Monday, 21 September 2015


“Dehumanising the victim makes things simpler, its like breathing with a respirator, it eases the conscience of even the most conscious and calculating violators, words can reduce a person to an object – something more easy to hate, an inanimate entity, completely disposable, no problem to obliterate…” – M. Franti

On the surface, Brad was a confident, seemingly bulletproof junior doctor. Outside of medicine, he played guitar and basketball on weekends. A cheeky smile and a way with words enabled Brad to make most people warm to him on demand. Few people believed he would take his own life. Fewer still would admit that humiliation was the cause.

Bullying of junior doctors was recently highlighted on the ABC’s four corners program in May 2015. The episode entitled ‘At their Mercy’ identified a toxic culture of ‘belittling, bullying and bastardization’ within the teaching hospital system. It went on to report an alarming statistic of one in five medical students who had thoughts of suicide in the previous 12 months. There was reference to a cycle of abuse ‘where teaching by humiliation is routine.’

‘Are you listening to me Brad? Did you even understand the question? Aren’t you supposed to be a third year medical student? A first year student could give me a better answer.’ Silence. ‘Well? Are you just going to stand there? Don’t look at them. They won’t help you. And don’t anyone else answer for him, he needs to learn.’

The definition of humiliate is to make someone feel foolish. But this doesn’t convey the emotional impact of humiliation in the slightest. Not everyone will admit to feeling bullied but few people can deny experiencing the feeling of humiliation at some point in their lives. I’d argue it’s hard to forget.

‘So welcome to your first intern term, what’s your name again?’ Brad. ‘Look, I’m probably not going to remember your name but as the Registrar I have to do most of the work around here so when I tell you to do something, just make sure it gets done and we’ll get along fine.’ “I’m Brad, this is Con, we’re both supposed to be on your team I think?” Sigh. Pause. ‘Why do they have to give me two tweedle dumbs this term… you do realise how much more work it is to teach both of you?’ 

In September 2015, the Royal Australian College of Surgeons (RACS) commissioned an investigation into toxic abuse and bullying. The report by the Expert Advisory Group indicated 49% of the 3500 RACS fellows, trainees and International Medical Graduates (IMG’s) have been subject to discrimination, bullying and sexual harassment. Importantly, the RACS has issued and apology and vowed to take action.

‘When I ask you a question, you answer me. Do you understand? Unless you’re a fucking mute? Are you a mute Brad?’ No doctor… I mean Mister. ‘Do you really think you’re cut out for this sort of work Brad? Plenty of less stressful jobs, you could always be a bus driver… I just don’t think you’ve got what it takes for medicine but lets see if you can prove me wrong shall we?’

Humiliation can often be hidden under a thinly veiled layer of humour. Plainly derogatory yet often overlooked. This is the insidious nature of humiliation. It also allows an opening for others to participate. Not necessarily with words but merely mutterings of approval serve to fuel the fire of humiliation.

I’d offer that humiliation is a combination of dehumanization, denigration and intimidation. People accused of bullying are often shocked at the label based on an alleged misinterpretation of intent. But humiliation suffers less from misinterpretation and far more from its participants being silent and complicit. Myself included.

‘Now Brad is it? You’re a resident doctor and required to be on-call over the weekend. Remember that I’m available over the phone if you desperately need me for something… but don’t hesitate to cope will you?’ But I’ve never done this job before and I’m a bit worried about being on call all weekend to be honest. ‘You’re not going to cry on me now are you Brad? Lets just be clear - I’m not your psychiatrist’

In 1998 Monica Lewinsky became one of the first people to experience humiliation on a world wide scale at the hands of the internet. Not only did she receive notoriety for her affair with former president Bill Clinton, her phone conversations and private life became public viewing. In the seventeen years since this incident we are seemingly more adept at identifying and labelling bullying. Yet the same cannot be said for humiliation. Lewinsky managed to very clearly articulate the problems with humiliation and its role as the currency of bullying. Several times Lewinsky felt so humiliated that taking her life somehow appeared to be the only option.

In order to understand this narrative more clearly, I should confess I went to medical school with Brad. I was also an intern in the same year as Brad and I completed residency years with Brad. Not once could I be accused of bullying Brad. However I participated in humiliating him on numerous occasions. I laughed, I sniggered and ultimately I condoned his humiliation. One could argue Brad was such a stable, resilient individual and appeared to take it all in his stride. Others were far less emotionally well equipped. But assumptions are misleading and often grossly inaccurate.

If what happened to Brad sounds trivial, you are most likely a part of the medical fraternity. The ubiquitous use of humiliation is widespread across all levels of medicine affecting everyone. The significance of humiliation is context dependent and completely subjective. Yet a failure to quantify humiliation does not prevent its catastrophic ramifications. Whatever you do as a reader, please don’t pity Brad or myself, or any other victim of humiliation. But please change (or consider) your own reaction the next time you witness or unwillingly participate in the humiliation of another.