Breast surgeon Ian Paterson has been convicted of 17 counts of “wounding with intent” and three counts of “unlawful wounding” and is now bailed, awaiting sentencing. Many women have come forward to claim compensation, which sounds richly deserved. For years, Paterson performed hundreds of unnecessary or inadequate surgeries, for mainly female patients at the Heart of England NHS Foundation in Birmingham and private clinics run by Spire Healthcare. As the case unfolded, there was a recurring theme of Paterson’s charming bedside manner, but also of his arrogance-cum-“God complex”, which was allowed to go unchecked, despite many concerns and complaints. Sometimes, Paterson would perform unnecessary disfiguring operations. At other times, his signature “cleavage-sparing mastectomy” procedure left patients in greater danger of developing secondary cancers. Reading this, one feels sickened for the patients. There’s a nightmarish feel, almost reminiscent of the 1988 David Cronenberg film Dead Ringers, in which an insane surgeon performed gruesome gynaecological operations. Paterson’s patients were at their most vulnerable and in such a specifically female way. For women, breasts are not just another body part but can be bound up in maternal and sexual identity. Paterson’s patients trusted him, not only with their bodies and lives, but also with their identity and he violated them in the cruellest possible way. Paterson has also undermined general trust in surgeons, not least with this recurring theme of arrogance and “God complex”. These are all too familiar complaints when it comes to surgeons. However, is it always a case of the surgeon being arrogant or could it sometimes be about the solid confidence that you need to do the job? My partner is a surgeon and, from what I’ve gleaned from him and other surgeons, a high level of confidence, in their decisions, in their ability, is crucial. They’re cutting people’s bodies open; they need to be in charge, to make the tough calls. The last thing anyone wants is an unconfident, self-doubting surgeon. This doesn’t mean that surgeons think they know it all. Far from it. Good surgeons not only welcome second opinions, they continue to train, learn new techniques, question and push themselves, like the driven type-A personalities so many of them seem to be. It sounds as though Paterson had stopped all that, if he ever started, instead letting himself slide into a state of self–serving toxicity and, from the sounds of it, lucrative complacency. In someone like Paterson, the “God complex” would emanate not from innate belief, but the self-conviction that, ultimately, their wrongful behaviour is justified. Certain details spring out: the endless operating, the fact that Paterson kept himself apart from colleagues. Not only is performing unnecessary operations simply not done, able surgeons are much more likely to confer over diagnoses, to want to share knowledge and expertise. When someone shies away from doing this, it suggests not so much arrogance as a fear of exposure or a mask for incompetence. None of this excuses how Paterson was allowed to continue mutilating patients or placing them in danger, unhindered, for so long. The culture of secrecy and protection around high-ranking medical professionals must be stamped out. Moreover, I’m sure that some surgeons are just arrogant sods who bully patients. No one is defending that, however good they may be at their jobs. However, this case shouldn’t lead to people automatically distrusting or fearing confident surgeons. While Paterson’s actions are the stuff of nightmares, they also feed straight into a paranoid, 1950s-style narrative of haughty surgeons badgering patients into doing as they’re told. In truth, whatever Paterson was (incompetent? greedy? psychotic?), his crimes clearly demonstrate that he wasn’t on the normal surgeon spectrum, not even at the arrogant end. What Paterson did was criminal and pathological. Source
