by Dr. John Crellin

"When you come from a long line of doctors, it's not good enough to be a doctor, you have to be the doctor." (Dr. Eugene Sands, drug-addicted physician in Playing God, 1997)

Fueled by Hollywood films, other areas of popular culture, and by various erudite commentators on health care, perceptions persist that physicians play God. If the "old medical paternalism" is less an issue than it was, say, 20 years ago, other considerations foster the image. The public has many worries over genetics research, germline interventions, reproductive technologies, withdrawal of life support and so on.

Not surprisingly, the phrase "playing God" means different things to different people. One theologian, L.S. Cahill, sees the reference to God as a potential policy strategy: "the phrase appeals to religiously colored moral affections and dispositions to win support for policy decisions, rather than proposing or defending a concept, a principle or a specific analysis of the relevant moral issues."

There is, however, no question that the emotive phrase defines a stereotype — a negative one — of physicians and researchers. Hollywood has reminded us of this a number of times in recent years. For instance, medical colleagues of surgeon Jed Hill (in Malice, 1993) observed his "indulgence in the God complex."

That also applies to Dr. Lawrence Myrick in Extreme Measures (1996, based on a novel by physician Michael Palmer). A renowned neurosurgeon/researcher, Myrick, when on the brink of restoring transected spinal cords recognizes that, at the age of 68, his time is "running out." He shifts to experimenting on humans to find the "medicine no one has ever dreamed of." His subjects include, without their consent, the homeless found on the streets. These men have "no family, nothing, no future," says Myrick. "They are not victims; they are heroes. Because of them millions will walk again." Myrick's protagonist, the idealist young physician, Guy Luthan, responds: "Maybe they are heroes, but they didn't choose to be. You chose for them . . .You can't do that, because you are a doctor and you took an oath. You're not God."

The film Playing God, for all its Hollywood kitsch, at least takes a different tack—the "fall" of a surgeon, Dr. Eugene Sands, through stress. Overwork ("I've been up for 28 hours"); taking drugs ("I don't take drugs to get high. I take drugs to feel normal . . .One day I found myself up and down at the same time. I realised I was not God."); a death on the table while operating "under the influence;" loss of medical license; illegal surgery for a crime boss ("I can make you a doctor again"); cold turkey cure; good triumphs over evil. And a throw away line that applies to many physicians in addition to the estimated 10 per cent of doctors with alcohol and substance abuse: "If you're in the business of saving lives, you'd better start with your own."