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SECOND THOUGHTS : Spare me the Gods in white coats

Monday 20 February 1995 00:02 GMT
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It was no surprise to me to read that some doctors are killing their patients by using techniques from outmoded medical books. Yes, I know that generally they are saints. And I know that among their ranks there are hundreds of good, great and kind men and women. But ever since I entered my doctor's surgery looking like a hamster who had just crammed her entire winter larder into two pouches under her jaw and he refused to believe it was mumps; ever since my healthy mother was solemnly assured that she was suffering from a terrible disease that would mean her bones would crumble and she would turn into a jelly before she was 50 ... no, even further back than that, ever since my grandfather, an anaesthetist, was struck off for hooking rich and beautiful widows onto morphine and then feeding their habit in return for sexual and financial favours - ever since then I've never completely trusted the men in white coats.

Despite the fact that in the last 10 years they have changed considerably, they still scare the daylights out of me - because of the sheer power they possess. On my rare visits to the surgery I have to psych myself up like a soldier going into battle: "Remember, Virginia, you're paying for his salary! He's your servant! Think of him as plumber, just someone in a service industry."

But naturally, if you're treated like a God, and your patients reduce themselves to emotional rubble in your presence, it can be pretty irresistible not to behave like one, albeit often a benign one. When I was last shopping around for a doctor I couldn't even get to see one to have a chat with - to find out if I liked him "and he liked me", as I smarmily added to the boggling receptionist. These Cerberuses who snappingly guard the gates to medical hell found the idea of a patient having a pre-signing-on chat with "doctor" quite baffling. (Like the word God, "doctor" does not merit the prefix "the").

The letters I've had from readers in my job as an agony aunt haven't helped my wariness of doctors. "My doctor doesn't understand ..." "My doctor doesn't believe in ..." "My doctor told me to pull myself together." "My doctor said I couldn't expect a sex-life after 50." Worse, apart from a few Latin words that when translated appear to mean "sorethroatitis" or "autoimmunevirusitis", doctors have, until recently, been chary of giving a patient any information at all, on the grounds that a little knowledge is a dangerous thing. Or, more likely, once a patient has a bit of knowledge, he/she might get to know more about his or her complaint than the doctor does, and then where would they be? Remember the story of the GP who asked a patient what the consultant had said when she'd attended the casualty department? "Nothing," she replied. "Surely he said something?" "No. It's that oaf, you see." "What oaf?" asked the GP, wondering which particular white-coated der-brain she was referring to. "That Hippocratic oaf," she replied, "which means doctors aren't allowed to tell nobody nothing."

True, doctors are changing. The last time I saw my doctor - a chap barely old enough to be a policeman, with blond hair tied in a ponytail behind his back - he had the decency to look my pills up in a book. Not for this doctor the crass killing from outmoded medical books. He had the grace to know he didn't know, and to find out by looking things up - in front of me. A very attractive act of courage. He didn't wear a white coat, he didn't look like a God, he looked pretty confused, and he looked as if he was really doing his best. And, blow me, he let me read my notes. ("I would not be a bit surprised if Virginia did not end up by killing herself," wrote one self-opinionated doctor 20 years ago. Wrong again.) But when I got home, I must admit I did look up everything he'd given me in MIMS. Just to make sure he hadn't given me anything I was known to be allergic to. Like the last time I went to the doctor.

Whenever I give talks to medical students these days they are cut from a different mould to the doctors I knew in the past. There's a reason. Since they can't know everything - there's far too much to know - it's much more difficult for them to play God to their patients. The old village doctor would know everything there was to know about practically all medical ailments. But today medicine is far more specialised, and GPs must find it hard to keep up with even basic developments. These days doctors are less likely to be bumptious, bow-tied bullies, and much more likely to be good-natured chaps in corduroy trousers or amiable girls - and many, many more girls.We're now much more aware that doctors are just fallible human beings like everyone else (more fallible, indeed; they rank among the highest in tables of both alcoholism and suicide).

So why is it that the hairs on the back of my neck still stand up when I have to visit the surgery? Why is it that, like Queen Victoria, when I travel I take with me a veritable pharmacy of my own tried and trusted medicaments, and, if at all possible, I'll medicate myself? Because it keeps the appointments with doctors to a minimum.

They still hold a greater power than they think over most of their patients - for great good and great bad. They still have the capacity to kill as well as to cure. And to me, they are still the men in white coats.

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