Article Text

Download PDFPDF

Eyewitness in Erewhon academic hospital
  1. I de Beaufort,
  2. F Meulenberg
  1. Erasmus MC/University Medical Center, Department of Medical Ethics and Philosophy of Medicine, Rotterdam, The Netherlands
  1. Correspondence to Inez de Beaufort, Professor of Health Care Ethics, Erasmus MC/University Medical Center, Department of Medical Ethics and Philosophy of Medicine, PO Box 2040, 3000 CA Rotterdam, The Netherlands; i.debeaufort{at}erasmusmc.nl

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

PART 8: WUTHERING ETHICS

You aren't too smart, are you? I like that in a man. (From Body Heat)

Claire's parents are bewildered when Sarah, in her careful, direct but not harsh way, tells them what has happened. “What do you mean murdered? Here? In this hospital? Good grief. For years we cared for our fragile girl. Only because we got doggone tired of the caring and finally accepted the idea that she would be better off in the nursing home did we let her go. And now? You would think a sick person is safe in here.” The mother is crying, the father staring, both in shock. Then Captain Furillo, apologising profusely for having to do it, questions them. He doesn't get much information. No, nothing particular had caught their attention. Yes, of course she was depressed, off and on. What do you think? She got MS when she was 19. Yes, the doctor visited her regularly. He prescribed antidepressants. No, they didn't know whether she took them as she was supposed to. It seemed to help. No, of course she had no enemies.

The deafening sound of the fire alarm disturbs everyone but nobody panics or undertakes any particular action. It is the biannual evacuation drill in which the department—without having consulted the ethicists—refuses to participate.

Gordon McIntyre: “Let me think. Is a predisposition for monogamy an enhanceable characteristic? Sounds suitable for the Singapore conference. I just happened to read a fascinating guide on this subject, Monogamy for the advanced.”

“Yes, there must be a difference between beginners and the advanced.” Like many beautiful women, Laura Vandeveer is able to hide her dyed-in-the-wool irony behind a varnish of charm, impenetrable for men. Sheer impotence. Of men of course.

“Well, I will be only too glad to assist Jody,” Gordon suggests, as usual both cordial and obtrusive.

“What is your own presentation about?” Laura inquires quasi-politely.

“I will present an overview of ethicists' diseases.” Gordon enjoys surprising moves, particularly their effect on his audience.

“Ethicists' diseases? What is there but stress and professional envy?”

“Well, let me enlighten you: there is casuistritis, binge-philosophising, Harrisitis complex, Ross' syndrome, principlitis seriosa also called B&C disease, argumentorrhoea, intuitosis, empirical mood swings, post-traumatic IRB stress, stroke of moral luck, heuristiculitis, existential doubtism, Rawls' disease, and Millinoma. And the worst of it is, all are extremely contagious. Just a few patients and you have an epidemic on your hands.”

“No cures, I suppose?”

“No, the cure is usually to opt for another disease. And if it's any comfort, you may suffer from wuthering symptoms, be unhappy, have rashes, itches, suffer from tiredness, burning eyes, depressive moods, and other discomfort, but none of the diseases is fatal.”

“It is quiet today.” Sven points to the dual-colour telephone in the clinic, which has been silent for hours.

“I presume the doctors can hold their own; after all, they are professionals,” Laura comments.

“My dear,”—Gordon sounds admonitory—“let me assure you that healthcare is far too important to leave to doctors.”

“The best mind is a clear mind.”

“Who has a clear mind, moron?”

The hospital world is neatly ordered. Ethicists ethicise, doctors doctor, nurses nurse, patients suffer, goldfish swim (till they die) and polishers polish, as Ishmael does while listening to Kate Bush's debut album. Nurses Jake Cummings and his elderly colleague Gwen Loyd stand at the counter, gossipping about patients, of course. Stirring her coffee, Gwen asks, “Have you already seen the athlete?”

“The one that was brought in yesterday? Yep.”

“Gosh, what a body. A torso like a god, a statue, a true Viking, the muscles on that guy, and shaved, you know, over his whole body. I wouldn't mind washing him every day. What's wrong with him? Beside the fact that he doesn't seem too smart. I like that in a man.”

“Don't you know him? He was on the Olympic team for Beijing, a celebrity in the world of athletes. The tabloids were full of stories about him. He apparently used all kinds of muscle enhancers, hormones—testosterone, to be precise, I think even a cocktail of steroids. Well, it went wrong.”

