Psychiatry’s tools: words, which can be as cutting as a knife.
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It’s been a week since I first wrote about the recent Salman Rushdie attack. Sometimes, there is more to consider about such a traumatic episode as time goes on and our fight, freeze, or flight responses die down, such as what struck me over this past week.
Take the stabbing of Salman Rushdie that we covered a week ago. The first time he was stabbed, really multiple times, was by the perpetrator at the usually tranquil Chautauqua Institute, resulting in injuries to his liver, an eye, an arm, and perhaps elsewhere according to early medical reports. These early reports said he was alert and talking, but nothing else has been updated in recent days.
Of course, after he was brought to the emergency room, a surgical knife, or knives, was used to begin to treat and heal his wounds. These knives have received much less media attention, as tends to happen in such traumatic events. We tend to be more attuned and absorbed in the dangers that have occurred and could happen to us, too.
This tale of the 2 knives parallels that of most any tool. We now pay much attention to harmful gun violence, but on occasion they are used for necessary self-defense, as in war or being attacked. Atomic energy can be used for benefits, as in safe energy production, or destruction, as in unnecessary nuclear bombing.
In medicine and psychiatry, medication can have harmful side effects at the same time as the benefits. It is up to us in psychiatry and in everyday life to use our tools—our knowledge and skills—for as much benefit and as little harm as possible. We, of course, operate without knives, but instead with words that can be therapeutic or cutting as we cut through various undue psychological defense mechanisms.
We have seen how harm can be medically helped in the Salman Rushdie injuries, and that is really the emphasis of the Hippocratic oath. There is a clause in the original oath that mentions the proper use of the knife on the human body, in that it should be left to those experts in its medical use:
“I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.”
Most likely, in the time of Hippocrates, Rushdie would have died. Gratefully, we often have the opportunity to redress the physical and psychological traumas we transmit to one another with therapeutic surgery and psychiatry.
Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.