It plays out like a modern-day digital horror movie. On my social media feed, a snippet of a horribly sad drama catches my eye: A young woman, devastated and paralyzed by an unimaginable tragedy, has taken the lives of her own children. She had previously been under medical care, presenting with a complex psychiatric history that navigated the difficult waters often met with multiple therapies: antidepressants, anti-anxiety agents, and various adjustments over time.
Let me be clear: This is not an attempt to analyze or dissect this specific case. I do not know its full intricacies. But what sent a chill down my spine was not just the tragedy itself; it was what happened next in the courtroom.
A young physician takes the stand. Under a hostile, unsparing cross-examination, they are grilled on the minutiae of medical care. The questioning demands absolute certainties: Describe serotonin reuptake inhibitors. Should they be contraindicated in patients with bipolar disorder? Tell us about serotonin. With limited time, under blinding lights, in an intimidating courtroom, the young doctor tries to explain the nuanced, probabilistic reality of clinical psychopharmacology. But outside those doors, the real terror unfolds in the comments section below the post. Hundreds of voices cry out that she belongs in prison and that the whole medical field is just in it for the money.
Where does this immense, visceral hostility come from? Don’t people know that the vast majority of physicians enter this grueling field at the cost of immense personal sacrifice? We give up our youth, our sleep, and often our peace of mind to study, to serve, and to approach human suffering using the highest standards of applicable knowledge available to humankind. Why, then, is there so much hatred and anger directed toward the very people trying to heal? Do critics not realize that in a catastrophic tragedy like this, the devastation ripples outward? Not only have innocent lives been shattered, but young physicians, who have spent decades training to help, are forever altered, traumatized by an adversarial system that treats healing like a premeditated crime.
The public perception of medicine often exists in a fantasy realm of absolute certainty. But the reality on the ground is starkly different. Most medical and psychiatric conditions are inherently unclear in their early or evolving nature, and we simply apply and approximate our best knowledge to alleviate profound human suffering. Cross-examining complex clinical decisions in rapid-fire intervals does not remotely reflect the real-world environment in which those decisions were made. A complete prediction of human behavior or the unpredictable trajectory of a pathology is impossible in medicine. All we can ever do is apply the best available patterns of disease, coupled with clinical judgment, while navigating human freedom, choice, and countless external variables that no clinician can fully control.
Why must our default cultural setting when tragedy strikes be a witch hunt? When a catastrophic outcome occurs, the rush to find a villain destroys more lives without solving the underlying human pain. Instead of hostile cross-examinations designed to trap and humiliate, we should strive for a more cooperative, objective experience. One that seeks to decipher facts rather than assign blame, and one that works to heal rather than further the cycle of suffering.
Farid Sabet-Sharghi is a psychiatrist.