Gwen, not interested in sports, nor a tabloid addict, is shocked. “Too bad, serves him right, I mean, one shouldn't, it isn't fair. Sports is about your own performance, about training.”

Jake, grinning: “Do you drink coffee before exams?”

“Of course, not only before exams.”

“Need I say more. His cocktail is his coffee.”

“But caffeine is legal.”

“I know, but it doesn't change the underlying intention: you want to perform better.”

“Come on, it's not the same. He was cheating, I wasn't.”

“It depends on your definition of cheating. Do you use make-up? Do you have a push-up bra?”

“Of course I use make-up. And my bra is none of your business, Jake Cummings.”

“That's an answer. So you admit to enhancing your looks by artificial means?”

“Guilty as charged. But make-up is legal. And so are push-up bras, if, I say if, I were to wear them. Besides, my coffee and make-up do not endanger my health. They may be artificial but they are safe. Bras in particular. And yes, I wear glasses, at my age one can't read without them, but surely that doesn't imply that an athlete is justified in taking illegal drugs.”

“I don't know, how about Prozac, Ritalin, Viagra? Everybody is depressed, so you help. I think Gordon could use some Ritalin, though he'd probably prefer Viagra. Who is to say, well, your sexual performance is pretty adequate, so no Viagra for you?”

“I have certainly no opinion on your performance, nor do I intend to develop one. But this guy, I mean, he has taken huge risks with his career and his health. It isn't worth it.”

“He thought it was.”

“It's the pressure, to excel, to be perfect, to have a perfect body, a perfect temper, no flaws allowed, nose jobs, boob jobs, facelifts, energy pills, botoxification, tampering with your health for the sake of perfection. It's stupid. And sad. The strain must have been huge. Society will not accept less, people think they are worthless unless they improve. What is wrong with good old natural us, with accepting one's imperfection?”

“I seem to remember that a few minutes ago you were rather enthusiastic about his body.”

“Well, yes, but then I thought it was sheer discipline and training. No unnatural tricks!”

“Let's grab a coffee, shall we, before we visit artificial Arnold Schwarzenegger.”

“No more coffee for me, I think.”

“We'll probably never agree, well, unless…”

Suddenly the air is filled with yells attracting everyone's attention. For one second Gwen thinks: the drill wasn't fake, it was real—what's fake and what's real anyway?—but she has heard Jake and looks at him with slightly narrowed eyes: “Unless what?”

“Unless we call the Eminent Ethicists. They will solve the problem raised by our athlete. Well, at least, they get paid to know. Maybe that new drug, Vitaletix, can enhance ethical performance. The research is promising.”

“No, please, don't do that to me—”

Jake walks away laughing. “I will call them, unless you confess about the bra.”

Shaking her head, Gwen watches him walk away, till the mounting noise requires her immediate attention. The noise comes from a big heavyset man with an disorderly beard. A tramp? A psychiatric patient? Trash in human form? With a resonant voice he enunciates his—what? Opinions? Stream of ideas? Muddle-headedness? “Here come the complainers marching in … what complaining? You have a roof over your head, soft drinks in the fridge, a fridge for the drinks, a warm bed, a toilet, television … and even then it is not good enough … not happy? As if doctors can do something about that. I'm not happy, do you hear me? Tramps rarely are. Booze, yes that makes me happy … well, at least less unhappy. You, colony of whiners, you think you have a right to the roof and the coke and the happiness. You glorious bastards. But happiness has nothing to do with rights and justice … nasty, short and brutish … and then you die … they cannot change that in here. The story of our life is never an autobiography, always a novel.”

“Call security,” Gwen hisses.

“They perform miracles: clone sheep, send people to Mars, put implants in brains—I know a few candidates for that treatment, but no one consults me—mobile phones, vaccinations against virtually everything, well except bird flu and HIV. Clever? doctors? What they can't do: curing an ordinary cold, have they found something against bedsores, against sweaty feet …? The most extraordinary diseases have patient societies … I hereby found the Society for Tramps with Cold and Sweaty Feet (plural—one sweaty foot does not qualify) … which also cares for people with bedsores, even though we don't suffer from them ourselves, as for us lying down is also very hard.” Like a senior rapper, he expresses his discord with the world, reciting with an almost professional diction.

“Can you make sense of it?” Gwen asks Sarah.

“No, nonsense on stilts.” Sarah is silent for a while, then mutters, smiling, “But I know someone who can have a serious conversation with him on an equal basis! He will be thrilled.”

Footnotes

  • Competing interests None.

  • Provenance and peer review Commissioned; not externally peer reviewed.