The Tall Poppy Syndrome (TPS) is a metaphor which symbolizes
viewing a poppy field and noticing one poppy towering above the
others; a penchant by an individual, group or society exists to
cut down this tall poppy so that all are equal and uniform. A “tall
poppy” is defined as someone with fame, fortune, achievements
or skills. The syndrome has been identified in many countries
with their own metaphors or phrases since antiquity. The entity is
relatively unrecognized in the United States perhaps because of the
constitutional rights of the individual and capitalism which is based
on meritocracy. Lack of recognition does not negate existence.
Daily examples may be found in the industries of sport, business,
entertainment and especially politics. TPS may be noted in medicine
since antiquity as well. Nearly every new discovery, technique, or
rivalry is a breeding ground for TPS. One of medicine’s greatest
rivalries occurred between Louis Pasteur (France) and Robert Koch
(Germany) regarding the germ theory of disease. Their rivalry leads
to denigrating each other privately, and at meetings which would
also draw in other doctors often with a dose of nationalism for good
measure. Envy was described as an early root of TPS especially in
people with low self esteem [1]. The envier lacked what the tall
poppy possessed and had the option to improve (good envy) or
denigrate or cut down the tall poppy (bad envy). Further psychosocial
studies have extended behaviors to include deservingness
and resentment as well as others [2].
Deservingness involves value judgments by the cutter about
the outcomes of the person to be cut down or “tall poppied”; the
persons got what they deserved. Resentment is indignation about
unfair treatment; cutting the person down could end in revenge.
A recently published career summary of an orthopedic surgeon
could also be interpreted as an example of TPS [3]. The young
orthopedist entered practice when arthroscopy and the specialty
of sports medicine were at their infancy. His surgical techniques
were disparaged by his orthopedic colleagues. Membership in the
state orthopedic association and other orthopedic organizations
were originally denied as were many of scientific papers. As he and
the surgical techniques became accepted, so did memberships and
publications. As medicine moves to a business model with more
physician employment, the hierarchy and promotion will become a
new source of TPS. Advancement may not always be based on merit.
Specific needs, “pull”, and persons with new social-justice identity
politics may prevent the high achiever’s advancement causing the
high achiever to be cut down to justify the elevation of the others
or forcing the high achiever to do some cutting. The White House
Doctor manages a staff of five physicians who provide medical care
for all things White House which includes being the President’s
physician. Dr. Lonny L. Johnson, President Trump’s private doctor,
wrangled with Dr. Jeffry Kuhlman, Johnson’s boss, for control of
the White House office. To settle the dispute the Navy’s inspector
general services were required which issued a report in 2012.
This rivalry forced people to choose sides. When President Trump
nominated Dr. Johnson to lead the Veterans Affairs Department,
accusations, mostly unfounded, emerged forcing Dr. Johnson to
withdraw his name from consideration.
The treatment of any disease begins with defining the disease
state, further elucidating studies and recommended treatments.
TPS is well defined in most English speaking countries, except the
United States, especially in Australia. Treatment involves emotional
intelligence. The tall poppy may become conspicuous for some
egregious reason which requires behavioral identification and
modification. The cutter also must evaluate the basis for proper
behavior or judgments versus improper behavior. Behaviors often
become so ingrained that outside assistance is necessary to identify
and treat them.
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