Saturday, 1 December 2012

What He Said

Having bleated incoherently about the medical profession yesterday, I discovered this morning that DG
Myers had written this beautiful piece which covered similar ground but with wonderful clarity, perception and intelligence. The account of his experience with a particularly insensitive doctor in the second last paragraph echoes the experience of a very dear friend of mine and made me want to cry. Why is empathy so difficult for some people?

Myers's reference to the 'Thou' form also reminds me of one of the things that has often puzzled me about our language. Why did we, unlike the speakers of so many other European languages, decide to abandon the more intimate form? Evidence of Anglo-Saxon stand-offishness according to a French friend - I'd like to be able to argue an alternative case, but thus far I've never been able to come up with one.


  1. guess it comes with the job - I work in the veterinary industry (not as a vet) and you would be truly shocked at what percentage of people become nasty and unreasonable when faced with illness of themselves or a loved one, its all part of human nature, that when faced with uncomfortable news, many people go on the atttack. After a while dealing with that every day (when you are only trying to help people) you'd probably get a fairly thick carapace I should imagine - meaning that even nice patients might get short shrift. Not excusing someone being rude, but I can well imagine how they got that way!

    1. Yes, I think I can imagine - I briefly worked at Social Security and I went in there thinking all unemployed people were wonderful people who one should be kind to and help; after being conned by two or three, I saw them all through a cloud of cynicism, which was probably v unfair.

  2. Hmm.... I don't know if things have changed in the 3 years since you left Z. At around the time you were packing your Factor 50, I was being diagnosed with the same condition as D G Myers' stepfather. Up until that moment, I had hardly been near a doctor, never mind a hospital.
    My first - in fact my only question when they told me was 'how will I die?' - I guess I was in shock, having just been told I had a cancer, and that couldn't be fixed. Let's just say that they moved my question from the front-burner to the back. I remember taking lots of paper and brochures from 'my Macmillan nurse', and then I was in the car park, unable to remember where my car was parked - a first.
    I have little to add to this debate save the fact that I feel now, that my education has allowed me to teach myself to control my fear. The bad behaviour that shocked me when I first saw it up close in the hospital, I now know was borne of fear and lack of knowledge. I have not been 'battling cancer' as the popular terminology goes. I am a body, a recepticle, into which is poured technology, chemicals, knowledge and, yes, kindness and understanding. I offer myself, they do what they can. After all, the alternative is the bone orchard, and I don't want to go there - yet.
    Myers' piece mentioned 'the google question', which I had myself a few weeks ago. I had developed another cancer, a sebaceous carcinoma called Torre-Muir Syndrome. It was only the fourth case they had seen. Dozens of doctors came to look. I felt special, almost unique. They cut my face and neck, taking something away to be tested in Guildford (why Guildford?). I googled it - but there was next to nothing, except a little about Mr Muir and Mr Torre fifty years ago.
    What I have managed to do over the last four years is turn a physiological nightmare into an intellectual adventure. The challenges I used to meet in sport, head on, with my fit body, I have now transferred to the clinic of the mind. And the people that help me do it are not my family, but a vast tapestry of men and women in ugly buildings scattered across South London who battle on my behalf. I find it humbling just to think about any one of them.

    1. You have far more - and more personal - experience than me, clearly. I can only go on what I saw when I used to take a library trolley round a large hospital in London once or twice a week for two or three years. Observing the staff over that time, I began to see that, while all were, obviously, qualified, there were some who were marvellous, dedicated, warm individuals but others who were not empathetic or even particularly kind. There were consultants who would progress through the wards, trailing clouds of students behind them, and treat the patients as little more than specimens. Other staff seemed to cope by being completely efficient but in an inattentive way - eg taking a patient's observations but all the time chatting with another of their colleagues, rather than really engaging with the patient themself. There was one ward that kept being closed off because of problems with infections - and all us volunteers were aware that this was also a ward where the nursing staff were at war with each other; in other words, it appeared that they were too caught up in their own personal rivalries to do their jobs properly. At first I thought it was rather an odd idea to be taking a library trolley around to sick people, but before long I realised that a large part of the service was actually just providing patients with someone to talk to. Of course lots of them were too ill for that, but there were others who seemed to find some reassurance in just having someone friendly who'd spend time talking to them as individuals rather than simply illnesses. Not sure if any of that makes sense, whereas all that you say does. Limited time is obviously one problem - there aren't enough qualified people to go round so they can't be engaging at every level and still get all their work done. Nevertheless, I remember when a relative of mine was very close to death in a London hospital. He had the immense good fortune to be treated by a doctor who was a rare and shining example of humanity and brilliance combined (as my father used to say about him, "That man is a god in our family"). Unfortunately, at one point that doctor had to go away for a few days and was replaced by a pompous, old school tie type, who seemed incapable of any sympathy, so intent was he on impressing his own importance on his patients and all bystanders. He was just as well-qualified as the other, but the days he was in charge were the ones when I was most afraid. In other words, in an ideal world, I still think the personality of the person treating a patient makes a difference and I also think that it would be a good idea if every day when staff enter a hospital someone reminded them that they could one day be at the receiving end of treatment rather than meting it out and that it might be a good idea to imagine themselves in the shoes of the patients as they go about their duties.

  3. Thou survived in dialect into the 19th Century, if one can believe Hardy's "The Ruined Maid":

    -- "At home in the barton you said `thee' and `thou


    The internist and author Abraham Verghese is better as memoirist than as novelist. But in his novel Cutting for Stone various persons repeat

    Q: What treatment is taken by ear?
    A: Words of comfort.

    1. That Verghese quote is lovely. 'Thou' seemed to last longer in Yorkshire, judging by Dickon in The Secret Garden. It's odd, if it did, since Yorkshiremen have a reputation for being rather reserved.