Sandie Peggie tribunal has given us some of the greatest hits from the brain-addled activist songbook

Of course, things such as degrees in medicine skew things in favour of the quack. But there’s something more than that.

When we visit our doctor, we don’t simply want a prescription, we want reassurance. At particularly difficult times, we want a protector, someone to stand between us and what threatens us, like a favourite teacher, or a parent. We find comfort in submitting to their wisdom.

In my experience, most doctors rise to the challenges created by this power imbalance, wearing their authority lightly and acting with empathy.

Those who devote their professional lives to the care of others are - by and large - among the best of us. The hours are long, the work relentless, and the tolls - both physical and emotional - heavy.

We all have stories of doctors who made all the difference, the family GP who made the referral, the consultant who drew up the plan, the surgeon who destroyed the threat.

But, though we owe the vast majority of doctors our support and admiration, were should not lose sight of the fact that theirs is a privileged job.

Noble though the vocation may be, nobody is entitled to be a doctor. Neither is anybody compelled to enter medicine.

Being a doctor is an honour. And it isn’t suitable for everyone.

One wonders, for example, whether a career in medicine is the right one for Beth Upton, the trans-identifying man currently at the centre of an extraordinary industrial tribunal during which a series of medical professionals have willingly humiliated themselves.

The details of this case are well rehearsed but retain their power to astonish.

During a late shift at Kirkcaldy’s Victoria Hospital on Christmas Eve, 2023, nurse Sandie Peggie entered the women’s changing room where she encountered Upton, a junior doctor.

Peggie bravely - for only the boldest would dare not affirm the identity of a trans woman - spoke up. This was a single-sex space, she said, and Upton had no right being there.

What followed was grotesquely unjust. Rather than considering that the 50-year-female nurse might have a point, senior staff rallied around Upton. While Upton was consoled and supported, Peggie was treated as a bigot and suspended from work.

On Friday, the tribunal heard evidence from a forensic computer analyst that Upton had altered supposedly “contemporaneous” notes relating to alleged incidents involving Peggie.

Upton looks less the victim, more the tormentor by the day.

Last week, it was the turn of - among others - Dr Kate Searle, a consultant with NHS Fife, to explain their roles in this scandalous mess.

Searle not only - without a shred of evidence - took Upton’s account of events as gospel, she shared unsubstantiated claims about Peggie with colleagues.

During an ongoing investigation, Searle spoke to a witness in what she admitted was a “flagrant breach” of confidence. Furthermore, she positively encouraged Upton to make a real stink about the whole thing, even suggesting police involvement.

Under questioning by Peggie’s lawyer, Naomi Cunningham, Searle was tearful and defiant.

She was a “kind person” - a statement which brought to mind my maternal grandmother’s favourite oratorical preface “I’m not a racist” - and if only other people could be kind then none of this mess would be playing out.

If kindness is encouraging a biological male to report a woman to the police for complaining about his presence in a changing room then it’s not for me, I’m afraid.

More astonishing still was Searle’s claim that, despite the fact Peggie had been cleared by an NHS Fife investigation of any wrongdoing, she remained convinced that what took place in the women’s changing room on that December night was a “hate incident”.

Searle also gave us some of the greatest hits from the brain-addled activist songbook. For example, she - a hospital consultant, remember, not a three-year-old - said she would not have known what sex Upton was “assigned at birth” because this was not her area of expertise.

During last week’s hearings in Dundee, Cunningham spoke to a number of witnesses about a man she called Pete.

Pete is not an actual human. Rather, he is both theoretical and an effective stupidity detector.

If a woman, Cunningham asked, walked into a female only changing room and found Pete, there, would she have the right to complain.

The general consensus was “yes, of course”.

What then, wondered Cunningham, was the difference between Upton and Pete?

The law - as clarified by the Supreme Court earlier this year - recognises Beth Upton as a man. This may be difficult for him to accept but reality does not care about his hurt feelings and nor, I suspect, do many who have been following this shameful episode. The comparison with Pete is legitimate.

The issue of Upton’s sex was at the centre of tense exchanges between NHS Fife’s KC Jane Russell and Naomi Cunningham.

Russell objected vociferously to Cunningham’s insistence on calling Upton a man. He was not a man and saying so was discombobulating to witnesses, one of whom had “misgendered” the doctor during questioning.

Peggie’s lawyer explained that since Upton’s sex was at the very heart of this extraordinary case, she would not be changing her language.

It was surreal when, while giving evidence to the tribunal last week, NHS Fife’s equality officer Isla Bumba said she did not know whether or not she was female. But it was also unsurprising: Bumba is a professional activist and that was textbook.

Searle’s evidence, dripping with the language of the activist, was far more troubling.

Without trust, the relationship between patient and doctor ceases to work as it must.

It’s not clear either Beth Upton or Kate Searle recognises this important truth.