The art of complimentary medicine

Joe is always grumpy, that diplomatic post at the United Nations getting further and further away every day.I have to admit, he’s very good at it, and there is a bright side; when he leaves the surgery, there’s an immediate lightening of the spirit, a sense of freedom and relief, like the sun coming out from behind a cloud on a winter’s day, or Liverpool getting a manager who actually knows what he’s doing, or the passing of a well-formed bowel movement after a prolonged episode of constipation.

So it was rather disconcerting when he came in one day beaming and showering me with compliments. I had good reason to be wary; a contented Joe is a dangerous Joe. It’s like when Frankenstein was happy, playing with the little girl, a really really bad time to go near him with a torch. I wondered if Joe was following the dictum of General Sun Tzu in The Art of the Consultation; ‘Always do the unexpected’.

Compliments can be double-edged and manipulative, and the wise clinician will look for an ulterior motive. As William Wilberforce said: ‘Flatterers are not your friends; nay sir, they are your deadliest enemies.’

Everyone likes a bit of approval. Fire out sick certs and sleeping tablets and antibiotics on request, refer every headache for a brain scan, and you’ll be everybody’s best buddy.
But patients aren’t your buddy; their expectations and what we consider to be in their best interests often come into conflict.

We don’t strive to give patients what they want, but what they need. We husband precious resources, and the hardest part of medicine is knowing when not to use it. It’s not a doctor’s job to be popular, and it’s much more important that we like our patients than that they like us.

‘We were talking about you last night at the match; nobody had a bad word to say about you,’ said Joe, ‘And anybody that did, I soon put them right.’

On closer inspection there was some ambiguity to this compliment, but I accepted it gracefully.

‘Thanks Joe,’ I said, ‘As La Rochefoucauld observed, “To refuse praise is to wish to be praised twice.”‘

But you’re still not getting any antibiotics.’

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