Monday, April 29, 2013

Dr., No

– on the inseverability of the title from certain graduates’ names

What is this (pre)fixation that Indian medical practitioners have with the prefix ‘doctor’? It is only a prefix, but quickly wriggles its way into the position of a praenomen, with both the individual in question and his/her associates taking every care to stuff it down people’s throats. Witness non-medical, social conversations such as –
(i) Caller: “Hello, could I speak to Sangeeta please? It’s about the matrimonial website profile.”
Responder (Raised eyebrows, (un)fortunately invisible to the caller): “Yes, this is Dr. Sangeeta speaking.”
Caller (unspoken): Ooh baby! You’re never going to be Dr. Mrs. Me!

(ii) “Could I speak to Dr. Anjali*. This is Dr. Sunita’s* father calling.”
(*both young medical students, neither even technically a doctor yet)

(iii) Cameraman: “Sir, please say your name and designation, and then describe the programme.”
Interviewee: “Good afternoon. My name is Dr. Satyanarayana, director of the Board of Pseudohypertrophic Medicos.”

Not to mention the innumerable lists of names you will find of participants in many conferences: Dr. A, Dr. B, Dr. C, Dr. S, Dr. W, Dr. T, P, Q, F, and H. Evidently, P, Q, F, and H do not warrant any title – after all, they are not doctors.

Granted it is a “noble profession”. If there is any doctor who hasn’t heard this, obviously he/she didn’t go to medical college in India. People who fulfill needs are naturally popular, wanted, welcome, or respected, depending on the urgency and importance of the needs and sometimes the individual’s skill to address them. So it is that someone who can attend to your body in its distress is much wanted and more respected than someone who can design a comfortable house for you, or give you a dashing haircut. The noble aura of the profession comes from the tacit understanding that compassionate service will be provided, and ability and well-being restored, preferably without taxing the poor recipient to despair. This purported nobility is questionable, if the contemporary state of society and the current membership of medical colleges are examined. Private medical colleges are prohibitively expensive. An enrollee may be expected to slog and pass out (in more ways than one) and then devote him/herself to years of money-making to redeem the outlay for the course – not the most natural circumstance for a service orientation. Government medical colleges offer excellent and far more affordable education, but to whom? Only a sliver of the truly outstanding applicants; the rest of the places go to those who may not be there on the basis of “merit”, and could go on to make somewhat indifferent graduates. So, there is a good chance that many doctors out in society today are not all that brilliant, or not as focused on nurturing health as on cultivating money. So much for noble professions. Surely all of us have come across doctors who have surprised us with their narrow minds, poor observation skills, and suboptimal advice. With time, even the healthcare system, somewhat uncomplicated in the decades past, has taken on corporatized, commercial, discriminatory, and confusing shades, incorporating a complex rigmarole of unfriendly insurance schemes, exorbitant drug pricing, and medical philosophy hegemonies. To complicate matters further, consider the fact that the average doctor today is not a health specialist, but actually a disease specialist. Health is so much more than just a freedom from a long list of ailments – but this is something that most people, including doctors, don’t have the luxury of reflecting on, beset as they are by one or more of a long list of ailments!

To return to the wide popularity of doctors, a health practitioner is clearly the only emergency executive whom everyone sanctions – it is difficult to imagine a socially accepted call to a tailor / lawyer / carpenter / beautician / architect at 2 a.m. You might call a policeman at 2 a.m., but policemen aren’t generally scholarly, and seldom eliminate pain. In short, granted that doctors could do much. Train reservation forms ask for this information for just this reason.

From the origin of the term 'doctor' itself comes an understanding of another reason why doctors are respected – they are learned. The tradition continues. Through the centuries, doctors have been expected to be well-read, to remember truckloads, and to correlate concepts promptly. Arguably every profession has a great deal of knowledge and skill for practitioners to internalize and demonstrate, but the arenas for most skills are somewhat circumscribed compared to the arena for knowledge related to the human body. Not everyone has a mansion to landscape, a feast to cater, or a sibling to fight over a legacy, but everyone has a body, and most will claim, a troublesome body. And everyone is curious about its workings – even the fashion-unconscious stockbroker who doesn’t care about the recipe for mirchi ka saalan wants to know why a blow to the solar plexus could stun someone. There’s no end to the stage, or the mirror, for a doctor’s preening.

