Confessions

There's an art to a real confession, thinks Naomi Mehta, and healthcare workers aren't skilled at it. They just seem to be playing a game of, well, doctors and nurses

There is an art to a good confession: a truly worthwhile confession has essential ingredients that set it aside from being just silly. Isolated in its genuine shame, the deed should be recounted in darkly honest terms, with full ownership, no snivelling excuses, and accompanied by an intention, however weak, to prevent reoccurrence.

As this relates to doctors and nurses, my thoughts turned firmly to sex--more specifically, sex and sexual overtures with non-consenting patients. There could be any number of recently struck off gynaecologists or psychiatrists--one lives just up the road as it happens--out of work and ready to talk. With this in mind I sat with my fish and chip supper waiting for a TV show about such confessions of doctors and nurses to start. Voyeuristically tantalised, and just a little edgy, I needn't have worried unduly. After all, it was before the watershed, and the chances of a confession of indecent assault on a patient followed by swift asphyxiation as they threatened to complain to the General Medical Council seemed unlikely.

In fairness, the title was always going to promise far more than it was capable of delivering, and the fairly anodyne tale of the mishaps of junior doctors was just sweet and lacked all the confessional essentials. Tales of mixing up the medicines due to the similarity of containers--which had no effect, because of maladministration--was cheerfully recounted by the happy chappy who seemed coyly reminiscent of a young schoolboy confessing to taking the Lord's name in vain. "It may have killed her though," he added coquettishly.

The nursing approach to confession was altogether more disturbing. As confessions in the true sense, they were rubbish: no shame, no ownership, and absolutely no intention to desist from the sick, abusive, and demented behaviour. These dark and horrid tales were delivered in a haze of sentimental nostalgia with a splash of righteous indignation thrown in. These were not confessions; they were manifestos. Patients were dealt with swiftly and with maximum brutality for being troublesome, generally unworthy, and randy.

"Remember the time we inserted a tube unnecessarily into a man's penis without the usual anaesthetic? He was in absolute agony." And for what? Having the audacity to pinch one of those saucy nurses on the arse. Not too long ago, a police force in the north of England was exposed for similar strange and barbaric practices. Male officers, it seems, thought it a great prank to attach sharp pegs to a fellow female officer's nipples when she got a bit above herself. How funny was that? But we were now firmly in the land of Benny Hill, where French maids were all of a spanking and blokes seemed to be fair game.

"Remember that time in the operating theatre, when that man's penis became erect and we had to hit it down?" Titter titter. The little teases. I'll bet they even took it in turns, until the whole room had got a pop at it, and I suspect the poor sod was still being badgered long after his flaccid state had returned. Where was the shame?

In a more distant and murky time, as an Ann Summers rep, selling prosthetic penises of every variety, I saw similar scenes played out at sales parties. Faced with a vibrator, the collective female approach was always yawningly predictable, even then--hitting, smacking, throwing, abusive, and hysterical. Everything, in fact, except an acknowledgment of possible pleasure. At the end of the night with my pockets stuffed full of orders, I was never entirely convinced that these items wouldn't end up in individual homes being smacked about. But no. That's the collective for you: safety and cleanliness in numbers. At least no "one on one" groping for sheer sexual gratification, you may say, but I couldn't help thinking, that from a patient's point of view, it might be preferable. What person wouldn't choose the odd unsavoury groper over mass heckling and humiliation?

So the nurses on TV, having gleefully sprung all their own party pieces, smashed any vague notions of ownership and just started telling tales on others like the worst kind of schoolgirl. What about the practice of surgeons chucking an amputated limb across the room at a new nurse to catch? A fine little initiation ceremony which no doubt stood her well for what was to come. Now you're in the club there'll be loads more fun like that, girlie.

Cut now to end of programme: a kind of health warning in reverse. "Oh dear," I thought, it couldn't be too long before persecutor turned victim. There it was: nurses looking detatched and wistful. They had to have a laugh you see, they had to keep it on that level and encourage that sense of humour "otherwise, well, you'd just get depressed." Hmmm.

Naomi Mehta, second year medical student, University of Leeds
Email: NaomiMehta@aol.com


studentBMJ 2002;10:215-258 July ISSN 0966-6494