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قراءة كتاب Doctor and Patient

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‏اللغة: English
Doctor and Patient

Doctor and Patient

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دار النشر: Project Gutenberg
الصفحة رقم: 7

what you call sympathy. In its loftiest meaning this is the capacity to enter into, to realize, and hence to feel with and for you. There is a mystery about this matter. I know men who have never suffered gravely in mind or body, who yet have some dramatic power to enter into the griefs of others, and to comprehend, as if by intuition, just what others feel, and hence how best to say and do the things which heal or help. I know others, seemingly as tender, who, with sad experience to aid them, appear to lack the imaginative insight needed to make their education in sorrow of use to their fellows. There are times when all that men can give of sympathetic tenderness is of use. There are others when what you crave is but the outcome of morbid desires for some form of interested attention. You may ask too much, and every doctor knows how curiously this persistent claim for what you call sympathy does, as the nurses say, "take it out of a doctor." The selfishness of nervous women sometimes exceeds belief in its capacity to claim pity and constancy of expressed sympathy.

In times of more serious peril and suffering, be assured that the best sympathy is that which calmly translates itself into the desire to be of practical use, and that the extreme of capacity to feel your woes would be in a measure enfeebling to energetic utility. This it is which makes a man unfit to attend those who are dear to him, or, to emphasize the illustration, to medically treat himself. He goes to extremes, loses judgment, and does too much; fears to hurt, and does too little. I once saw a very young physician burst into tears at sight of a burnt child, a charming little girl. He was practically useless for the time. And I have known men who had to abandon their profession on account of too great sensibility to suffering.

There is a measure of true sympathy which comes of kindness and insight, which has its value, and but one. Does it help you over the hard places? Does it aid you to see clearly and to bear patiently? Does it truly nourish character, and tenderly but, firmly set you where you can gain a larger view of the uses of pain and distress? That is the truest sympathy. Does it leave you feebler with mere pity? Does it accentuate pain and grief by simply dwelling on it with barren words? I leave you to say what that is. We have a certain gentle disrespect among us for the doctor who is described as, oh! so sympathetic,—the man who goes about his work with a pocket-full of banal phrases calculated to soothe and comfort the cravings of the wretched. The sick and feeble take gladly these imitation crumbs cast from the full table of the strong. But sometimes people of firm character revolt at such petty and economical charity. I heard a vigorous old Quaker lady say once, after a consultation, "Thee will do me a kindness not to ask me to see that man again. Thee knows that I don't like my feelings poulticed."

The question of the truthfulness of physicians is one often raised. It troubles the consultant far more than it does the family doctor, and perhaps few who are not of us understand our difficulties in this direction. Every patient has his or her standard of truth, and by it is apt to try the perplexed physician. Some of the cases which arise are curiously interesting, and perhaps nowhere better than in the physician's office or at the bedside do we see sharply developed the peculiarities of character as to this matter of truth in many of its aspects. There is the patient who asks you to tell him the whole truth as to his case. Does he really want to know? Very often he does not. If you tell him, you sentence him. You do not shorten his life, you only add to its misery. Or perhaps his wife has written to you, "On no account tell my husband that he cannot get well. He dwells now on every sign of failing health, and you will make him wretched." You parry his question and try to help him. If he is resolute, he returns on you with a query so positive that you must answer frankly. His wife was right. You have done him an injury. There is the other man who insists at the start that you must on no account tell him if he cannot get well. You inform some relative of his condition. But perhaps he ought to know. He contemplates some work or travel which he should not undertake. You say so, and he replies, "But you have not told me that I am seriously ill." Such is sick human nature.

The people who really want to know if they will die of some given disease are few in number. Those who pretend they want to know are more common. Those who should not know are frequent enough, and among them one is troubled to do what seems right and to say in answer to their questions what is true.

Wise women choose their doctors and trust them. The wisest ask the fewest questions. The terrible patients are nervous women with long memories, who question much where answers are difficult, and who put together one's answers from time to time and torment themselves and the physician with the apparent inconsistencies they detect. Another form of trouble arises with the woman whose standards are of unearthly altitude. This is the woman who thinks herself deceived if she does not know what you are giving her, or who, if without telling her you substitute an innocent drug for a hurtful one which she may have learned to take too largely, thinks that you are untruthful in the use of such a method. And you would indeed be wrong if you were of opinion that to tell her the whole truth, and invite her to break the habit by her own act, were available means. I certainly do not think that you have any right (indeed, I would not even discuss this) to take active means to make her think she is taking, say opium, when you are only giving her something which tastes like it. If she asks, you must answer. But she may not, or does not, and yet when she is well again and learns that the physician preferred to act without her knowledge because he distrusted her power to help, she is very likely, if she chance to be a certain kind of woman, to say that he has been untruthful. Happily, such cases must be rare, and yet I know of some which have been the source of much annoyance to sensitive men. Thorough trust and full understanding is the way to avoid such difficulties. A nervous woman should be made to comprehend at the outset that the physician means to have his way unhampered by the subtle distinctions with which bedridden women are apt to trouble those who most desire to help them.

I omitted above an allusion to the most unpleasant inquirers, those who are either on the verge of insanity or are victims of that singular malady, hypochrondriasis. A patient clearly staggering to and fro on the border line of sanity consults you. Here is a wilful, terrified being, eager to know the truth. "Am I becoming insane? Will I end in an asylum?" How can you answer? You see clearly, are sure the worst is coming. What shall you do with this morbid, scared, obstinate child-man? You put aside his questions, but you have here a person quite or nearly sane to-day, resolute to hear, afraid to learn the truth he dreads. I leave my reader with this patient, and my stated knowledge and my shifted responsibility. "Doctor, if I am going to be insane, I will kill myself." Good reader, pray dispose of this case. Or take the ease of a confirmed hypochondriac. He is miserable, has a hundred ailments, watches the weather, studies the barometer, has queer delusions as to diets, clothes, and his own inability to walk. The least hint of a belief that he is not as well as he was a week ago, or even a too close examination, leaves him with a new malady, and he, too, is a sharp questioner. As a rule, he has no perceptible changes in his tissues. But if he has some real malady,—it may be a grave one on which he has built a larger sense of misery than there was need for, and the case is common enough,—how shall you answer him? It is a less difficult case than the other, and I gladly leave him also to my consultant

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