Watchman Syndrome: Why do people die on the doorsteps of hospitals
Olga Lukinskaya
A couple of days ago, a resident of Yekaterinburg it became bad on the street, in front of passersby she died. The cause of death has not yet been reported, but the case boomed all over the country: it all happened two steps from the city hospital. Eyewitnesses ran there and asked for help, but the receptionist answered in a tired tone that "there was enough of their own affairs." This conversation was recorded on video, it was spread on social networks, and yesterday a message appeared that a criminal case had been opened on the failure to provide medical assistance.
This case is not a precedent, it has already happened, and more than once. Many people remember a police officer who refused to help the victim of domestic violence with the wording "if he kills you, we will definitely leave and describe the corpse"; A woman who called the police, a few minutes later, was killed by her former partner. Police Major Natalia Bashkatova was charged with negligence, but the article could be replaced with a more serious crime.
Such cases are becoming more and more common: when everyone has a smartphone, the ability to record audio and video and instant access to the Internet, it becomes very easy to fix violations. The result - at least notoriety, like that of the employee of the registry, who attacked the patient with his fists in the same Yekaterinburg. Maximum - dismissal, administrative or even criminal case, court, broken careers and, possibly, families; not to mention the fact that it is not clear how to live on and look into your own eyes, knowing that another person died or suffered because of your inaction. Why do people not learn from the mistakes of others and this continues to happen?
Perhaps the reason for this is unloved work, where there is no career growth or praise from the authorities, but you don’t want to disturb the superiors once again - then suddenly you have to work overtime. Perhaps - the reluctance to stand out: when colleagues only do that they drink tea and shift pieces of paper, without taking the initiative even in emergency situations, I don’t want to be the first. And there is also the fear of responsibility and the desire to pass it on to others (even under the condition that sooner or later they will have to answer for their actions).
But one cannot say that in medicine one's own negative experience does not become a lesson - on the contrary, such a dismissal and unwillingness to help may be dictated by the consequences of the initiative once taken. After the accusation of Elena Misyurina in the death of a patient, many began to predict that doctors would simply stop taking risks and would not take on complicated procedures in order to save their lives. Misyurinu was acquitted, but before and after this loud case, there were trials for medical errors, for example, in Voronezh and Nizhny Novgorod. Doctors are between two fires: it is impossible not to help, but it is dangerous to give it - if something goes wrong (and the risk cannot be ruled out), you can be in the dock.
It seems that this is still a big deal - to make the public atmosphere more humane, and medicine - more qualified.
According to psychotherapist Amina Nazaralieva, the coldness and detachment of hospital administrators and clinics is a cumulative result of burnout (due to low wages, heavy workload, repetitive work) and what is sometimes called watchman syndrome. This is not a syndrome in the medical sense, but a pattern of behavior characteristic of people endowed with a little power — for example, working as watchmen, guards, and receptionists. At the same time, a person is trying to assert himself at the expense of using this power, to show who is in charge here - and therefore, not to be led by the begging.
Perhaps, in situations similar to Yekaterinburg, another social problem becomes visible: the distrust of all to all. In the end, when help is needed by friends or colleagues, people are often not afraid to take the initiative and actively try. When it comes to strangers, everything is different: in Russia they trust neither each other nor people in uniform (the first follows from the last). Nazaralieva notes that the hospital could simply not believe the words that a man is dying on the threshold.
According to the theory of small cases, you can raise even more noise, shoot all disputable situations on video, publish them and hope that something will change. To arrange training in ethical communication for everyone who works with people. At work, if you are a manager, make sure that employees are praised and that they have the strength and time to communicate with real people. But it seems that this is still a big deal - to make the public atmosphere more humane, and medicine - more qualified. Then, falling on the street, we will have the right to hope for salvation.
Photo: Sykwong - stock.adobe.com