Published 19 January 2002 Cite this as: BMJ 2002;324:179
Laurel: “What’s for supper, Ollie?” Hardy: “Fries and beans, Stanley.” Laurel: “Gee, Ollie, you sure know how to plan a meal.”
Laurel innocently fuels Hardy’s conceit, and the boys are much too contented. They have committed the sin of hubris and you know disaster is about to befall them. It’s like when Frankenstein was happy, playing with the little girl: it was a bad time to go near him with a torch.
With the right partner either Laurel or Hardy might have gone far, but their mutual dependency feeds their worst qualities and constantly places them in impossible situations, like trying to carry a piano across a rope bridge between two alpine cliffs with a gorilla in the middle.
Forget viruses, bacteria, trauma, cigarettes, radioactivity—what screws most people up is relationships, with other people mostly. Firstly, I’d like to quote myself: “If general practitioners have any specialty it is the individual.” And then I’d like to quote Nietzsche, because great minds think alike: “It is easier to understand mankind than to understand one man.” But once it goes beyond one man and becomes a man and a woman, or two men, or two women, or one more woman going nowhere just for show, with the church maybe getting into bed beside them to complete the brew, no understanding is possible.
If it was only as simple as drug interactions. My pharmacist can call me and say, “That guy you prescribed aspirin for, he’s on warfarin, and you wanted him to have verapamil, but he’s already on digoxin.” And I can reply, “Thanks, pal, you take over his medical management, and I’ll flog him some cheap aftershave.”
But there is no predictability to relationships, no database to allow any kind of rational forecast; we throw our balls up in the air and they come down in a totally random manner. Two beautiful and gentle people can produce plutonium, two obnoxious and dysfunctional people can sing as sweetly as a linnet.
Trying to help in any way is fraught with pearls. Non-directional counselling and a sympathetic ear are usually the most we can offer. Anything more interventionist invites retaliation; no longer a soothing escape valve, we have become part of the problem. As Joe said to me, “I’m angry with my wife, with my mother, and with my kids, but most of all, doctor, I’m angry with you.”