Sunday, October 21, 2012


There has been a lot of attention to the issue of bullying in Canada after this video was posted followed shortly after by the poor teenager taking her life. The video is quite long but you really should watch it to the end.  She obviously made some poor choices but nobody deserves to be put in a place where taking one's life is the only way out.  This has resulted in more action than I can remember ever happening in response to bullying.  The provincial premier has commented and there is talking of new anti-bullying laws.  The police are investigating aspects of the case and the vigilante group Anonymous has posted on line the name and address of the alleged harasser.

As a serial victim of bullying, I am following this with interest.  As a child I was fat, not good at sports, I stuttered and I got good marks, which made me a natural target.  Moreover, my parents instilled in me that fighting was wrong, so I never fought back.  I certainly not the only child bullied at my school; as Ralphie in A Christmas Story observed society was divided into bullies, toadies and the bullied.
This was accepted as part of the natural order of things as a child.  There was always somebody weaker than you to whom you could be a bully or the toady to a bully.  Bullying could be physical or was often psychological, teasing and excluding from activities.

When I took ethology (animal behaviour) in university, it all made sense.  Human as everybody, except Republicans, know are primates.  Most of the higher primates have strong pecking orders with one dominant male and female; the rest of the tribe neatly ordered each one dominant over the one below.  We are possibly more intelligent than our chimpanzee and gorilla cousins and have evolved a more complex society.  The pecking orders still exist in the smaller divisions of our society and especially in our children and adolescents.  Bullying is unfortunately just the manifestation of our baser primate dominant-submissive relationships.  That doesn't necessary condone it, but it does explain it.  Much bullying goes beyond what is necessary for our inner primate and many of our natural alpha males and females live their life without having having to bully at all.

Anyway most of us down the dominance chain, learned our place we stayed out of the way of the bullies, toadied when necessary and that was how we survived childhood and adolescence.  In junior high and high school with more of us, we were able to form cliques where those of us in the lower or less high social stratas grouped in order to mutually shelter us from the alpha males and females.  These cliques often had their own social strata.

Teachers were often bullies themselves and quite often enabled bullies.  I remember in junior high, one of the track stars punched a projector nerd in the face.  Normally that would have resulted in a suspension from school, but that would have hurt our school's chance of winning the city track meet.  Therefore the principal announced that while what the track star had done was wrong, the service to the school he provided by running fast mitigated his crime.  (Our school didn't win the city championship that year....karma?).  There was also in our school a young man who was hated universally by both teachers and students.  I'm not sure why we all hated him; he was short and a little mouthy but that is hardly a reason.  I wonder now if his mouthiness wasn't just his way of dealing with how we dealt with him.  He moved away after a year.

Quite a while ago our high school class had it's 25th year reunion.  I was talking to the guy who organized the reunion and he was telling me about a friend of mine from high school who didn't come to reunion.  My old friend is now a professor at the local university.  When the organizer phoned the professor up to invite him to the reunion, the professor angrily told him never to try contacting him again.  A few years later, I was having beers with another friend I have known since Grade 5 and told him that story.  "Do you not remember," said my friend, "how badly all of us were treated in high school?"  I obviously had never thought this over or was perhaps more accepting of my place in society.

University seemed a reprieve from the whole tribal culture.  UBC where I went was not a big jock school, most of us were pretty ordinary nerds.  (I told my kids that Revenge of the Nerds is loosely based on my career but it really wasn't like that much)  What bullying went on in University was more of the psychological type.  There was of course hazing in the residence where I lived but this was fairly benign and we thought that this was something that brought us together as a tribe. Residence life was in some ways quite tribal but in a nicer way if you were prepared to accept that ways of the tribe. I never thought about how people who didn't want to accept the ways of the tribe lived.   Some professors and lab instructors were bullies but we worked around them.

Eventually I went to medical school.  I remember our first day, the Dean standing in front of us, telling us all how special we all were and how we were finally joining the exclusive brotherhood of medicine.  I had no idea I was about to enter a world of bullying worse than the worst high school, lasting 9 years (with a three year break for general practice).  Bullying and intimidation were the mainstays of teaching and patient care in that time.  This came from the super-competitive other students, professors, residents and nurses.  We sometimes got a sense of joy and relief watching another student being humiliated at rounds or teaching sessions; we all knew it could (and would) easily be us on the hot seat.  5 years ago we had our 25th reunion.  I always thought we had a really close class but even though the reunion was in Vancouver where a lot of the class had ended up, only 50 of 90 graduates attended.  I was astounded that people wouldn't at least come to part of an event that was taking place in their home town but then I realized that medical school may not have been the nicest time for many of them and that it may have been some of their classmates who contributed to that experience.

Internship and residency wasn't much better except that we now had medical students to pick on and as we got higher up the chain more lower level residents to deal with.  In fact the knowledge that we were now doctors and were getting paid to do what we did served to turn up the heat.  Anaesthesia was a little less hierarchical  (an internal medicine residents was amazed that as a senior resident, I took the same amount of call as the junior residents);  we only had to deal with OR nurses, staffmen and surgeons.  And, of course to remind us of what we were missing, 6 months of internal medicine.

I remember telling someone about what medical school and residency was like.  She was incredulous, "Aren't doctors caring, compassionate people?"  she asked.

Great Zs has blogged about bullying in training programs

The culture of bullying and intimidation never really ended with becoming a consultant.  I still think of the culture of blame I lived through at the Centre of Excellence.  If things have improved for me, it is merely that I am so close to being an alpha male, as to be immune to all but the most malignant bullies.  One of the problems with the whole culture of intimidation which still exists in medicine is that sometimes the only way to get anything done in a timely or reliable fashion is to go into bully mode yourself.   A medical school classmate of mine now a urologist observed a few years ago while we were drinking beers, that he likes to have the staff "slightly" afraid of him.  I was a little shocked but could sort of see where he was coming from. So many bullies in medicine bully to their advantage and quite a few of them have moved themselves into a position that no matter how much the hospital talks about respect and anti-intimidation measures, you know they are never going to be called onto the carpet.

I should have a snappy conclusion to this but I don't.   I am not sure what I went through or what others went through is as bad as it is today.  I am not sure how getting a wedgy relates  to having your boobs displayed on Facebook.  Thinking back about the school and playground bullying and the workplace bullying I experienced, it is hard to imagine having been able to tolerate the workplace bullying without having first had to deal with the play ground bullying.  Dare I say, it built character?  Bullying is in our nature, we can pass laws, hold workshops,  education campaigns and all we are going to do is shift the method of bullying.

We are after all just apes.

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