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firecoloredwater  asked:

Hey Aunt Scripty! So in the world I'm building, one of the cultures has for assorted historical reasons decided that healing/medicine is The Most Important Thing. As a result, all powerful people are involved in medicine in some way (that way may be "I was really good at it as a princess but am now somewhat busy with being a queen" but usually at least former involvement), and anyone with a career in medicine has relatively high status and cultural power. (1/2)

So my question is, what sort of impact would that have on the culture?  What priorities do healthcare workers have that just don’t have the cultural power to be made reality (but presumably would if healthcare and power was basically synonymous)?  I should admit that this world does have magic, but I think that would impact the details of procedures and not so much what’s a priority.  (Or: dear Aunt Scripty, if you ruled the world, what would you do?) (2/2)

Hey there! This is probably one of my favorite questions I’ve ever received on this blog, and it’s a goddamned travesty that I haven’t answered it already. Hop to, Scriptificus!

This, like almost everything, is a double-edged sword. I think there are a few good things about this society: for one, science would be emphasized (assuming they’ve discovered that evidence based treatments are the right path to follow). I think it would lend itself to a very analyticas lsocial structure, and the question “what’s your evidence base for that?” migt get asked a LOT.

However, there’s a real downside to letting doctors run things, which is: doctors can be elitist pricks, especially when given social standing beyond what they’ve earned. This was a huge element in the 1950s thru 1970s, and only really started to turn around relatively recently. Medicine in THIS verse has found its humility, at least a little bit, but in a society where the power of life and death is conflated with political power over society…? This has the potential to go off the rails.

I think what I really want to know about your culture is, who is praised, exactly? Are nurses as exalted as doctors? What about pharmacists? What about nursing aids, or occupational therapists, or X-ray techs? What about midwives–or have doctors abolished them altogether?  Are hospital janitors praised for their contributions, or are they forgotten as the wheels that make the machine turn?

(Just so we’re clear, I think hospitals and medicine in general would fall the fuck apart without allied health professionals and environmental services workers, and kitchen staff and nutritionists, and the ones who  fill the oxygen tanks. These are the heroes of medicine: the ones who make it possible for clinical staff to do their thing.)

I think a medicocracy would make a neat society to consider. Consider both sides, though. Here are some questions I would ask in building your world?

  • Which is more in their interest: the public good by positive measures (nudges, public health initiatives)? Or the public good by experimentation (Tuskegee type experiments)?

  • Has this society embraced the notion of informed consent, or have they adopted another approach (especially for the non-medical ones in society): “Oh, you won’t understand it, so I’ll just do it and you’ll get better”?

  • Who gets to decide when doctors give up on a patient? How have they approached the rationing problem? Do they try to give everyone everything (US model) or do they decide who gets what treatments because they’re Doctors™ ? How does that mindset apply to everyday life?

  • What has been outlawed in the name of public health? Can people still choose to smoke, or is tobacco regulated like cocaine? What about alcohol? Is exercise mandatory? Are body weights mandated “for your own good”? How far does the push  for public benefit get?

  • Are doctors considered fallible by others? What about by doctors themselves?

  • Is your character on the inside of the medicocracy, or the outside? Have they been trained to “keep the faith”, as it were, or to fight the power?

I think if you want more help considering other angles and other questions, @script-a-world​ is probably the blog you want.

Thanks for the absolutely great ask!

xoxo, Aunt Scripty


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