We Know What's Good for You

Our new Foreign Minister, who happens to be our old Prime Minister, was asked about his 'body language' when he attended the swearing in of our new Prime Minister, who happens to be the person who gave our old Prime Minister the push. Our old Prime Minister, or, if you prefer, our new Foreign Minister, realised that this was not a question about his habit of eating his own earwax (that link, by the way, is only for those with a very strong stomach) and suggested that the people asking the questions did not possess degrees in psychiatry and were therefore not in a position to speculate on the states of other people's minds.

After reading an article in Saturday's Sydney Morning Herald about the miners trapped underground in Chile, I can't help wondering whether, even if they did have 'appropriate' qualifications, Mr Rudd should show any respect for the people asking him these kinds of things. If the measure of psychiatrists is the behaviour of those looking after the Chilean miners, the profession should be treated with suspicion at the very least.

Under the heading, "We Know Best: Doctors Tussle with Miners" this is what the article said:

"The honeymoon is over," explains Alberto Iturra, the lead psychologist in the operation to free 33 men trapped 700 metres deep in San Jose mine. As point man for the psychological health of the trapped men, Iturra is at the receiving end of the rage of relatives of the miners, who are upset at the Chilean government's refusal to deliver letters considered "psychologically inappropriate".

The widespread censorship of letters to and from the miners – which the government now claims has ended – acted like a spark to ignite what was already a simmering conflict between family members ever more desperate for their loved ones to be rescued and the government medical team battling to keep the miners psychologically united and working as a group.

"The honeymoon lasted two weeks," said Dr George Diaz, the lead physician in charge of monitoring and maintaining the health of the 33 men. "Now the men are starting to demand certain things and we begin to restrict others. We are measuring each other's strength" ...       

With their health improving and patience expiring after six weeks underground, the 33 miners are restless. On several occasions, they have refused to talk to psychologists, cancelled a series of meetings with doctors, delayed implementation of vaccinations. The men have few problems, however, making their desires clear: cigarettes and wine.

Over the past 10 days, the Chilean government psychological team has ceded to certain demands. Last week, the initial delivery of cigarettes was sent down the 700 metre tube that is essentially a lifeline to the trapped men and widely known as the "umbilical cord".

Monitoring the mental health of the miners is itself a challenge. For the initial two weeks after they were found alive, the miners assented to daily hour-long conference calls, in which psychologists peppered them with questions in an attempt to build a profile of the group and the individual members.

As the miners regained weight and strength, however, their antagonism to the daily sessions increased.… In recent days, the miners have been asked to conduct interviews using a video camera. The videos were then carefully listened to by a team of psychologists, psychiatrists, doctors and nurses.… In an effort to dominate the miners, the team of psychologists led by Mr Iturra has instituted a series of prizes and punishments. When the miners behave well, they are given TV and mood music. Other treats – like images of the outside world – are being held in reserve, as either a carrot or stick, should the miners become unduly feisty.

In a show of strength, the miners have at times refused to listen to psychologists, insisting that they are well. "When that happens, we have to say, 'Okay, you don't want to speak with psychologists? Perfect. That day you get no TV, there is no music – because we administer these things,'" said Dr Diaz. "If they want magazines? Well, then they have to speak to us. This is a daily arm wrestle." After weeks of demands, the miners are now focusing on a few precious requirements – they want daily letters from their families and wine to celebrate Chile's Independence Day today, particularly noteworthy this year as Chile celebrates its bicentennial.

While NASA experts brought to Chile as advisers have recommended sending the wines and withholding the cigarettes, the Chileans have done the opposite, saying the miners have nearly two kilometres of ventilated tunnels to smoke cigarettes and relax (as opposed to the confinement of space travel) while further noting the average miner consumes large quantities of alcohol.… Despite rising tensions, the medical and psychological team is content, and they have received glowing reviews from the team of NASA psychologists. Furthermore, many of the symptoms now being shown by the miners are typical of group dynamics when people are placed in confined and stressful environments for more than six weeks."

I used to think the world was divided into two kinds of people - those who love being looked after and told what to do, and those, like me, who would rather break something in the process of trying to get it to work, rather than be given instructions or help. Reading this article made me realise that there is a third type - those really noxious individuals who think they know best and want to do the looking after of their fellows - in order, as the article so bluntly puts it, to 'dominate them'

I do understand that this team of professionals almost certainly has - or imagines it has - the best of intentions. Its members clearly believe that they are taking care of the health of the miners much better than the miners can take care of themselves. It is the idea that they know best that I find so objectionable. After all, these miners are adults. Until they had the misfortune to end up in this frightful situation, it was entirely their responsibility to decide whether they wanted to smoke or drink wine. It was their right to make mistakes and then, possibly, learn from them. Now, their autonomy has been removed from them by people who have set themselves up as their superiors. Working on the assumption that they have better judgment, the professionals have robbed the miners of their last scraps of freedom. They have instituted 'a series of prizes and punishments', which seems to me an utterly degrading thing to do,  and they have given themselves permission to withhold images of the outside world so as to use them "as either a carrot or stick."

This strategy is outrageous in any circumstance, but it seems particularly so in this situation. Apart from anything else, these poor miners are only in this horrible situation because of the mistakes of other well-qualified professionals - mining engineers. I'll bet those 'experts' displayed the same lofty certainty that they knew exactly what they were doing as they planned and constructed the deep, dark hole in which the miners are now stuck. The miners, having put their lives in those professional hands, believing they knew what they were doing, are probably, if they've got any sense, beginning to question the value of help from those who regard themselves as smarter and more qualified than they. And as the various care teams bask in their self awarded "glowing reviews", soothing themselves with excuses about typical symptoms in such a "stressful environment" does it ever occur to them that their behaviour is probably the major source of that stress?

Can you imagine it? Being stuck down a mine with a bunch of smelly workmates for weeks on end would be bad enough. To add to that a nagging bunch of shrinks and do-gooders, sitting above you - pestering you with nosy questions, controlling what you do and what you're allowed to have - is just out and out cruel. "You don't want to talk to us?" these so-called healers yell down the "umbilical cord", "Okay, you can't have TV - because we administer these things" (I have the idea that they finish that statement off with peals of maniacal laughter, but, of course, I have no proof of that at all)

The poor miners are being reduced to the status of infants, sent off to bed without their so-called 'treats' (and even the concept of 'treats' strikes me as extremely demeaning). They are being handled like prisoners, but they have done absolutely nothing wrong. They have all my sympathy. Just thinking about what they are being subjected to makes me feel apoplectic. And what I can't understand - apart from the perennially baffling issue of why psychiatrists always seem to be the people least able to imagine what it is like to be in the shoes of those they are treating - is where the human rights activists are on this one. They should be protesting about the way these men have been stripped of their dignity. Of course, I know they are pretty fully occupied with protests against the planned stoning and beating of a woman in Iran. That, obviously, is keeping them extremely busy. Sorry, what's that, Sooty - they're not busy with her? Aren't they? What are they doing then? They're what? Oh, they're demonstrating against the Pope are they? Oh yes, of course.