Doctors’ solemn oath something to strive for but not always obeyed
ONE of the most moving moments in a graduation ceremony is when the newly minted medical doctors rise to take their solemn oath.
They promise to be ethical in the conduct of medicine and to act with the highest integrity demanded of the profession. And then they might say something like this, as at a Wits graduation ceremony: “That I will not permit consideration of religion, nationality, race, politics, or social standing to intervene between my duty and my patient.”
Even as I sat moved by these oathtaking ceremonies year after year, I often said to myself: If only this were always true.
Last Sunday night I found myself deeply disturbed by the travelling exhibition brought to South Africa by the South African Holocaust & Genocide Foundation. It is called “Deadly Medicine: Creating the Master Race” which reminds us of the Nazi regime’s so-called science of race. Their pursuit of “racial hygiene” included gross experimentation on Jewish bodies to controlling reproduction to the extermination of those deemed to be biologically unfit.
In the audience at the Cape Town Centre of the Foundation sat a handful of survivors of the Nazi death camps.
None of this racial madness was possible, we were reminded, without the deadly collaboration of scientists including psychiatrists, geneticists, anthropologists, and of course doctors.
At Sunday’s remembrance a courageous Dr Handri Walters, a new PhD from Stellenbosch University, told of how she had stumbled upon hair and eye colour charts in the department of volkekunde (the Afrikaans universities’ version of anthropology, now closed) as well as a skull of a “mixed race” woman from a period of South Africa’s own obsession with the now-discredited science of eugenics.
Eugenicists believed you could improve the human race through genetic manipulation such as selective breeding.
And who can forget the horrendous Aversion Project where doctors tried to “cure” gay men in the South African military through treatments that included electric shock therapy, chemical castration and hormone therapy?
A distant past best forgotten? Think again. There remains in our society evidence of the enduring relationship between race and medicine. What was the Life Esidemini case about if not the contempt for mental health patients who were sent to die at the hands of unaccredited agencies?
About 1 700 chronic psychiatric patients were moved to NGOs and home-based care facilities and at least 144 died tragically. They were deemed less than worthy of dignified treatment at the hands of the best health professionals in the country.
This had little to do with cutting costs on the part of the province; it is about contempt for the vulnerable people deemed inferior by virtue of their race, class and health status.
The absence of discriminatory laws does not mean the absence of discrimination when it comes to race and medicine. Last month a doctor in Mokopane, Limpopo, was found to be running a surgery with racially segregated waiting rooms, consultation rooms and even toilets.
I am quite sure that doctor also took some kind of oath when he graduated. It is also very likely that pointing out his behaviour would come as a shock for his racism had entered the realm of what Dr Walters calls racial commonsense.
Such racial commonsense is still deeply embedded in medical science research and practice. Just recently a top medical journal in the world published an article on racial differences in susceptibility to mycobacterium tuberculosis. TB, for short, is still regarded among many health professionals as a coloured disease – just as in another century it was called “tailor’s disease” or “Jewish disease”.
Of course TB has nothing to do with being coloured or Jewish and everything to do with the socioeconomic conditions of poor people, including overcrowded and damp dwelling places. But commonsense has a strange way of imputing disease to race.
With commonsense in mind this powerful exhibition, Deadly Medicine, intends to remind us of how the monster of race still lurks in the shadows of our everyday experiences such as discrimination in the dispensing of medical care.
So how do we unlearn commonsense? I was delighted to notice the participation of two high schools – Muizenberg High and Cannons Creek Independent School – attending the exhibition. Congratulations to the forwardlooking teachers of these great schools. These children will learn much more about history, humanity and healing from a couple of hours studying these moving images from a nearby past than they will in the humdrum lessons of any subject classroom. It is with this generation that I stay hopeful that when we say “never again”, we actually mean it.