries and are not concerned with race or class or “magical ideas” about “gender falling on a spectrum.”He was particularly incensed by the remarks of the dean, Nicholas Rule, a social psychologist. Rule had won an award from the International Academy of Sociocultural Research. His credentials were obtained at a mediocre American university, Tufts.According to his U of T bio, Rule “identifies as gay and is a stalwart advocate of equity, diversity and inclusion.” Revers had noted that he also was gay, thus nullifying any anti-homosexual card his woke opponents might be tempted to play. He confined his critical remarks directed towards his administrative superior to the latter’s DEI advocacy. Sensitive readers might also detect the conventional superiority and elite Brit scientist towards a middling American-trained administrator.More precisely, Revers objected to Rule’s new rule that all faculty members had to provide him with a DEI statement as part of their annual performance report. Revers called this requirement “an ideological litmus test,” which seems to me to be about right.Revers then summarized his own intervention in the town-hall discussion as well as those of several woke graduate students. “The meeting rapidly slid into rhetoric and grandstanding.” Revers was especially irritated by the “brusque, narcissistic and self-entitled” remarks “so prevalent among modern students,” and noted that such behaviour as recently as a decade ago would have been an “unthinkable affront” to the practice of deference to a “knowledge hierarchy that was once the norm in higher education.”Revers was not complaining that the students were rude but that the professors had been cowed by the likes of Dean Rule to abandon the norms of their vocation in order to nourish the grievances of a bunch of privileged snowflakes.That same day I received an electronic off-print from one of my physician pals in California. The article was by Lisa Rosenbaum, MD, and was published in the New England Journal of Medicine, one of the most important general medical journals in the world. It was part of a series on “medical training today.” She had probably never heard of Dean Rule, but her article vividly described how the consequences of his “ideological litmus test” were playing out in real medical schools. She began by describing how an intern, Dr. A., undertook tasks that were outside his medical training strictly considered and were looked down on by his classmates as being beneath their dignity. What he did was advise the primary care docs how their patients were doing in hospital, update patient records and so on. He did so, he said, because it “unambiguously advanced patient care.” Indeed, traditionally such activities were considered normal and were undertaken as part of the informal education of apprentice physicians, teaching them that patients came first, not them.Today, for Dr. A.’s classmates who disapproved of what he did as well as for an increasing number of med school administrators, such activities are seen as harmful. Why?Because as one department head said to Rosenbaum, “encroachments” on time away from strictly defined hospital duties “were often deemed threats to mental health.” Likewise the medical honour society, membership in which was accorded to outstanding med students, was considered a threat to treating the best and the worst equally. Of course it was. That was the whole point.Same with giving medical students any “negative feedback.” Only positive comments deserved to be recorded. Nothing that engendered “discomfort” would be permitted — such as not making the honour society.One justification for this patently stupid rule was that it disrupted the balance between “well-being, self-care and work-life balance” and the demands of the workplace for rigorous training. Now, medical school has always been rigorous and the demands on interns and residents have always been tough. This was deliberate. Docs need to be able to work long hours when necessary and by long-standing conventions, internships and residencies provided the time when young MDs had to figure out how to do it. If they can’t hack it, maybe they should learn to repair bicycles or grow organic kale.For many young docs today apparently, these difficult, challenging, uncomfortable aspects of medical training are called “traumatic.” To say that invoking the advent of trauma among doctors makes rigorous training difficult is a gross understatement.The result is not that the pursuit of excellence in medical training conflicts with the pursuit of self-care, etc., but that it has become difficult, even impossible, to raise any serious questions about real balance. The apprenticeship model is also out the window because it relied on the transmission of traditional professional standards from one generation to the next, as Revers had maintained as well. Because excellence in training and excellence in medical practice were central to that tradition, it is much easier to forget entirely about excellence, which is bad enough.Worse, because excellence really does require negative feedback, criticism and the ability to deal with difficulties, how are young MDs ever going to become good docs?