COMMENT: Physician, heal thyself - Saroop Ijaz - Wednesday, April 13, 2011

The response of the young doctors to go on a strike is a model example of countering stupidity with yet more stupidity. It was a race to the bottom, with both parties displaying extraordinary abilities of being senseless 

“Cheti bohreen ve tabiba nain te main mar gai aan” (hurry physician or else I will die) wrote Bulleh Shah in the 18th century. Bulleh Shah would have probably died waiting, had he been alive a few days ago. The young doctors of Punjab have recently ended a month-long strike. The primary demand of the doctors was for an increase in salary, which is abysmally low given the amount of rigour, energy, time and financial resources spent on becoming a doctor. The demand is hard to take exception to. The management of the public health sector in the country generally, and in Punjab particularly, oscillates between being non-existent and pitiable. The Punjab government adopted its usual strategy when confronted with the problem, that of initially employing mindless, pompous buffoonery and eventually surrendering. The doctors decided to call a province-wide strike when negotiations with the Punjab government proved frustrating and futile.

The fiasco is instructive of exactly how not to resist government incompetence and idiocy while having perfectly legitimate and rational demands. The response of the young doctors to go on a strike (including in emergency rooms) is a model example of countering stupidity with yet more stupidity. It was a race to the bottom, with both parties displaying extraordinary abilities of being senseless. There are two things that remain beyond doubt in this otherwise muddled debacle. Firstly, the young doctors should be paid considerably more than what they are being paid at the moment to give an incentive to the practice of medicine in Pakistan. And secondly, the choice of strategy by the young doctors was appallingly unintelligent.

The young doctors initially had reason and public opinion on their side, and were pitted against an egotistical but less than worthy adversary in the Punjab government, hence this battle was theirs to lose. And lose they did, losing all semblance of sanguinity and public support in the process. The reason for the strike was to protest against the raw treatment meted out to them with the eventual aim of compelling the government to capitulate. The refusal to work in public hospitals including emergency wards conveyed to the government, and more significantly to the general public, that if their demands were not ceded to, they would not be responsible for any deaths of unattended patients. This pathetic and sinister appeal to the basest fears of society is a new low even by our dismal standards. This stratagem meant that their objectives, however righteous they may be, become irrelevant. The nonchalance with which resort was made to being willing accomplices to death and misery is horrifying.

Even if one were to disregard any notions of the Hippocratic Oath and a higher noble calling, still there remains an extremely persuasive case for the practice of medicine being a unique profession. It is implicit in the demand of the young doctors themselves. Doctors perform a highly specialised function and hence are incapable of being substituted en bloc in the short to medium run. This is also one of the key arguments for them being entitled to superior, competitive remuneration. However, this also entails that they are expected to act at least as conscientiously as lesser mortals. I had serious disagreements about the manner and form in which the lawyers’ movement was conducted. In hindsight, the reservations were completely warranted. Nevertheless, the movement had a principle that could be advertised as worth fighting for, rightly or wrongly. The right to be remunerated fairly is a right that should be taken exceptionally seriously. Yet there is something very petty, very philistine about a battle in which the highest principle that can be cited is a marginally increased salary, especially when the collateral damage is dozens of human lives.

The reason put forth by the young doctors for adopting this particular course of action is the foolishness and malice of the Punjab government in handling the whole affair. The Punjab government hideously mishandled the situation — as it usually does — yet a display of insanity by the adversary cannot become a justification for responding with similar lunacy. To be fair, the young doctors are not alone in falling prey to this folly. The imprudence of the foe is deemed to be a license to abandon all reason, and in this particular case all humanity. An example is that after the blasphemy law fatwas and martyrdoms, some liberals proposed to obtain new fatwas against the moronic issuers of the previous fatwas by different ulema to get back at them. What to say of this nauseating strategy of fighting ignorance with ignorance, even if the intention was to mock?

One does not have to be Gramsci or Skocpol to recognise this drivel about no other options as utter nonsense. The young doctors had an array of options to choose from: weekly or daily protests, media campaigns and storming the legislative chamber (which they tried feebly). Instead, they opted for the most ghastly option. Possibly because it was guaranteed to bring about immediate results, but probably because it was the easiest, ignoring that it was also the goriest. This has disturbing implications for the kind of society we have become, and specifically the kind of doctors we are producing. Alexander Pope in An Essay on Criticism writes, “So modern apothecaries, taught the art, by doctor’s bills to play the doctor’s part, bold in the practice of mistaken rules, prescribe, apply and call their masters fool.” In the Children’s Hospital, a poem written by Alfred Tennyson in the 19th century, describing the death of a child named Emmie in a hospital, should be made mandatory reading for our budding doctors.

One would presume that the individual doctor would not deliberately let an ailing patient die to punish the government for its incompetence. However, as a crowd that is precisely what they have done, proving Nietzsche right when he said, “Insanity in individuals is something rare, but in groups, parties, nations and epochs it is the rule.” Let no one take the higher moral ground here. The complicity of every young doctor absent from duty in the deaths of those left unattended cannot be obscured by the established ineptitude of the Punjab government.

It is a shame because with a name reminiscent of the ‘Young Turks’, the protest looked so promising. The infantile doctors have squandered an ideal opportunity to talk about serious medical administration and health policy. I wish for the babyish doctors to get their desired raise and hope the few extra rupees were really worth the innocent lives.

The writer is a lawyer based at Lahore and can be reached at

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