Appendix 35 - Torturers

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]


From an article in the New England Journal of Medicine:

It is argued that, similar to military boot camp, sacrifice in residency is integral to the process because it promotes group cohesion, emphasizes congeniality and bonding, solidifies social identity, and teaches humility in preparation for powerful social roles.[397]

Playing Doctor

Greece 1964-1974. According to Amnesty International, people were mercilessly tortured simply for being in possession of a leaflet criticizing the regime. Through official testimony and in-depth interviews with former soldiers in the U.S. supported[398] ESA (Army Police Corps), investigators were able to study "The Education of a Torturer."[399]

A training method model was developed to explain how one could cause people to commit acts, often over long periods of time, that otherwise would be unthinkable for them. Normal people. "One probably cannot train a deranged sadist to be an effective torturer or killer," the authors explain. "He must be in complete control of himself while on the job."

Not so coincidentally, all of the steps in the training model were described as, "part and parcel of elite American military training." They also found college fraternities using similar methods for initiating new members, to ensure their faithfulness to the fraternity's rules and values. Guess how many of the eight steps of torture training apply to medical school:

1) Screening to find the best prospects: normal, well-adjusted people with the physical, intellectual, and in some cases, political attributes necessary for the task....

2) Initiation rites to isolate people from society and introduce them to a new social order, with different rules and values.

3) Elitist attitudes and 'in-group' language, which highlights the differences between the group and the rest of society.... [For example] 'Tea party' meant the beating of a prisoner by a group of military police using their fists, and a 'tea party with toast' meant more severe group beatings using clubs....

4) Techniques to reduce the strain of obedience: Blaming and dehumanizing the victims, so it is less disturbing to harm them.

5) Harassment, the constant physical and psychological intimidation that prevents logical thinking and promotes the instinctive responses needed for acts of inhuman cruelty.

6) Rewards for obedience and punishments for not cooperating.

7) Social modeling by watching other group members commit violent acts and then receive rewards.

8) Systematic desensitization of repugnant acts by gradual exposure to them, so they appear routine and normal despite conflicts with previous moral standards.[400]

 
 

[397] Green, MJ. "What (If Anything) is Wrong with Residency Overwork?" Annals of Internal Medicine 123(1995):512-517.

[398] Blum, W. Killing Hope Monroe, MN: Common Courage Press, 1995:215.

[399] Gibson, JT and M Haritos-Fatouros. "The Education of a Torturer." Psychology Today 20(1986):50-58.

[400] Ibid.

 
 

Reader's Comments

From an article in the New England Journal of Medicine:

It is argued that, similar to military boot camp, sacrifice in residency is integral to the process because it promotes group cohesion, emphasizes congeniality and bonding, solidifies social identity, and teaches humility in preparation for powerful social roles.[397]

This is an interesting quote. Rediency training is like preparing for a war... I would actually venture to say that military boot camp is more humane than residency. My brother recently went through boot camp in the navy. He hated it. However, it only lasted 6-8 weeks. Residency is at least 3 years long! I also found residency an extremely isolating time. I liked most of my fellow residents, but I barely had time to talk to them, much less bond with them. I feel like I really never knew them. Most of the time you are working alone, or with one other person who you probably will not spend any significant amount of time with once your 4 or 6 weeks together are over. You're too tied up in your own misery to have the energy for anyone else. And too exhausted.

-- Emilia Gan, May 1, 2001

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