Possibly the young hospital doctors deserve everything they get. After all, it's the life that they chose for themselves. Nobody made them do it, and most of them must have had a pretty shrewd idea of what lay ahead from the very first day in medical school, the greatest oxymoron of them all. For medicine and school are antithetical terms. School for the rest of us means broadening our horizons; but the study required to be a doctor is the precise opposite of that. In what it does your brain, medicine comes a narrow second to placing your head under a piledriver. The latter is, to be sure, a little quicker and somewhat more Hammer-horrorish in special effects, but the net result is the same. Encephalectomy.
Why does the medical profession do this to young undergraduates? Why are they forced to know the christian names of every single cell of the body? Why do they spend 23 hours a day force-feeding their brains with vast quantities of useless information which they will never ever need again? If geese were so treated there would be uproar: so why is it acceptable to turn the bright young brains of medical students into cerebral foie gras?
Conditions worsen
And having spent about half a dozen years in the medical school Grand National, in which every jump is Beecher's Brook, they head for the winners enclosure of qualified doctordom, where, incredibly, conditions actually worsen. This happens to nobody else in this world, simply because it wouldn't be possible. For in addition to being (at the outset anyway) extraordinarily brainy, doctors have this wretched thing called a vocation. Bad things, vocations. They cause you to perform stupid and unrewarded deeds; and nobody knows this more than young hospital doctors. Only the truly idiotic, the cretinously supine or the hopelessly vocational would endure for a week what hospital doctors do for years.
And that is only marginally less amazing than that our hospitals do not look as if they are run by Harpo Marx. A fellow can't really complain if he goes into a hospital with a bad case of dandruff and finds himself being given a hysterectomy; and his wife can't really utter a word of disapproval when the doctors treat her ingrowing toenail by removing her prostate. This is the world we have created for hospital doctors; we should not be surprised at the anatomical and surgical improbabilities which result.
So why have the Irish and the British Governments, acting in concert, chosen to block a 48-hour maximum working week for junior hospital doctors for 13 years? Because there aren't enough doctors, as Brian Cowen declared? Or is it because the British and the Irish share a similar (and frankly bizarre) medical culture, with similar highly restrictive and rigorously enforced medical practices, which create extraordinary distortions in the labour market?
Absurd practices
If we were prepared to pay doctors of any age the appropriate money for the god-awful labours of the casualty unit, then there would be no labour shortages and we would not be engaged in the absurdity of expecting 23-year-olds to work a 100-hour week for a handful of groats. But we are not. We want a largely free national health service at point of delivery, but will not pay the necessary money to maintain it; so it is kept going by absurd and archaic work practices which are effectively outlawed in all other areas of employment.
And the medical profession and the political establishment are united on this; the former because it is intensely hierarchical and conservative, and those in its dizzy commanding heights want young doctors to come through the same gruelling mill as they did, no doubt on the same principle that people used to think corporal punishment was good for you - toughened you up. The latter supports this system because it provides grossly underpaid but highly talented and absurdly devoted labour at a cost-per-hour so low that you couldn't employ a teenager to wash dishes for it.
Political perception
The galley-slave culture at the bottom of the legal profession has for generations concealed the true cost of running a medical service. We talk as if access to medical assistance were a natural right. It isn't. It's as much a natural right as a journey on the space shuttle. It has become, within our modern and liberal and welfare-deluded society, a political right, but at public expense, and only up to a point. As Brian Lenihan's experience in the financially real world of American health might remind us, transplants are savagely expensive things. But we have allowed the political perception be created that cost is not an issue in medical treatment.
Far from it not being an issue, it is the primary issue. We could, for example, spend fortunes putting the entire population through annual CAT-scans, thereby saving countless lives, but we don't. In fact, for financial reasons, we run a highly discriminatory health service - the exchequer would simply buckle if the preventative health programmes for women were equally applied to us males. We have fed ourselves a diet of political and economic falsehoods about the real cost of modern medicine; and the young hospital doctors, poor eejits, are the ones who pay the price.