Tembeling 2.0

Tag: integrity

  • Leading as a Doctor With the Head, Heart, and Soul

    By Jamalludin Ab Rahman

    Leadership in medicine does not begin with a title, an appointment, or a position of authority. It begins the moment a person chooses to serve others through the profession of medicine. From that point onwards, every doctor carries leadership responsibilities, whether visible or not, formal or informal, recognised or unnoticed. Leadership is not something added to a medical career, it is woven into it and practised daily across a lifetime.

    Competence is the head of leadership. A doctor who leads must first be able to do, not merely instruct. Competence allows a leader to think clearly, decide wisely, and act safely. Leadership without competence erodes trust and places others at risk. In the life of a doctor, competence is practised continuously. As a medical student, it is shown through preparation for ward rounds, knowing one’s patient thoroughly, taking responsibility for learning, and helping peers understand without being asked. As a house officer or junior doctor, competence is demonstrated by performing the procedures one expects others to do, personally checking investigations, recognising limitations early, and seeking senior input before harm occurs. As a specialist or senior doctor, competence means remaining clinically relevant, staying updated with evidence, guiding complex cases by example, and making sound decisions during uncertainty. Competence is not optional, it is part of the amanah entrusted to every doctor.

    Compassion is the heart of leadership. Leadership is not about being served, it is about serving. Compassion allows a leader to understand the people they serve before making decisions that affect them. In the daily life of a doctor, compassion begins with patients. It is expressed by listening before deciding, explaining diagnoses and plans even when time is limited, and recognising fear, pain, and uncertainty alongside clinical findings. Compassion extends to colleagues and healthcare workers. It is shown by understanding workload and fatigue, correcting mistakes privately rather than humiliating publicly, supporting nurses and allied health professionals, and fostering a safe working environment. In leadership roles, compassion means understanding the impact of policies on people before implementing change, doing the best sincerely without seeking recognition, and remembering that recognition, if it comes, is only a bonus. Without compassion, leadership becomes mechanical and disconnected from those it is meant to serve.

    Conscience is the soul of leadership. It is the inner compass that keeps a doctor accountable to Allah above all else. Leadership guided by conscience requires moral courage and clarity. In a doctor’s life, conscience is tested in moments of pressure and power. It is practised when patient safety is prioritised despite inconvenience, when one speaks up against unsafe practices, and when ethical principles are upheld even at personal cost. As authority increases, conscience is reflected in resisting misuse of power, acting with integrity when no one is watching, and remaining sincere when recognition or reward is absent. Towards the later stages of leadership roles, conscience is shown by preparing successors, mentoring juniors, and being ready to let go of position willingly. Leadership is temporary, accountability is not.

    Leadership as a doctor is not measured by how long one holds power or how many titles one accumulates. It is measured by how faithfully the trust was carried across a lifetime of service. When competence guides the head, compassion shapes the heart, and conscience anchors the soul, leadership becomes not only effective, but meaningful and sincere. This is leadership that honours the profession, serves humanity, and seeks only the acceptance of Allah.

  • Rosenhan versus Cahalan: The Importance of Proper Records and Methodology in Research

    In the history of psychiatric research, few studies have made an impact as profound as David Rosenhan’s 1973 paper, “On Being Sane in Insane Places.” It challenged the validity of psychiatric diagnosis and exposed the depersonalisation of patients in mental hospitals. Decades later, journalist Susannah Cahalan revisited the same study in her 2019 book, The Great Pretender, only to uncover troubling questions about its accuracy and documentation. Together, their work presents more than a disagreement. It is a reminder that no matter how compelling a message may be, research must rest on a foundation of reliable records and sound methodology.

    Rosenhan’s Experiment

    Rosenhan led a group of eight pseudopatients who each presented themselves at different psychiatric hospitals claiming to hear voices. Once admitted, they behaved entirely normally and reported no further symptoms. Despite this, all were diagnosed with serious mental illnesses, mostly schizophrenia, and were prescribed strong antipsychotic medication. The average hospital stay was 19 days, with one patient held for 52 days. None were identified by staff as imposters, although other patients often suspected the truth.

    In a second phase, a hospital challenged Rosenhan to send more pseudopatients as a test of their ability to detect imposters. Over the following months, the staff identified 41 such individuals. In reality, Rosenhan had sent no one. This revealed how psychiatric labels could cloud judgement and foster error.

    The study was published in Science and quickly became one of the most influential critiques of psychiatry. It led to greater scrutiny of mental health institutions, the development of new diagnostic manuals, and the closure of many asylums.

    Cahalan’s Re-examination

    Susannah Cahalan approached Rosenhan’s study with admiration, but her investigative journey revealed serious flaws. Despite extensive effort, she was only able to locate two of the supposed eight pseudopatients. The others could not be verified. Hospital records, raw data, and detailed transcripts were either missing or had never been released. Even more concerning, one of the individuals who had taken part described their experience positively, in contrast to Rosenhan’s bleak narrative.

    Cahalan also discovered an unpublished manuscript written by Rosenhan. It contained inconsistencies and altered case details, raising concerns that parts of the study may have been exaggerated or fictionalised. This lack of transparency stood in sharp contrast to the study’s enduring influence.

    Scientific Integrity

    Rosenhan’s core argument about the dangers of psychiatric labelling was valid. However, the absence of clear documentation raises questions about the reliability of his findings. The study lacked:

    Clear and replicable methodology Comprehensive records and raw data Transparency in patient selection and hospital procedures

    Scientific research depends on verifiability. Without access to original data, no study can be replicated or properly critiqued. Rosenhan’s failure to preserve and share such records weakens the credibility of what was once considered a foundational piece of psychiatric literature.

    Why This Still Matters

    The debate between Rosenhan and Cahalan is not only about psychiatry. It highlights a broader concern within science: the need for rigorous, accountable research practices. Especially in fields that affect people’s lives so directly, such as mental health, ethical research must be rooted in truth and open to scrutiny.

    Public trust in science depends not only on powerful stories, but on the integrity of the research behind them. Narrative alone cannot replace evidence. Researchers must ensure that their work can withstand examination, even many years after it is published.

    Conclusion

    Rosenhan’s study brought attention to real issues in mental health care, and Cahalan’s investigation reminded us that lasting change must be based on fact, not fiction. Their contrasting accounts demonstrate that bold claims require careful evidence. Proper documentation, transparent methods, and reproducibility are not optional features of good science. They are its very foundation. Without them, the line between truth and assumption becomes dangerously unclear.

    References

    Cahalan, S. (2019). The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness. New York, NY: Grand Central Publishing.

    Rosenhan, D. L. (1973). On being sane in insane places. Science, 179(4070), 250–258. https://doi.org/10.1126/science.179.4070.250

    Spiegel, A. (2008, July 31). On being sane in insane places: Revisiting a classic study. NPR. https://www.npr.org/templates/story/story.php?storyId=93646216

    Carey, B. (2019, November 27). The Rosenhan experiment: On being sane in insane places. The New York Times. https://www.nytimes.com/2019/11/27/books/review/the-great-pretender-susannah-cahalan.html