Trust Me I’m A Doctor

Trust Me I’m a Doctor is a 26 second viral made for the Helen Bamber Foundation to raise awareness of doctors and psychiatrists involved in torture. Despite torture being outlawed in the 1948 Universal Declaration of Human Rights, the Foundation works with tortured clients from over 80 countries. Medical accomplices have long been recruited by torturers to ensure victims are fit to be abused. The tribunals of the Spanish Inquisition hired ‘physicians’ to keep heretics cognisant through prolonged acts of cruelty because God only accepted confessions from ‘people of sound mind’. Quite what constitutes torture has always been a thorny ethical issue. Is evidence extracted through torture worth the paper it’s written on? What kinds of physical and psychological pressures can you apply before persuasion deteriorates into coercion? Is a doctor who force-feeds ‘a patient’ who has chosen to die of starvation jeopardising the Hippocratic Oath or observing it? The suffragette Emmeline Pankhurst had this to say about the force-feeding of her comrades in 1912:

“Holloway Prison became a place of horror and torment. Sickening scenes of violence took place almost every hour of the day, as doctors went from cell to cell performing their hideous office.”

In 1974, Michael Gaughan died in Parkhurst Prison after 64 days on hunger strike. He was one of many IRA volunteers in British jails demanding political status and repatriation. The pathologist who performed the autopsy declared pneumonia to be the cause of death, but Gaughan’s family claimed the fatal wounding occurred when doctors punctured his lung with a feeding tube. Gaughan’s death triggered contentious debate about the ethics of interrogation; that some forms of medical assistance could be seen as collusion, or even assault if applied against the patient’s will. The US Army force-feeds inmates in the Guantánamo Bay detention camp, and displays photographs of the ergonomically designed chairs with straps and restraints on the Defense Department website.

Torturers don’t want to kill their victims; they want to infantilise them. They use fear to control them and destroy their autonomy, and the methods get ever more sophisticated: enforced nakedness incapacitates, helplessness increases dependency, induced incontinence crushes self-esteem, drug regimes loosen tongues, mind games bewilder, darkness disorientates, sexual degradation humiliates, threats against families terrorise, de-humanisation scars people for life.

The CIA Interrogation Manuals produced in the 1960s and 70s became the benchmark for aspiring torturers around the world. A sophisticated understanding of physiology and psychology is a distinct advantage when trying to break someone. The manuals bask in zen-speak that fetishises the perversity of torture; that nothing is what it seems; that torturer and victim build an interdependent bond; that the threat of the next torture session can be more terrifying than any inflicted violence. Forcing a person into excruciating contortions for hours on end can deliver remarkable psychological insights:

‘The pain which is inflicted upon the detainee from outside of himself may actually intensify his will to resist. But the pain which he feels he inflicts upon himself is more likely to sap his resistance.’

A still from the video ‘Trust Me I’m A Doctor’

Gourevitch & Morris’s book ‘Standard Operating Procedure’ paints a lurid picture of rudderless US military police in Abu Ghraib prison. These innocents abroad were overwhelmed by the pressures of guarding hundreds of Iraqi detainees in squalid conditions under daily mortar bombardment from passing insurgents. Most of the internees were innocent bystanders swept up in mass arrests, and many of the worst tortured were mistaken for other people. The top US brass abrogated responsibility for the prison and the catastrophic breakdown in discipline hemorrhaged in the snap-shots of physical, psychological and sexual abuse that swarmed around the internet. Medical orderlies patched torture victims up for the next session, and attached intravenous drips to bodies of prisoners who had been beaten to death to imply they died of medical complications. At one point the dysfunction becomes so chronic, a hysterical doctor sticks a loaded revolver in the mouth of a prisoner who he accuses of ‘malingering’, only later to discover he is suffering from terminal cancer. Occasional inspections of Abu Ghraib by US generals were a charade. The military police simply put on a ‘dog & pony show’. All privileges (mattresses, clothes, showers) were restored…and then withdrawn once the VIP entourage had moved on. A Red Cross delegation observed that conditions on the maximum security block for high-value prisoners constituted ‘ …gross and systemic violations of the Geneva Conventions tantamount to torture’. But Red Cross reports are bound by confidentiality and can only be issued to the authority under investigation, so even this health care driven organization failed the detainees. Prisoners continued to be denied sleep, chained in stress positions and isolated in blacked-out cells. Most were incoherent and many became suicidal due to extreme psychological trauma.

And who is to say that faced with the invasion of our country, or the rages of a volatile dictator, or the excesses of a corrupt police force, or to save our family from persecution…we might not do the same? In conjunction with the 1961 trial of Adolf Eichmann for war crimes, the Yale University psychologist Stanley Milgram designed an experiment to investigate whether Nazis involved in the Holocaust shared a mutual sense of morality. To explore levels of obedience to authority figures, volunteer ‘teachers’ were easily persuaded to abandon their humanity and give ‘electric shocks’ to volunteer ‘learners’ to make them obey instructions.

