Friends in Low Places

Clarke Ching‘s enthusiastic response to my earler post about Friends in Low Places provoked me to read further. Dr James Willis has put his book online. Here’s a sample of his thinking: Chapter 6 –Everything in life is relative. Willis points out that over-regulation of the medical profession means Doctors have to break the rules in order to give good care. Indeed, the rules become so overwhelming that no sane person can observe them all to the letter.

Society as a whole is now being confronted with that reality for the first time because for the first time it has the machines and the systems which it thinks it can use to control life at the individual level. So the hidden cop-out is being revealed. The shabby posture of media scale society has been to rely on individuals for the slippage upon which life is utterly dependent. And yet, when instances of that slippage are exposed on the media stage, the individual is ruthlessly sacrificed.

By permitting slippage within the National Health Service, GPs act, in a sense, like the cut-throats whom the outwardly noble Macbeth secretly employed to do his dirty work for him. We follow our personal judgement, educated as it is, rather than the rules we are nominally meant to follow. Thus we provide the essential discontinuity on the logical road which, in an increasingly litigious world, would otherwise lead every patient with a headache to the brain scanner.

In order to do this we have to take a series of more or less carefully balanced risks, all expressed in relative terms. In other words we use common sense. But if society continues to denigrate this process and begins to expect perfection, as judged by the false perceptions of the media scale, then doctors are not going to let themselves be rewarded in the way that Macbeth rewarded his servants. We will eventually be forced to work to rule and not to life, in order to defend ourselves. And society will be the poorer.

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