'Medicine' and 'What the Doctor Said' by Raymond Carver

I am surprised that Professor Sir John Tooke, former President of the Academy of Medical Science (on this morning's edition of  Radio 4 'Today' programme) was himself surprised how the majority of patients trusted the opinion of relatives or friends more than their doctors. Don't get me wrong: tablets are keeping me alive (and very grateful I am to you all for paying for them) but the public is very wise to have in mind the various relations and frank conflicts of interest between doctors, big pharma and the man (or woman) in the waiting room.

The act of giving a medicine was, until recently, most powerful in its symbolic function than any inherent active ingredients. 

I was given a very important lesson in this fact in my first house physician appointment. 

My boss, Dr Davidson, was the archetypal, elegant, grey haired and white coated 'Doctor in the House' physician coming to the end of his career - an extremely astute and kindly man, adored by staff and patients alike. By the way, when was it that doctors (and nurses) took to wearing their stethoscope around the neck (like a priest's stole and it's unconscious reference back to the priest/ shaman/ healer) instead of being stuffed in a pocket in my own time?

One day, on the big ward round, he caught me looking askance at his prescription of a 'tonic' for an elderly lady beyond the reach of anything more potent available. After the round and in complete privacy, he took me to one side and said quietly and gently: ' Dr Brady, if I thought it would do my patient some good, I would 'black up', push a bone through my nose and do a war dance at the end of the bed'. 

I remain deeply grateful for the lesson in humility - and respect for the deep mystery of the psychic relation between doctor and patient. Not, I dare say, something given any more attention in the present medical school curriculum than in my own days of thirsting ignorance.

Raymond Carver's poems remind me too (amongst all sorts of other things) of Jung's dictum that 'only the wounded physician heals - and then only to the degree he has healed himself'.

Thanks Ray - and Dr Davidson - for the help along the way.



Medicine

All I know about medicine I picked up
from my doctor friend in El Paso
who drank and took drugs. We were buddies
until I moved East. I'm saying
I was never sick a day in my life.
But something has appeared
on my shoulder and continues to grow.
A wen, I think, and love the word
but not the thing itself, whatever
it is. Late at night my teeth ache
and the phone rings. I'm ill,
unhappy and alone. Lord!
Give me your unsteady knife, 
doc. Give me your hand, friend.






What the Doctor Said

He said it doesn't look good
he said it looks bad in fact real bad
he said I counted thirty-two of them on one lung before
I quit counting them
I said I'm glad I wouldn't want to know
about any more being there than that
he said are you a religious man do you kneel down
in forest groves and let yourself ask for help
when you come to a waterfall
mist blowing against your face and arms
do you stop and ask for understanding at those moments
I said not yet but I intend to start today
he sad I'm real sorry he said
I wish I had other kind of news to give to you
I said Amen and he said something else
I didn't catch and not knowing what else to do
and not wanting him to have to repeat it
and me to have to fully digest it
I just looked at him
for a minute and he looked back it was then
I jumped up and shook hands with this man who'd just given me
something no one else on earth had ever given me
I may even have thanked him habit being so strong.