Torture does not just happen in the torture chamber. Three million girls between four and ten years old undergo genital mutilation across Africa, the Middle East and Asia every year. The cutting is done with knives, scissors, scalpels, pieces of glass and razor blades by tribal elders, midwives and doctors who seldom use anesthetics and antiseptics. The long-term implications include damage to the reproductive organs, complications in childbirth and psycho-sexual trauma. Children are easy prey to torturers who are respected member of communities and use their status to abuse their ‘duty of care’. Torture is rife in enclosed societies, and educational, religious and welfare institutions close ranks to protect their own. Throughout the 1970s, adolescent patients at the Lake Alice Hospital in New Zealand were routinely punished for ‘misbehaving’ with electroconvulsive therapy and chemical sedation. In 2010 a grand jury indicted a Delaware paediatrician with 471 counts of sexual abuse against 103 children. Parents who made their suspicions known to the local medical council were disregarded because he was such a charismatic consultant. One of the most difficult issues for people abused by authority figures is the betrayal of trust. The trauma for children – and subsequently adults – results in a wide range of mental health issues including depression, substance abuse, self-harming and eating disorders. Torturers control their victims with a cocktail of dependency and rejection, reward and punishment. Abused people live in fear that it will happen again – the knock on the door, the chance meeting in the street – and that they will become abusers too. Cruelty is a symptom of the breakdown in relationships – in families, communities and countries. Many vulnerable people in care homes for the elderly are abused by inadequately trained, overworked, poorly paid staff who are vilified by the media but labour under immense pressures in chronically under-resourced circumstances.

A still from the video

Democracies that sign conventions against torture subcontract their dirty work to countries happy to oblige for favours and rewards. The Blair administration flatly denied knowledge of Binyam Mohamed’s extraordinary rendition to be tortured in Pakistan, Morocco and Afghanistan. After his arrest by the CIA in Pakistan, Binyam maintains that he was flown to Rabat for 18 months and subjected to regular beatings by Moroccan interrogators who asked questions on behalf of the British government. At one of many sessions, a guard sliced Binyam’s genitals with a scalpel, and suggested that cutting off his penis would prevent him breeding any more terrorists. Binyam recorded in his diary that doctors were on hand to check he was okay:

“Doctor No 1 carried a briefcase. ‘You’re all right, aren’t you? But I’m going to say a prayer for you.’ Doctor No 2 gave me an Alka-Seltzer for the pain and asked how it happened. I told him. He looked at my penis as if I was just another patient. ‘Put this cream on it two times a day. Morning and night.’”

In 2009, almost seven years after Binyam’s arrest, the Americans dropped all charges and he returned to the UK. In 2010, the UK Court of Appeal ruled that he had been subjected to cruel, inhuman and degrading treatment by the United States authorities, and ordered the British government to reveal details of MI5 complicity.

In 2010 the Nobel Prize winning watchdog, Physicians for Human Rights published a white paper entitled ‘Experiments in Torture’ charting the involvement of medical personnel in the ‘enhanced interrogation’ techniques of the Bush administration; the euphemism for its post-911 torture programme. Employees of the CIA Office of Medical Services were directed to monitor interrogations of detainees being held in Iraq and collate data that could improve the efficiency and efficacy of information gathering. They studied waterboarding sessions and the susceptibility of subjects to severe pain and the effects of sleep deprivation. In this excerpt from the CIA guidelines on waterboarding, medical personnel are explicitly directed to record:

‘…how long each application (and the entire procedure) lasted, how much water was applied (realizing that much splashes off), how exactly the water was applied, if a seal was achieved, if the naso or oropharynx was filled, what sort of volume was expelled, how long was the break between applications, and how the subject looked between each treatment.’

Thanks to their expert recommendations, potable saline solution is now used instead of tap water because it reduces the risk of contracting pneumonia or hyponatremia, which can lead to brain edema, coma and death. A specially designed gurney enables rapid upright movement of a detainee in case of choking, and a blood oximeter measures vital signs of life. Prior to interrogation, detainees are placed on a liquid diet to soften their vomit, thus reducing the possibility of asphyxiation. A tracheotomy kit is always available in case an airway has to be surgically opened to prevent drowning. One CIA detainee – Khalid Sheik Mohammed – was waterboarded at least 183 times. Sometimes doctors are not directly involved in abuse but turn a blind eye or provide administrative smoke screens. In 2010, nine senior Turkish police officials were convicted of beating a human rights activist to death, and the prison doctor was prosecuted for falsifying medical reports. While we were filming Trust Me I’m A Doctor, a Saudi judge was shopping around for surgeons willing to sever the spinal cord of a prisoner convicted of paralyzing a man in a brawl.

Victims of extreme torture become convinced that their body has betrayed them, and encouraging them to take possession of themselves again is central to recovery. Ironically, our therapists at the Helen Bamber Foundation ask the same questions as the interrogators: “How are you feeling today? Is there something you’d like to tell me?” They have to ‘deconstruct the bad doctor’ and ‘reconstruct the good doctor’, and create a place of safety before survivors will even begin to trust them.

Big thanks to an amazing team who worked on this project with me, and to Radley Yeldar for their unflinching support. You can see the full credits at the end of the video.


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