Why don't we challenge figures of authority?
Posted on 8 February 2013 by Freda McEwan
What was the name of the US president who was assassinated in the 1960s? Turns out I don’t know. This is one of the questions testing long-term episodic memory in the Addenbrooke’s Cognitive Examination-Revised. When I was using it to assess older adults with memory problems, some people would suggest ‘Jack Kennedy’.
‘Ah, no,’ I would intone. ‘It was John. Jack was his brother.’ Quite often, I’d add a patronising ‘nearly right though’ and an encouraging grin.
The interesting thing about this is that nobody told me I was wrong. The befuddled older adults no doubt just felt more befuddled and not in a position to argue. But most of the time I’d be doing the test in front of cognitively intact relatives, and there was never a peep from them.
What else did I get wrong that everyone else in the room didn’t point out?
I got a taste of how it felt to be on the other side of the power divide when I was called to be a witness of fact in court. It was the first time I had performed the role, and I felt a bit nervous.
In the waiting room I was pleased to see a friendly young court official giving individualised briefings as to what to expect. She must have attended a communication skills course: she crouched down to your level, smiled and made good eye contact, chunked information, checked regularly for questions, and even had visual aids.
She had a moderately reassuring effect upon me, until we got to the bit about oath taking. She showed me a laminated sheet with two options in large print: swearing by God, or just declaring sincerely.
I don’t believe in God. So, given the choice, I would feel it more principled not to swear something important by him. But the nice young woman just pointed to the top (God) option, and said leadingly ‘you’ll be happy to say that then, will you?’
A flurry of thoughts ensued: should I say no and point to the other option? Why hasn’t she offered it? Will asking make them think I’m a trouble maker? Will the cross examiner spot my non-establishment choice and attempt to blemish my character? I chickened out, and nodded.
But it got me wondering. If I’m too scared to challenge a junior representative of an authority about something I can see written down in front of me, I could start to see what it must be like for my poor patients. No wonder they don’t attempt any corrections when I turn up to quantify their incompetence, stalking into the room with my sheaf of sheets.
Freda McEwan is a specialty trainee in psychiatry in Scotland