Dear Carlos, 

17% of the medical students have a Narcissistic personality disorder (NPD) and the education may contribute to the sense of entitlement.  This means that they may have cognitive but not emotional empathy. In medicine you have to confront failure often. The failure is a blow to the ego. Your defense mechanism can be a NPD, which goes with a sadistic superego. "Within the cohort of medical professionals, surgeons expressed significantly higher levels of narcissism" from one of the papers. 

Article Malignant narcissism: From fairy tales to harsh reality

Article Addressing Narcissistic Personality Features in the Context ...

Article Mental Health of Medical School Students and the Effects of ...

Article Validation and factor analysis of persian version of the nar...

Article Mirror mirror on the ward, whos the most narcissistic of the...

Dear Carlos and Beatrice,

Personally I saw a Consultant doing the same procedure - Cardiac Catherisation (CC) with nobody to help him even though there were 10 assistants including operating theatre nurses, anesthetist and fluoroscopy monitor technician talking at both lab corners. Then it was a long queue outside for the CC.

This man (48yo) was reeled in on emergency because his Dobutamine Stress Echo (DSE) proved positve. The Consultant was seen very unhappy because of his long queue. so what he did to cut short the cue was to force in the catheter from the right arm of the patient forcefully all the way to the heart. At the elbow side, he pushed to a vein block, the patient was screaming for extra painkiller if not lignocaine or local anaesthesia to stop the pain but this vindictive Consultant, still without the assistants at hand, push through another vein block at the shoulder. By this time, the patient was trying to unstrap his body and trying to pull the catheter out but the Consultant started to shout and the other 10 of them came pushing him down until the catheter stuck straight to his heart that he became so weak that he could not even talk and lie limpless beyond recognition.

If the Medical Officers suffer Narcissistic Personality Disorder (NPD) and this Consultant is behaving like a Sadistic Superego Surgeons (SSS) - we should report them to the Psychiatry Department for follow-up. They not only represent very mentally disturbed medical officers and consultants where others pin their high hopes on these "professionals" to relieve them of any impending pain if not remove them totally. But the hospitals think differently because they are short of "skilled" NPD and SSS. No amount of complaints would ever place these very sick medical "professionals" to their rightful place - Mental Hospital.

It is a pity that the Hippocrates Oath has no meaning at all - Do No Harm - is not the abiding rule but the rule to be reversed and be paid huge salary owing to their disorders at the patients' and government expense.

What can we do as the patient? Nothing, just pray the NPDs and SSSs get their own medicine and start to perform their job as they rightly should. Till then, patients concern and expenses are nothing but experimental grounds for the super losers and super ego.

Even if you know the Sadistic Personality Disorder (SPD) exist especially among the consultant surgeons or their team, there is nothing much you can do, Carlos. Their fraternity will shield them as they would them (not all).

If they have the licence to "kill" - what is there the licence to  "hurt" - they are the UNTOUCHABLES. I do sincerely hope my RG Doctor friends has nothing to do with  NPDs and SPDs whatsoever because from our engagement, they are real healer and great professionals too.

Best Regards - Mariam

Dear Mariam, dear Carlos, 

That kind of "care" is just awful. There are bad people and good people. Surgeons among other doctors are subject to burnout and are then less empathetic. Also greed may cause unwanted behavior. I cite from one of these papers: ...

"these professionals show emotional mismanagement due to lack of subjective recognition of affective experiences. This causes an overflow that physically manifests itself in the absence of any mental processing, resulting eventually in the triad features of the syndrome. Subjectively, we find the origin of this in the “medical ideals” that hinder these professionals from recognizing the above mentioned experiences since they consider them as inadequate for the performance of their work and contravene their values. At the same time, these subjects were busy helping others, but were unable to help themselves or ask for help ."

Article Greed and the medical profession

Article Subjective Aspects of Burnout Syndrome in the Medical Profession

Article Stress and burnout in anaesthesia: A real world problem?

Article Depersonalization or cynicism as dimension of burnout syndro...

Hi Beatrice & Mariam

I appreciate very much your communications and the papers attached. I've observed some NPD doctors and their sense of entittlement, indeed. Of course there are many exceptions and of course there are good and bad people in all professions. Unfortunately, doctors are the untouchables.

The good news: my mother is really better now and her arm is almost normal. I wil take some time to review the documents you kindly send me and then design some effective actions as contributions to the issues herein.

All the best,

Carlos Barrera

Dear Carlos,

I pray your mother will recover fully. While the arm may heal, the trauma, the heart and the fear would remain. Time will heal some but will not forget most. Carlos, go find good doctors, they are around, check their background, ask their patients, you'll be fine. I met, saw and have good relations to only two good ones doctors-consultants-surgeons-friends all role into one out of 100s that I have met and dealt with before and now.

Thanks to Beatrice for providing good materials for Carlos, me and fellow researchers to read and understand the disorders, the greed, the mental exhaustion and all.

I sincerely hope the disorder doctors are being noticed and referred to by their fellow, supervisors, mentors, Professors, Dean, whoever higher and mightier than them to the Psychiatry Department or Mental Department for further review, evaluation, medication and proper management. It is very dangerous to have them around sick patients when they are already sicker themselves wielding scalpel and all with sadistic smile, greed and superman attitude.

Rest assured, they may remain untouchable for as long as their significant others do not notice or prefer to turn the other cheek. Do them far too often, these sick doctors would make great patients to get the Electro Convulsive Therapy (ECT)  touch instantly. There are CCTVs everywhere, mouth cannot be shut, karma is everywhere and God is never blind. What goes around comes around. Just don't fret Carlos. Your mother is fine.

Best regards - Mariam