Reviewed by Ian Lipke
Dr Nikki Stamp has written a memoir, a non-fiction form of writing that is like a biography but differs markedly from it. A memoir may be described as a record composed from personal observation and experience. Closely related to, and often confused with, autobiography, a memoir usually differs chiefly in the degree of emphasis placed on external events; whereas writers of autobiography are concerned primarily with themselves as subject matter, writers of memoir are usually persons who have played roles in, or have been close observers of, historical events and whose main purpose is to describe or interpret the events.
Memoir-writing has been available since at least the first century BC when Julius Caesar’s Commentaries on the Gallic Wars offered not only a play-by-play of each battle but also a peek into the mind of one of Rome’s most dynamic leaders.
During the Middle Ages and into the Renaissance, memoirs continued to be written with the aim of interpreting historical events. The gentry — who had the luxuries of free time, literacy, and spare funds — would document the events and machinations of court, as well as the many military crusades. It was the French who particularly excelled, with diplomats, knights, and historians, such as Philippe de Comminnes and Blaise de Montluc, seizing the opportunity to cement their legacy.
From the 17th century, memoirs began to revolve around people rather than events, though typically, the focus was not on the author’s own life but on the people around him. Once again, the French took the lead — namely, Duc de Saint-Simon, who has received literary fame for his penetrating character sketches of the court of Louis XIV.
As time wore on, this elite posse of memoirists came to include noted professionals, such as politicians and businessmen, who wanted to publish accounts of their own public exploits. One thing that all memoirs have in common, however, is that they allow us to get to know a stranger on an intimate level.
It is in this tradition that Dr Nikki Stamp writes her expose of the medical profession. Her book is not a biography – we receive no information about her childhood spent in Perth. There is no account of her life outside of the medical profession. Her focus is narrow and sharp, and confined to a specific topic. She is very well equipped to write about her experiences with surgery and surgical practices as she is one of the few cardiothoracic surgeons at the front of her game. Dr Stamp’s memoir is a caustic account that focuses on the liberties that senior practitioners take with their junior colleagues, as well as on the maladministration of medical practice in this country. It is a convincing, but sorry, story that reveals the inner workings of one of the most admired professions of the modern world.
Nikki Stamp wanted to be a doctor, always. As she grew, so did her love for all aspects of medicine. As we read her memoir, we note her compulsion to make a career out of the hugely demanding specialty of cardiothoracic surgery. But her path was not always strewn with flowers. She supplies compelling evidence of immature behaviour among the senior men of her profession. Faced with enormous challenges and gifted with opportunities denied other men, senior doctors, according to Stamp’s account, choose to pursue activities that in other vocations would be career-destroying. Rife, according to Stamp’s account are sexism, enormous egos and, at times, outright bullying in the operating theatres and bureaucratic mismanagement. If her account is true, it becomes completely understandable that she called an end to her career.
Scrubbed is a revealing account that places the real life and experiences of a surgeon in brutal context. Stamp documents example after example of junior doctors accepting by right of seniority that their more experienced professional colleagues may take carte blanche with their personal lives and professional careers. Whether it is a true expose of the medical profession at its most senior levels is an aspect that only a properly constituted enquiry can discover. Readers will find it necessary to evaluate the character of Stamp herself. (She is not as likeable as she appears to believe). They will need to read accounts reported in newspapers by writers who are usually finely tuned to wavelengths that feature medical matters. An example that might be considered unhelpful where bureaucracies play is the waiting times that ambulances spend while discharging patients into Emergency Rooms. These can be no more than indicative – Stamp raises much more serious issues. She comments:
I don’t know very many doctors who hate medicine or wish to be removed from their patients and the altruism of our profession, but I know plenty who have been broken or damaged by the system. The politics of medicine, however, are what hurt us: the interpersonal nonsense, the inhumane hours and lack of sleep, the separation from our friends and family, the chronic underfunding of some areas of health care, and the futility of fighting the bureaucracy (xiv).
Scrubbed is an important paper that deserves to be published and argued over.
by Dr Nikki Stamp
Allen & Unwin
$26.25; 336 pp