“Beware the Jabberwock, my son,
The jaws that bite, the claws that catch . . .”
Danger can be obvious, something dark and wicked, easy to perceive and to shun. But, as any heartbroken lover will tell you, when it comes in the guise of something beautiful, something gentle and kind, it is hard to recognise and avoid, and then it is perilous indeed.
Two of my patients died last week. I'd looked after them for years, and they were good people and easy to be good to, but I can't pretend to have felt any great grief over their deaths. Over the years I've got pretty hardy, not one to blubber.
We are not made of rock, but of flesh and blood; we are not gods, just simple men and women doing our best. You can care deeply for your patients, like them, be their friend as well as their doctor, and that's as it should be, but there is a thin line to be crossed where we give too much of ourselves.
“Equanimity,” according to William Osler, was what we should strive for, and most of us do manage to muddle through somehow.
No matter how exquisite the pain, we usually walk away after our shift and forget about it, watching a game of football, having dinner with our family, a few beers with friends. We go back to our own lives. Yea, tho we walk in the Valley of the Shadow of Death, once I'm out of the Valley it's not my problem anymore.
But we do have to care a little bit, and sometimes our profession can let us down very badly. A tribunal is under way in the Republic of Ireland at present to investigate the use of contaminated blood products which led to many people with haemophilia developing AIDS and hepatitis C, the cure devastatingly worse than the disease; don't trust me, I'm a doctor.
Whether this was a result of incompetence or laziness or bad luck or lack of resources is not yet clear. We have only heard the patients' side of the story, and no matter how stark the tragedy it is too simplistic to look for scapegoats; doctors are easy targets for blame.
But what has clearly emerged is a picture of an aloof, secretive, and unfeeling profession. Even after the mistake was made some of these patients were treated with an offhand discourtesy that seems barely credible.
Surely this picture can't be right; surely.