The gift……

All actions are ultimately self referential, observed Spinoza, and though he wasn’t a GP, he knew what he was talking about

We like to think that gifts from our patients are a symbol of generosity and gratitude, a sign that our relationship is not purely cold and professional, that the care we give to them comes from our hearts. But I have a salutary little parable.

Many years ago, a young lad came to see me in some distress. He was gay, and in a society where cows were considered rather effete, this was a tough cross to bear.

I was young then myself, and desperately trying to avoid becoming cynical like all my senior colleagues (that turned out well). So I listened sympathetically, reassured him that beyond redneck central feelings such as these were considered perfectly normal, that sexuality was a spectrum, and put him in touch with the appropriate support groups.

I didn’t see him for a while, but I heard he was living in San Francisco, which seemed a smart move.

But one day he came back to the surgery. He wanted to thank me, he said; before me, no-one had understood him. San Francisco was great, he’d really found himself there, had a lot of friends, and got in touch with his feelings. He’d become an artist, and had brought me one of his paintings, in appreciation of all my help. I was genuinely touched and thanked him sincerely.

And then he said: ‘I can get you a good deal on a frame.’

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