On Bedside Manner

It occurs to me that Dr. H is the only doctor I've met with the most impeccable bedside manner. After I leave his surgery, I feel satisfied, reassured and comforted.  In the grey suited world of medical profession, he cuts a dash with his beautifully made and effortlessly stylish Harris Tweed jackets or dark suits, perfectly tailored, and a Paisley silk handkerchief, in his breast pocket, gives a finishing touch on his immaculate look. A nicely folded handkerchief in his breast pocket is a necessary accoutrement to his profession as much as a watch or a stethoscope. I have never seen him without it as if his handkerchief was there for a reason, to offer his patients when they start to weep. 

When he is walking on the street, he can be easily spotted because of his distinguished looks and his athletic movement with a distinct spring in his step. He would raise his bowler hat when he meets his patients on the street. The same Mackintosh raincoat, in khaki colour, like that of gentle muddy streams in April showers, with a modest check lining, would suffice over his shoulder whether it is summer or winter. To the outside world he must appear to be a restraint, austere and even forbidding figure.

In his professional capacity, his elusive and aloof manner disappears. He remains silent when a patient is presenting his symptoms to him. He wastes no words. His comments are completely sincere. His questions are razor sharp and acute like a detective gathering his evidences. He always refers to his patients by their surnames.

A word or two should be said about the way he shakes hands. I began to notice the familiar ritual of his handshake after several meetings with him. His "Hello" handshake when you first meet him is firm and sturdy like hugging an oak tree. After the consultation finishes, before you leave his surgery, he would give you another handshake. And that farewell handshake is more lasting than the first one. He would put his left hand on the grasped hands and pat a few times gently on your knuckles before he releases his grip. One is not entirely sure if Dr. H is performing a fraternal rite of freemasonry in his eccentric way of shaking hands but then, I've never met any Freemason in my immediate circle of friends, so it is hard to judge if it is a sign of initiation, dominance or reassurance to his patients. Nevertheless, this peculiar gesture generates a strong bond as they leave his surgery, smiling indulgently, in sweet forgetfulness of their afflictions and ailments.

My great uncle, unlike Dr. H, was the kind of doctor who preferred to stay in a laboratory to do his research; but he had to make ends meet as he earned a better salary in his physician role than in his research.  His colleagues regarded him as a towering figure in his field of pioneering research and academic publications. His influence was admirable, his standards incredibly high as one would say, "Yes, he knows his stuff".

However, when it came to bedside manner, he had none. He avoided patients like the plague. He would write down a prescription on a piece of paper just by looking at the patient. Especially, he was weary of his women patients, especially the ones whom he referred to as "overwhelmingly capable women". No doubt he felt stifled at times by the regular dates and appointments, and the dull individual he was bound to encounter. And that’s how he developed unusual tactics. Once he was doing an interview with a young doctor at the hospital, he got frightfully bored from listening to the candidate's facile or slovenly effort, he pulled out his newspaper from his briefcase and read it in front of the young doctor who "was nearly in tears".

When not actually disapproving of you, he was the wittiest company in the world. Partly, it’s because he was a composite of dichotomies. He managed to survive from a dangerous combination of his extremely Marxist opinions with his aristocratic taste for hand-made shirts and expensive shoes from the clothes shops with a sartorial reputation. Like a Regency dandy, Beau Brummell, he would often go to see his tailors and there, he would proclaim his most radical views about the Labour party as he stood on the stool while he was being measured for his new suits. The tailors who were most loyal to him didn't seem to think of him as a hypocrite because they embraced his lovable eccentricity by saying "his bark is worse than his bite".

His comments made to his patients were both tonic and astringent. It took some intelligence and understanding to reach the full meaning of his sometimes allusive approach and comments. On one occasion, after he diagnosed his patient, he apparently said to her: "My dear, I have good and bad news for you. Which one would you like me to tell you first?" The woman replied in a strained state of nervous worry and anxiety, "The bad news please". 

He said, "The bad news is that you have rheumatism. The good news is it won't take you to the grave. But you'll take it to the grave with you."

In the metaphorical kingdom of his personality, the subject of tact and bedside manner has no place or refuge. One can’t prescribe or request compassion on a piece of paper. It’s like asking a young disk jockey at a disco party, “Don’t you ever do a slow number?” His answer: “No”.

In one of his famous essays, Francis Bacon wrote: “It is good, in discourse, and speech of conversation, to vary and intermingle speech of the present occasion with arguments; tales with reasons; asking of questions with telling of opinions; and jest with earnest: for it is a dull thing to tire, and as we say now, to jade anything too far...And generally, men ought to find the difference between saltness and bitterness. Certainly, he that hath a satirical vein, as he maketh others afraid of his wit, so he had need be afraid of others' memory.”

ESSAY XXXII. Of Discourse, FRANCIS BACON’S ESSAYS (1601)