We often think of doctors as the most compassionate people in society, but the truth is, their job also demands something unusual — the ability to detach.
Imagine being in surgery, holding a scalpel, and cutting into someone you reassured just hours before.
To get through that moment, a doctor has to treat the body as something to fix, not as the person they know.
It sounds harsh, even a little psychopathic, but it’s a psychological wall that allows them to focus and save lives.
Why Medicine Attracts Tough Characters
Getting into medical school is notoriously competitive.
Only those who are fiercely determined, ambitious, and sometimes even a little ruthless make it through.
Once inside, the environment is relentless — long hours, high expectations, and no room for error. These qualities, often linked to “psychopathic traits,” can actually be strengths, because they help doctors keep their emotions in check when the stakes are life or death.
When Trust Is Exploited
Of course, there’s a darker side. The respect and authority doctors are given means their actions aren’t always questioned.
History has shown how some have abused that power in devastating ways. In France, surgeon Joel Le Scouarnec was jailed for abusing children in his care.
In the UK, surgeon Peter Brooks was sentenced for the attempted murder of a colleague.
Breast surgeon Ian Paterson carried out unnecessary surgeries, leaving scars both physical and emotional.
And then there’s Harold Shipman, who murdered over 200 patients.
These extreme cases remind us that while psychopathic traits can help in medicine, unchecked, they can also lead to horror.
What Surgeons Learn to Do
In surgery, the psychological challenge is immense.
A junior doctor might see not just a body, but the person they know — the patient who spoke of their fears, their family, their life.
Meanwhile, the experienced surgeon is able to put all of that aside.
One heart surgeon summed it up perfectly to a trainee: “It’s open-heart surgery, not open-hearted surgery.”
This mental compartmentalisation may feel cold, but without it, operations couldn’t be carried out.
Understanding What “Psychopath” Really Means
When people hear the word “psychopath,” they often picture movie villains like Hannibal Lecter.
In reality, psychopathy isn’t an official psychiatric diagnosis.
The clinical term is “antisocial personality disorder,” which includes traits like lack of remorse, low empathy, impulsivity, and superficial charm.
While these traits can be dangerous in the wrong hands, they don’t always lead to violence.
Many people show psychopathic tendencies in small, everyday ways — being blunt, cutting ties, or making hard decisions without letting emotion cloud judgment.
The Science Behind It
Research shows that people with psychopathic traits have brain differences in areas linked to empathy and emotion, like the amygdala.
Genetics play a role, but so does environment and upbringing.
The key point, though, is that psychopathic traits exist on a spectrum — and everyone has at least a hint of them.
When Being Detached Helps
Far from being purely negative, a touch of psychopathy can be useful.
Professions like law, policing, business, and journalism often require people to be detached, focused, and sometimes unflinching in the face of pressure.
For doctors, this detachment is essential. Without it, they would crumble under the constant exposure to suffering and death.
Lessons from the Frontline
Take one example from A&E. A doctor had to tell a grandfather that his daughter and grandson had died in a car crash.
The grief in that moment was overwhelming. Yet, minutes later, the same doctor had to treat a child who had fallen off a climbing frame.
He switched instantly — moving from heartbreak to light-hearted reassurance.
That kind of emotional control is a psychopathic trait, but in that context, it made him an excellent doctor.
Finding Balance Between Compassion and Detachment
So, while the word “psychopath” carries frightening connotations, in medicine a balance is required.
Too much detachment and you lose compassion; too little, and you risk being unable to cope.
Doctors walk that fine line daily. Their ability to wall off certain emotions isn’t about cruelty — it’s about survival, for themselves and for their patients.