Blaming the Baby — The Language of Medical Infallibility

June 11, 2018
Posted by Jay Livingston

In a recent article at Vox (here), Julia Belluz says, “Only 4 percent of women give birth on their estimated delivery date. . . Medicine is surprisingly bad at measuring the precise age of a fetus or how far along a woman is into her pregnancy.” The rest of the article explains why doctors suck at predicting the date of delivery.

But that’s not the way we talk about it. We don’t say, “The doctor was wrong.” We don’t say, “The doctor made a really bad prediction.” Instead we blame the woman. We say she was “late.”  She “missed her due date,” as though childbirth was something akin to a term paper. I guess if she provides a good excuse, we’ll give her an extension till Friday. 

Or we blame the baby. Look at the opening sentence of the article, “A pregnant friend of mine is due to give birth on Saturday, but as she told me this week, she really has no idea if the baby will come on time, or two weeks from now.” [emphasis added.]
   
The kid is still in the womb, and already we are taking him or her to task for not arriving “on time.”  

It’s not just obstetrics. Talk related to most other areas of medicine also rests on the same charitable assumption of doctor infallibility, especially when the ones doing the talking are doctors. The patient “failed to respond to treatment,” not “the treatment we used didn’t work.”

I caught on to this trick long ago, when I was reviewing the literature on compulsive gamblers. There wasn’t much to review, and most of those accounts were from psychiatrists. One of them said that treating compulsive gamblers was difficult because they “do not make good patients.” At first, that tallied with what I had found. Many of the compulsive gamblers I was listening to had tried psychotherapy without much success. It took me a while see that if you translate this idea out of the language of psychiatric infallibility, it sounds very different: “We psychiatrists have no idea how to cure these guys.”

This way of speaking — the one we frequently use — places the blame for failure on the patient, not the doctor. Those compulsive gamblers don’t make good patients. And babies — don’t get me started. Totally unreliable. They just have no sense of punctuality.