Medicine men are a menace

Exactly a year ago, this column first warned of the menace of the doctor as disciplinarian.

Commenting on the British Medical Association’s mounting stridency, it said: “Each new carefully-crafted sensation simply serves to confirm the impression that the doctors are led by a bunch of rather nasty types, stern advocates of restrictions, bans, regulations, controls, warnings and penal taxation, all directed to secure a world in which every one of us is at last compelled to behave as the BMA wishes.”

I know that’s what I said because I still have a cutting from the British Medical Journal in which its columnist “Scrutator” responds: “I would observe that the BMA leaders Mr Murray castigates do not match the sober, cautious, far-from-nasty doctors I meet in the corridors of BMA House.”

I do not claim prescience. Anyone with eyes to see and ears to hear in the mid-Eighties could see that the health lobby was a growing menace, a force for intolerance that was not so much creeping as galloping. I certainly did not predict – though in retrospect it seems inevitable – that the advent of doctor as preceptor would end up in the High Court with the plaintiff an aggrieved man deprived of a career by the censorious judgment of a medical practitioner.

Mr Peter Baker, 53, had exulted in not merely landing a top job but also in the heady joy of having been headhunted for the post, a signal honour. This was the pinnacle of his long climb as a television sales director. He quit his existing job, accepted the offer from the US broadcasting company NBC, and looked forward to an exciting and fulfilling challenge, not to mention 45,000 a year.

But that was before he met Dr Georges Kaye, a company doctor whose habit of wearing a bow tie ought to have sounded an alarm, signifying as it does, a lack of the modest self-effacement that so becomes a man. Dr Kaye examined Mr Baker and concluded that he was unfit for work. The job was lost, Mr Baker’s dreams lay in ruins. Why? Because he confessed to having drunk a bottle of wine a day on a recent business trip to Monte Carlo. That, in Dr Kaye’s judgment, was evidence of a tendency to “spree drinking” that would interfere with the “crispness of Mr Baker’s thought processes”. To add pomposity to nonsense, Dr Kaye cast a critical eye over Mr Baker’s 14-stone frame and pronounced him “clinically corpulent”.

Such a case was inevitable from the moment doctors ceased to treat patients as fellow sinners whose foibles and frailties were inextricably bound up in their common humanity, and began stridently to lecture them on what they must and must not do to meet with medical approval. Heaven knows how this worm entered the soul of medicine, but once there it began to wreak havoc. Doctors, at one time friends and advisers, became martinets given to drawing up precise guidelines on how we must live, an impertinence reaching its apogee (so far) in the decree that we are permitted only so many egg-sized potatoes a year.

Since these precepts cannot allow for the differences between human beings – some clinically corpulent, others clinically given to offensive neckwear – they are inevitably scientifically unsound. Nowhere is this more true than in the matter of alcohol consumption. People differ widely in their ability to metabolise alcohol and in their reaction to it. One man’s excess is another’s moderation. Doctors, therefore, set their “safe levels” at a point where all, regardless of size, age, sex, or experience, will remain sober. For men, that is 28 “units” a week, the equivalent of two pints of beer a day. For women, it is 21 units.

None of this nonsense would matter if we were truly free to go about our affairs unhindered by the sober, cautious, far-from-nasty doctors who stalk the corridors of the BMA. But, as Mr Baker’s case so vividly illustrates, we enjoy no such freedom. A bottle of wine a day keeps employment at bay. The very notion of medicine being used not to treat sick people, but to pass a rod over their fitness to meet criteria established in response to sociological pressures is, to put it no higher, sinister. If a test must be applied, let it be no more demanding than that set by WC Fields: “Either you’re drunk or your braces are lopsided”.

If Dr Kaye’s guideline were to be applied in France, pretty well the entire working population would be deemed unemployable. In this country, the City would come to a halt, as would the legal profession, the universities, and great swathes of industry. As for the media, well, a press without drink would be like a camel without halitosis, sweeter smelling but profoundly contrary to nature.

Presumably, Mr Baker’s position at NBC has been filled by a teetotaller, or at any rate someone who meets with Dr Kaye’s approval, which would appear to amount to much the same thing. Such a decision could rebound on the company. Never mind the crispness of thought process, when your task in life is selling US television around the world, I would have thought pissed was the only way to be.