Don’t think you’re a victim? You may be the victimizer.

Let’s talk about cycles of abuse. Sexual abuse. Domestic violence. Human rights violations. Why does this stuff continue? Why does a woman end up dating a violent man and then another violent man over and over again. Why does incest pass on from generation to generation? Why are some countries plagued with human rights violations decade after decade? How can we stop the abuse? Oppressors won’t apologize spontaneously. Change depends on the victims. Here’s the problem: victims who don’t realize they’re victims are at high risk of becoming victimizers—thus perpetuating the cycle of abuse.

In the history of human rights abuse, I’m fascinated by what was once normal. Slavery and segregation. Women denied the vote. Only men could be doctors. All normal. How did we normalize what’s totally unacceptable today? Common practice. If everyone’s doing it then it must be okay. The younger generation inherits the beliefs of the older generation. Until one day someone disagrees. 

People with new ideas are often ridiculed or vilified. Sometimes they’re killed. Until suddenly everyone supports the heretic-turned-hero. 

Arthur Schopenhauer, a German philosopher, once stated: All truth passes through three stages. First, it’s ridiculed. Second, it’s violently opposed. Third, it’s accepted as being self-evident.

The United Nations Declaration of Human Rights guides us toward right behavior. Yet human rights violations continue. In poor countries with dictators and right down the street within our very own hospitals. Institutional bullying and abuse of doctors and nurses trickles right down onto patients. Health care human rights abuse—it’s an oxymoron. Yet every day in first-world hospitals our doctors are working 28+ hour shifts and 100+ hour work weeks, many times without adequate food or bathroom breaks. Some docs are so sleep deprived they start hallucinating and having seizures at work! Common practice. Normal. But it’s not really normal. Is it? 

Why do human rights violations persist in our hospitals? Maybe it’s because victims don’t consider themselves victims. This is how we train doctors. Right? Sleep deprivation is a torture technique condemned by the United Nations, yet it’s also a medical tradition in American hospitals. I’ve been told tradition is just a bad idea held by a lot of people for a really long time. So why not change the tradition? What’s stopping us?

Stockholm syndrome maintains these cycles of abuse. It’s a condition in which victims develop empathy for their captors. Somehow, in a weird way, they support their oppressors. Call attention to their abuse and victims defend it. Docs with Stockholm syndrome fight to maintain antiquated medical traditions rampant with human rights violations. Why? To save us from future generations of lazy doctors, they warn:

Let’s not turn medicine into some coddling group hug where anyone with a brain can get through.

Physicians who complain about bullying are just spoiled brats and crybabies who are not cut out for a profession that has individual lives in the balance.

Younger docs living on trust funds just want to be treated like special snowflakes.

The newer generation of physicians is emotionally weaker and more likely to succumb to suicide.  

I just hope when I have a problem that I’m lucky enough to have one of the cold-hearted, knowledgable, and tough physicians, not a crybaby taking care of me.

Is it possible that some petunias tap danced into medicine ignorant of the fact that life is hard?

In med school, I was called a flower child, I was ridiculed for crying with patients and was the brunt of many jokes for caring so deeply about my psych patients in particular. Years later after opening an ideal clinic (and helping hundreds of docs do the same), I was invited to deliver a keynote on how to create an ideal medical clinic. Check out the various comment cards after my speech:

She’s a nut. *  Thoroughly enjoyed her talk and will start a similar practice. * Too ideal. * Excellent and extremely informative. * Complete waste of time. * Charming, sweet, encouraging, and completely impractical. * Realistic insightful, and quite revealing about human nature. Excellent and so simple. * Totally unreal. 

My favorite physician feedback: “Oh my! Love and peace! No help at all with reality.” Fact: patients come to us for love, peace, hope, and healing. That is the reality. 

Truth passes through ridicule on its way to acceptance. So I accept that some doctors are on their way to embracing a more humane health care system amid their attacks on me, my patients, and those of us who are actually creating innovative medical models of the future. Remember: “Those who say it can’t be done should get out of the way of those doing it”

So tell the truth: Do you want a cold-hearted physician or a crybaby? If you think these are your only options, maybe you’re a victim too.

Liberate yourself from the abuse. Here’s how.

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Pamela Wible, M.D., reports on human rights violations in medicine. She is author of Physician Suicide Letters—Answered. View her TEDMED talk Why doctors kill themselves.