ABSTRACT
In practice, physicians, and especially surgeons, have always had to learn some type
of detachment (or dispassion to use the early modern term) in order to cope with
the more revolting aspects of their art.1 At times the relationship between acquiring
dispassion and the effects it has on the (in)humanity of medical practitioners
has been questioned. Does constantly seeing sickness and death make one lose
compassion? If so, what is one left with in its place? As recently as 1994, tempers
flared in the British Medical Journal following the publication of a letter from an
anonymous London-based general practitioner. She, or he, accused some doctors
of ‘disturbingly callous and rude behaviour’ towards patients and suggested that
‘courses to remind (or perhaps teach) doctors how to behave to their patients be
put high on the agenda.’2 The letter prompted a strongly worded editorial in the
Weatherall agreed with the sentiments of the letter and offered explanations for why
so many medical practitioners appeared to be detached from their patients’ pain and
suffering. First, he suggested that ‘doctors may always have had a limited facility
to treat their patients as humans’; second, they are worse at it now ‘because of the
rushed and specialized nature’ of medical training and practice; and third, we could
try to reform medical education but there is probably little point, as ‘problems of
doctor-patient relationships have been around for hundreds of years and during times
of completely different patterns of medical education, clinical practice, and social
pressure’.4 Weatherall ended his editorial with a plaintive cry:
It is difficult to equate the delightful, caring, and extremely gifted young people whom
one encounters on their entry to medical school with some of the horror stories described
in today’s journal. What on earth has exposure to a few years of the medical profession
done to some of them?5
