Credibility the Cure?
“Here Harry,” S.Q.
Lapius commanded as he tossed the magazine into my lap, “read this.”
I picked up the magazine
and started to read the lines that Lapius had demarcated with a marker.
“Well?” Lapius
said, impatiently.
“Well what?” I
answered. “Read the piece.”
“I am reading the piece,
Simon.”
“But you are not reading
it out loud,” S.Q. Lapius complained.
“But you have already
read it.”
“Of course, but I want
to hear it again.”
I read aloud, from the
Talk of The Town column of the New Yorker Magazine, December 17, 1973. It
was all the more remarkable, because it was only the 14th of
December, 1973. But I read aloud anyway,
“…Credibility is the
modern version of candor. Candor entails truthfulness, but credibility
does not. Credibility is the public relations version of
truthfulness. It is truth’s ‘image’. And, like any other image, it
can be manipulated and faked. Probably none of us should be surprised
when politicians offer us credibility instead of the truth. What is odd
is that audiences sometimes seem to be satisfied…”
“A nice distinction, eh,
Harry,” Lapius said, after I had finished.
“Very nice,” I agreed.
“I always like The New
Yorker,” Lapius confided, as if I didn’t know, since he had me read excerpts such
as this from the different issues of the magazine almost weekly. “It’s
sort of a cerebral decongestant. The New Yorker does to the mind what
Dristan does for the nose. Clears away congestion.”
I found myself
reluctantly forced to agree with Lapius. I enjoyed the distinction drawn
between candor and credibility, between the truth and believability. It
is what I had been trying to put my finger on for months. The nation and
its institutions, for a long time now, from the presidency down, had been floating
trial balloons of credibility. Advertising agencies had been creating
images of credible products to the extent that we have become used to the
appearance of truth in place of truth itself.
I mentioned this to
Lapius. “Yes, Harry, of course. You understand the point. We
have become overly concerned with the representation of truth. I see this
in hospitals all the time. Weekly I am called to the medical records
library to sign out charts. While doing this I must affix my signature to
orders that I neither gave nor sanctioned at the time that a resident on duty
ordered a drug for one of my patients. This is because some higher
accrediting authority has proclaimed for reasons unknown, that the orders of
all resident physicians must be countersigned. This is obvious fraud,
sanctioned by the hospital administrator, the board of trustees, the state and
federal authorities.
“I must also sign all
justifications for prolonged utilization of the beds by patients and back date
my signature. Again, a fraud, sanctioned by the powers that be.”
“The fact is,” Lapius
sighed, “that we have become hypnotized by the appearance of records and
charts, as if, in fact, they represented reality, and we have been coerced to
commit minor perjuries in writing to confirm a demand by authorities that dole
our accreditation, or other inspection agencies. Everyone in the hospital
conspires to perpetrate this type of deception. The end result is that
more money is spent taking care of patient’s charts, than of the patients
themselves.”
“Have you any
suggestions?”
“Yes, of course.
To thine own self be true. The doctors should stop being accessories to
the trickery.”
“But when there is the
possibility that accreditation will be withheld, that third party will withhold
funds.”
“Sheer blackmail, isn’t
it Harry. We are asked to yield ground on our morality and ethics to
satisfy our leaders and bankers. Physicians should decline to become
partners to this chicanery.”
“But Simon, be
reasonable. If we don’t countersign resident physician’s orders, then we
will be called at all hours of the night for minor things that the house
physician can take care of.”
“Wouldn’t it be better
to admit the truth of things. That the resident physician is empowered to
treat hospitalized patients in an emergency.”
“But if you don’t
countersign an order, then the physician may be held liable if a patient
succumbs, not necessarily because of treatment. Your signature is
admission of your responsibility in the case.”
“And if I do sign, than
I am taking responsibility for an act over which I had no authority.
Actually, the system is a fraud. It should admit the truth of
things. That on occasion a resident physician will have to take
responsibility for patient care. That is the bald fact, and no amount of
post dated countersigning alters it. It only alters the appearance of
fact.”
“In other words, come
what may, you opt for candor in place of credibility.”
“Precisely.”
“Then how come you’ve
adjusted our scale so it is shy about three pounds?”
“That’s different,” said S.Q. Lapius.