Medical education is expensive – in terms of time and effort, certainly, and all too often in terms of money too. Students who have breezed through over a decade of education from childhood to teenage, come up short at the first set of examinations and face the horror of sleep-robbing days of study, poring over model question papers, all academic snobbery discarded, some even turning theistic at this juncture, mentally crawling through the written, practical and oral trials just to bloody pass, forget first-class and distinction. Of course, the ignominy of failing an examination in a medical course isn’t too great – many wonderful people have trod that path. The next few waves of examinations are never as bad as the first, even if they’re tougher, because by now the student is tougher too. Anyway, after years of this, and torturous labs, and horrific hospital rounds, students feel that they’ve earned the title. So they have. But to use in a professional set up. Not to attend a wedding in. You may be Dr. So-and-so in a hospital, or in a healthcare conference. In a recreational club, a movie theatre, or your cousin’s house, you’re So-and-so, maybe even an insufferable old so-and-so. That’s it.

Rampant in India is the custom of calling people Dr./Mr./Ms. [first name], no initials or surname. This is an unintended sort of name-dropping that people do – analogous to going barefoot while wearing a three-piece suit. And it is fairly silly – when you take the trouble to attach a title such as "Dr." to the name, shouldn't you take the next (previous?) logical step and add the surname/initials too?

What about the universally recognized scholars? PhDs. A lot like medicos who go through the academic and clinical grind for years and emerge with the feeling that they might as well have been named “doctor” at birth, are the PhDs who once they get the coveted letters following their name feel affronted if anyone refers to them as “Ms./Mr.”. PhDs should ask themselves if they really are Dr. So-and-sos at a child’s birthday party, or just bloody gift-bearing, cake-chomping so-and-sos. Among PhDs is a strong feeling that only they deserve the title "doctor", or then medicos who have slogged for a comparable number of years and at least earned an MD. It irks many a PhD to find bachelors of medicine calling themselves doctors. This complex is complicated further in countries where there is no bachelor’s degree of medicine (e.g., USA), and where surgeons were traditionally not doctors (e.g., England), and therefore not addressed as “Dr.”, but instead as “Mr.” (female surgeons were obviously hard to come by in those days). However it must be noted that PhDs are better about confining their airs and affronts to their academic circles, and refrain from strewing their titles around as indiscriminately as medical graduates do, perhaps for some of the reasons outlined ibid.

There are situations in which the title “Dr.” can be parlayed to good use – such as in a diagnostic centre or hospital (when you are a visitor, and can have the benefit, and admittedly the pleasure, of being taken seriously instead of being herded around like sheep). Contemporary society is such that people have a reflex surge of respect for anyone with the title "doctor" (medical or not), and so it is a title that can be used to convey respect. Which is to say that if you want to register respect for a doctor, you can rightfully introduce her/him as “Dr.” But note that this is strictly one-way: Far from sounding respectful, and indeed respectable, it sounds pompous and overly self-important when you introduce yourself as “Dr.” And worse still when you say, “My name is Dr. So-and-so” rather than “I am Dr. So-and-so”. Surely you cannot mean to suggest with a straight face that your name is Doctor.
“What’s your name?”
“Dr. So-and-so.”
“Interesting name. What do you do?”
“D-uh, I’m a doctor.”
“Wow! Are your parents astrologers?”

Lighten up, doctors. Keep your profession in its place, and your stage name for use when you play the role. At other times, be Doctor? No.


Lakhwani Deepak said...

There is a new one .. in small towns.. Er. for Engineer. People have stickers with green cross saying "Engineer" . I go facepalm everytime i see that.

Nice post BTW. You win .. :)

Anonymous said...

Nice rant :). Have you also noticed Prof. Dr. and Dr. Dr. (especially in Europe)? That really amuses me :).

The only objection I have is to your generalization on the lack of scholarship in the police force!


Ananya Nair said...
This comment has been removed by the author.
Ani said...

Attn: Anonymous

I am sorry about the seeming dismissal of the entire police force as unscholarly. To be sure, there are learned people everywhere. I just think (despite a lack of evidence to base this on) that the representative of the police force whom you may reach at 2 a.m. is likely to stress brawn rather than brain.
I appreciate your keen eye in reading this essay though. Thank you.

Ani said...

As for Prof. Dr., I found my own uncle being one such at one time!
And once, years ago, I attended a conference whose star speaker was a "Lord Prof Dr. Sir" (in a similar, if not identical order) - no exaggeration. Seemed like a lot of buffer to ensure deference from the public.