[This was written 13 years ago. Nothing has changed and only gotten worse. See the linked contemporary video commentary at the end.]
Humiliation
Recently I was subjected to a frequent form of humiliation that I fear so many do not recognize and feel that they “deserve.” Of course, that is the whole point of humiliation those that have the power certainly think you deserve it and should take your just desserts and for the most part, know who they can and cannot dish it out to. All of this is mostly on a subconscious level until it is not. Let’s try and bring a bit of it into consciousness.
I was talking to someone who will remain and nameless about my income who I had not seen in a long time. l am a physician. I am supposed to have a very comfortable living. I have the income I have. The range of physician incomes is from the very low to the very high. Low incomes happen more often than you would expect. And low incomes are not something physicians often chose like most. Most people don’t choose them.
It is also true that high incomes come at a high price. But I don’t believe I have chosen my status. I have perused what I think is good medicine and caring for a population of my choosing that deserve medical care like everyone else and I should in return make a good living. Now, I have also learned that “a good living” is certainly a slippery thing. To repeat, if we have lived at all, we know that “good” living can come, as I say, at a very high price.
I take this moment to note an institutional form of humiliation built into capitalism, a sleight of hand that teaches us to have a Pavlovian response to the gross yearly income instead of a balanced quality of life. It was pointed out to me once that Europeans sensibly tend to talk about actual take-home pay whereas we talk about gross pay. We also talk about gross pay and hours worked and workload be dammed. To me, 100,000 dollars and 60 hrs a week is not 100,000 dollars a year, but 75,000 a year as far as your quality of life as you worked a year and a half in a year. I have seen many job offers supposedly for 180,000 a year. As I would assuredly believe that would entail at least 60 hours a week, which would only be 120,000 thousand a year and I have seen ads intimating that one should be raring to go to see 45 patients a day. As far as the workload that could often be considered double workload so now we are up to two and half years' worth of work in one year or equivalent. That is, you are seeing twice the number of patients and working 60 hours a week. To be sure many people “like” doing this. I believe this to be mostly a type of “avoidance” of other areas of life or what some people call an “ism.” But it is whatever it is out and out promoted as normal.
I try and keep these pieces very general and I hesitated to mention the specifics of physician incomes as that in itself can be humiliating. Although the point is many primary care physicians do not make more than an average income. Still many, will think I am whining about an income that is well above average, at times. I could have done it without mentioning the numbers, but I wanted to take the opportunity to educate about the real numbers and precisely to point out that it is all relative. That if you are making 40,000 and really like your job and working 40 hours a week instead of hating your job and making 60k and working 60 hours a week who is better off?
So with that background I was trying to chat with this person, let’s say an old “financial advisor” and I let him know that since the recent downturn in the economy, I had received almost no offers for work outside the office to supplement my income. He looked at me, mentioning nothing of the financial crisis. “Only that many days of work, huh.” He then repeated the phrase a few times and said “There must be something wrong, must be something wrong for a doctor not to be working more than that?” Here in the light of the prior pieces on humiliation, I suggest to the reader that I was now suffering from cognitive shock or that I was in a state of humiliation. I did realize it at the time, but not fully until I was in the car was I able to assess the full extent of the damage. So we are and so we tolerate such put-downs even when we deal with these themes daily. He then informed me of doctors making in the million category and at least 250,000. Of course, the big guys were specialists.
But of course, the point is this was supposed to be a friendly chat with an advisor after a long hiatus. He might catch up on who I was first. But of course, even then you might guess I am not into humiliating people. No, he had pigeonholed me a long time ago as such and such a person, especially I am in the category of “doctor.” And any self-respecting doctor has to make money.
Woe was I also when I emphasized my caring for “addicts” and the wonderful new treatments available. I said I nevertheless lacked access to patients for some reason. This was an ill-advised move. Now, out came what I took was an obvious prejudice towards addicts. I assured this person that it was certainly my belief that every addicted person wanted off drugs. He retreated into mumbles of “I don’t, I don’t know, not my area.”
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