Thou shalt joust
Jousting is a medieval term for a contest in which knights on horseback fought with lances.
The term has been imported into medical jargon, where it refers to a derogatory comment/criticism made by a doctor on the work or treatment done by another doctor.
A dystopian description
Dr FAK Niazi gives a rather dramatic opening to his editorial on Jousting.
He stood determined, focused on the target, his grip on the lance tightening just the right amount, aimed toward the enemy warrior with the precision of an excellent marksman. All set to joust, he leaped gallantly toward his opponent. So sure of himself, he wanted the win, and victorious he was. The triumphant doctor, our knight in shining armor, stood tall beside his trophy. Was he dead? He didn’t really care; he had won. The crowd cheered for him as he waved proudly and then stooped forward to reach for the helmet; he wanted to see his face! Who was he? Prince Covid, Sir Typhoid, or the Lord Dengue? He was dying, and a bare murmur could be heard over his last breath: “I am your brother!”
Jousting in the medical profession can be
- Direct verbal: When a doctor pushes the patient to take action against the previous doctor.
- Indirect verbal: When comments like, 'this isn’t what I would’ve done’, are made.
- Body language: Looks of surprise or horror when a patient mentions something about the previous care.
- Written: Entries like- the previous doctor should have asked for advice.
- Written advice: Posting critiques on social media or review websites.
Studies show that doctors are generally dismissive and opine negatively about their colleagues. 67% of comments about other doctors are critical, 29% are supportive, and 4% are neutral.
Whilst the medical professionals can mull over the incidents of jousting that they have witnessed, this article attempts to narrate some correlative stories that could be discussed within the same ambit.
The carpenter, the mason, and the plumber
We often call upon these workers to help us repair and reconstruct our homes. These skilled practitioners usually let out a barrage of invectives about the previous worker. The plumber will point out that the previously laid main pipe is small, the carpenter will suggest that the hinges have been fitted poorly, and the mason will turn up his nose while looking obliquely at the wall. Skill-based individual professions are competitive and unforgiving. When the competition is direct and the difference between the professionals is marginal, the tongue tends to become tart. In a world where a film star can sell education, cars, and pan masala without knowing much about any of them, a snide remark in the way of advertisement might be relatively harmless.
The traffic light
The red light at a junction is a funny snapshot of life. The first arrivals stopped by the red light at a crossing are a bit wistful, and the ones slowing down behind them are impatient. There is relative discipline until the two-wheeler riders run through the gaps and become leaders by opportunism. Even as the light turns orange, the jousting starts in earnest—horns, brakes, and smoke. This is automobile jousting. However, all of you will stand witness to drivers pointing fingers and blaming each other for their lack of skills. If a passerby witnesses this joust, he becomes an involuntary judge. Often, one hears phrases like ‘bank loan car’ and ‘fake licence’. This comparison might appear far-fetched, but medical professionals are trapped in a similar competitive snarl.
The administrator and the applicant
Being a doctor means being educated. In medicine and surgery. However, no syllabus teaches us life skills. As a doctor grows older, a mix of professional knowledge, experience, and hope. However, a childish worldview is often embedded due to the grinding nature of the profession. Seniority brings an ability to joust for top power posts. An administrator in a selectorial capacity has to separate applicants based on observation, information, bias, and merit. However, any administrator has to factor in the jousting in the pre and post-interview information flow. I must admit that facing a jousting group of capable professionals must be an education in itself.
Jousting at the apex
One wonders what ascension to the top post of any medical institution does to the jousting thought process. It is, after all, lonely at the top. One would expect that the principal, the director, the CEO, and the Chief would let go of this process. Any person at the top post is a captain who has to lead the team and be a benevolent head in the absence of obvious competition. However, whilst rare, some of the heads tend to joust against their own team. It is quite funny, but it is a clear sign that a bit of childish behaviour remains within us even at the top.
The future
Men have always jousted, and they will continue to do so. It cuts across professions. However, there has to be an attempt at an individual level to recognise it and maybe try to lock the devil within.
By: Dr Saleh Tabib
