Merriam-Webster dictionary declared ‘gaslighting’ as one of its ‘word of the year’ for 2022 and calls it, ‘the act or practice of grossly misleading someone especially for one’s own advantage’. It further elaborates on the definition of ‘gaslighting’ as, ‘psychological manipulation of a person usually over an extended period of time that causes the victim to question the validity of their own thoughts, perception of reality, or memories and typically leads to confusion, loss of confidence and self-esteem, uncertainty of one’s emotional or mental stability, and a dependency on the perpetrator’ [1]. It largely has a negative connotation and is considered as a driver of forced mistrust and disorientation, working to the advantage of the person gaslighting, and at the peril of one being gaslighted. The term derives its origin from a 1944 psychological thriller American movie, starring Ingrid Bergman and Charles Boyer, based on a 1938 play, with the plot of a husband attempting to ‘gaslight’ his wife into believing that she was insane. He fraudulently dims the gaslights of the house, but keeps telling his wife that the lights are not dimming, thereby creating an element of doubt in her mind that she was going insane and that her perceptions were not reliable. Another movie, in 2021—‘Gaslighting’—had a similar plot with the beau psychologically manipulating and fraudulently misappropriating the girlfriend’s money, who is left questioning her own sanity. Bottomline, which even derives intuitively, if one is disparagingly denigrated over an extended period of time, then one starts having doubts on one’s own capabilities.

‘Gaslighting’ can have medical connotations too with a lot of relevance to the medical profession at large. Very often patient’s symptoms are trivialised and dismissed as a figment of imagination of the patient. All those symptoms that the doctor either does not understand because of lack of personal knowledge, or is unable to find an objective scientific explanation because the science has not yet advanced far enough, are second-guessed, dismissed and attributed to the patient’s imagination. This is a kind of ‘gaslighting’ in medicine. In fact the New York Times, in an article on 28 March, 2022, ran patients’ stories highlighting the problem, which is especially common in women, elderly, and coloured races in America. It garnered over 2800 comments and needless to say, the malady is ubiquitous, transgressing all barriers, even in India.

Another form of ‘gaslighting’, probably more relevant to the medical profession, is the forced demand for altruism. This may be contributing significantly to the high prevalence of burn-out and depression in medical profession. Every single student, the moment he or she enters the hallowed corridors of the medical schools, is constantly exhorted to behave like a ‘God’, as the medical profession is considered to be on the godly pedestal. Altruism is driven into every student and resident doctor, and no matter the situation, in every and which way, the patient has to be kept foremost. They are not allowed to behave like normal, fun-filled, human beings and to have any form of fallibility at all. All this leads to a young, budding doctor to get emotionally exhausted, thereby providing a fertile platform for a burnout, sooner rather than later. All this to my mind is ‘gaslighting’.

The corporatisation of medicine has created another platform for ‘gaslighting’, wherein the corporate masters keep drilling into a young physician’s mind to practice mechanistic, investigation and technology-based, revenue-generating medicine, irrespective of the needs of the patient. Revenue targets are set and monitored on a daily basis, in the garb of investigations and interventions prescribed by each individual doctor. Emoluments are linked to money generated and euphemistically called ‘Performance Linked Payment’ (PLP). This constant drilling of the medical professionals to fill the coffers of the corporate groups is yet another form of ‘gaslighting’, where the individual doctor’s competence is gazed by the number of investigations that he/she can prescribe, and the business in terms of money that he/she generates. If they use their clinical sense and relegate investigative medicine to the second rung, then they are considered second rate antiquated doctors. This is, quite blatantly, influencing of physicians’ mind by repeated interventions to make them believe what their perpetrators (the corporate masters) want them to believe. Besides harming the patients, all these forms of ‘medical gaslighting’ are contributing significantly to the physician burnout. And this means not necessarily a long period of time; ‘medical gaslighting’ can be effective over a short period too. This becomes all the more relevant when one realises the extent of the problem. In a 2015 systematic review and meta-analysis, it was shown that 28.8% (range: 20.9 to 43.2%) of the trainees were suffering from depression or depressive symptoms during their residency days [2]. The matters have been made worse with the recent events like the coronavirus pandemic. Shanafelt et al. found, ‘Overall, 62.8% of physicians had at least 1 manifestation of burn-out in 2021 compared with 38.2% in 2020, 43.9% in 2017, 54.4% in 2014 and 45.5% in 2011 (all p<0.001)’ [3].

During the coronavirus pandemic, the medical professionals were again gaslighted with the altruistic demands of rising to the occasion. They were made to believe that if they take care of their self-interests, or those of their families, then it will amount to immorality and would make them lesser physicians. Just when the industry was exploiting the patients through misinformation for use of untested remedies, like zinc and vitamin C; and other fields of human endeavour had retreated, medical profession was gaslighted into altruism with no safeguards and limits attached. They were neither recognised nor compensated including in situations when they died and sacrificed at the altar of the call of the duty—the families were left to fend for themselves. No effective and sustained protection against violence was provided to the medical professionals and even little safeguards, which came in the wake of the Epidemic Act being enacted during pandemic times, got removed, the moment the act was withdrawn.

It is therefore time that the medical profession realises that we have to treat our young budding doctors as human beings—as human and fallible as any other member of the society. No point putting them on a godly pedestal and extolling them of virtues which may do the Gods pride. All professions are good and should be celebrated as equals. Let the Gods stay in the heaven and let us behave and act as mortal human beings, sans any aspirations or expectations of demi-godly attributes. Let us not pressurize our profession and let us allow our trainees to enjoy and savour being a doctor, rather than being ‘cooked in a pressure cooker’ with societal pressures of idealism—as so very eloquently expounded by the Bollywood movie ‘3 Idiots’.

If we look around, we will find many, a dime a dozen, instances of ‘medical 'gaslighting’, which are doing tremendous harm to the profession. With the recent stupendous advances in ‘artificial intelligence’, simpler, albeit more dangerous, forms of ‘gaslighting’ could take the shape of mischievous fake news and deep fakes—e.g. a celebrity purportedly endorsing an ineffective treatment modality. Let us all be on the guard against this fast expanding malady.

Even the society needs to be eternally vigilant, cognisant and aware of presence of ‘gaslighting’ and understand its implications. So very often it is well-masked and not easy to discern. Classical examples being the cola and fast food industry giants taking out apparently healthy, albeit dubious, options to perpetuate the consumption of their products by masses. Public has been ‘gaslighted’ by the political class too for times immemorial. Lately it has taken gargantuan proportions, with ‘welfarism’ and ‘religion’ being used as tools to brainwash and subjugate the bourgeoisie to vote for them, with each political party, sans a single exception, vying for one-upmanship on this front. We must recognise and call out all these protean kinds of nefarious ‘gaslighting’, lest we become slaves to many masters. Let us all stay chastised by American political scientist and activist Norman Gary Finkelstein’s admonition, ‘People have to liberate themselves, because liberation is not a single act. It's a question of eternal vigilance. Otherwise, you'll just become enslaved by someone else.’