Amy Eileen Hamm and patient-centered reality

The process is the punishment for outspoken doctors

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By Anonymed (an anonymous Canadian Doctor)

I went through medical school at a time when the woke behemoth was just beginning to bare its teeth. Medical education was increasingly sanctimonious, activist, and anti-intellectual in its outlook, but there was as yet no (explicit) requirement to deny reality. Cultural relativism was rampant, but lip service was still paid to the idea of objective truth.

For a long time medicine’s progressive ideologues hid behind made up terms like “cultural safety” and “cultural competence”, pretending as though these were feel-good, “patient-centered” concepts rather than the ideological subversion they really were. Back then, calling attention to such distortions of language was met with dismissiveness and looks of  counter-revolutionary derision rather than outright cancellation.

It goes without saying that since 2020 the mask has come off. No longer, for example, do we simply learn to care about Indigenous health (which we should) or reflect on the historically fraught relationship Indigenous peoples have had with the medical profession (which we ought to). Students are instead taught that Indigenous health is qualitatively different than that of other citizens’, that “Western” medicine is, at its core, racist, and that the only solution is to “Indigenize” or “decolonize” curricula.

Similarly, while we once learned about sex differences as important elements in risk stratification - repeating ad nauseam that women present differently than men when having a heart attack, etc - students are now taught that really this whole man-woman thing is an anachronistic colonial invention, one meant to foist European prejudices on unwilling subjects in perpetuity.

Way back in 2020 I was sent a screenshot from a UBC medical school exam which featured the question, “Which of the following is a western colonial concept where there are two distinct genders, men and women?”. The correct answer, of course, was “gender binary.” Compared to where we are now, this is almost charming in its banality. The idea that men can become women and vice versa is now taken as iron clad fact in the halls of medical education, and transition itself (social, medical, even surgical) is discussed with the kind of insouciance reserved for nasal sprays and plantars warts. I can't count the number of times I’ve had to sit through a "quality assurance" discussion wherein physicians agonize over whether there is sufficient evidence to recommend daily baby Aspirin to prevent heart disease, but when it comes to transforming a person's entire identity (not to mention body), we seem prepared to take much of it on faith.

Most doctors, I suspect, know deep down that the small number of patients with genuine and refractory gender dysphoria is dwarfed by those caught up in a social contagion that preys on people with real mental health issues and incentivizes others with more than a few narcissistic traits to go around. But we (myself included) are too afraid to say this openly for fear of professional annihilation.

Which brings me to the case of Amy Eileen Hamm, a nurse currently undergoing a public hearing (and hazing) at the hands of the BC College of Nurses and Midwives for stating what all sensible people know to be true: that while every patient, transgender or not, is entitled to compassionate, individualized care, we cannot continue, as a profession and as a society, to put reality up for grabs. Her support for JK Rowling and willingness to point out the reality that men cannot just become women (and certainly cannot lay claim to women’s hard won rights and spaces) has rendered her persona non grata in her profession. To stand and fight despite the lies and abuse this has wrought, takes (forgive the gendered language) a pair of brass balls. If only more of us in medicine, who know implicitly that she’s right and that this is an ideological witch-hunt, had half the stones.

At bottom, this isn’t just a culture war issue. It is also a patient care issue. Be it in nursing or doctoring, health professionals didn’t historically exist to affirm a patient’s beliefs about themselves. It’s our job to help them, and sometimes that requires a lot of skepticism, even if it makes them hate us. This is basic stuff. Even if this were not a consequential civilizational question (which it is), it is devastating that the medical profession has bought into the idea that the only way to help such patients is to affirm, immediately and unequivocally, what in many cases amounts to outright delusion. At the very least, it signals that, from the highest echelons on down, we care more about being seen as progressive than we do about standing up for what is true. This is not patient-centered.

People like Ms. Hamm are doing the work of defending sane, compassionate medicine for the rest of us. In the long run, she will surely be vindicated (as dissenters in the UK and Europe increasingly are), but make no mistake, the process is the punishment. Her connection to her chosen profession will be irreparably tarnished and that alone is a tragedy. I have rationalized countless times why I too haven’t been open and unequivocal about this madness. In the end, it may come down to the fact that people like Ms. Hamm are just better than me. Who knows, but one thing is for sure: she is orders of magnitude better than the ideologues and useful idiots denouncing her.

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Thanks for reading. For more analysis on Canadian medicine from this author, read White coat sanctimonies: We need to talk about medicine

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