Beware of doctors who cry wolf

We usually overestimate medical dangers – but not with COVID

Last night, unable to sleep, I thought back to my patients.

The first who came into my mind was a taxi driver in his sixties. I took his history as usual, and asked him where he had lived as a child. He gave his address, and then said something that has remained with me ever since: ‘We lived there until Adolf Hitler moved us on.’

How admirable the understatement. How genuinely self-deprecatory the irony! To be bombed out in childhood and make light of it many years later! Not for him the siren call of self-pity! What a moral example!

He understood something more important even than social distancing in a time of COVID-19, namely psychological distancing. That is to say, an imaginative ability to experience and observe one’s experience at the same time.

He was fortunate, perhaps, to have grown up in a time before the study of psychology undermined the sophisticated, instinctive understanding of life’s exigencies that was once a population’s.

The second patient who came to my mind was a man who would surely have delighted Charles Dickens. Once, as he was leaving the consulting room, he turned to me and said, ‘It’s not that I’m ungrateful, doctor. I’m very grateful. It’s just that no one’s doing anything for me.’

How I looked forward to his periodic visits, though it must be admitted that he was inclined to smell of voluntary incontinence – or perhaps inaccuracy of aim. He always said something much more interesting or arresting than the things you’ll find in the pages of our allegedly serious newspapers or literary novels. Once he said to me, ‘Sometimes, doctor, I feel like the little boy with his finger in the dyke, crying wolf.’

What a perfect summary of our existence – that of us intellectuals. All my life, like so many others, I have been like a little boy with his finger in the dyke, crying wolf. The only difference is, of course, that this time, with the pandemic, the cries of alarm – at least in my own opinion – have been justified.

A third came to mind. I met him in prison (I was the doctor there). He was a middle-aged alcoholic who, drinking too much, had become depressed. His doctor had prescribed for him antidepressants that, sometimes, especially in conjunction with alcohol, gave rise to hallucinations. While suffering from such hallucinations, he had attacked a person seemingly at random, and had been sent to prison.

Of course he shouldn’t have drunk too much, but neither should his doctor have prescribed him the antidepressants. With a colleague, I wrote to the court to ask that this mitigating circumstance be taken into account, and his sentence was reduced by half.

He was a highly intelligent – though not highly educated – man who realised his prison sentence was the best thing that could have happened to him. We used to have long, quasi-philosophical discussions.

I continued to see him when he left prison, where he had formulated an idea for creating an internet business in the days when such businesses were in their infancy. Within three months of his release, he had made £75,000 – perhaps £150,000 today – all perfectly legally. But then he decided to stop; he thought that fulminating success would lead him to personal disaster.

How many people would have the strength of character – or perhaps self-knowledge – to take such a step? Very few, I suspect. We were talking one day of art, he having a refined aesthetic appreciation. I asked him whether he had ever been to the National Gallery.

He replied with something I have never forgotten, and which seemed to me infinitely tragic: ‘It’s not for the likes of us.’