TELLING THE PATIENT
SIR,-11 Mr. Dickson Wright subscribes to 'an obscurantist medical attitude which is as old as the witch-doctor.' he is in good company. for he ex- presses the view of 90 per cent. of the profession.
Many come to us with the fear of cancer and go away reassured. The majority do not want to know that they have a limited time to live. There are a few strong-minded people who can stand the know- ledge, and the doctor can judge by experience who these people are.
One has always to remember that One may be mistaken. I remember one patient in whom all the symptoms and clinical signs, together with X-ray findings, pointed undoubtedly to malignant disease. An exploratory operation followed by a biopsy showed that the trouble was non-malignant. The appropriate measures cured him. If I had informed him before the operation, when everything indicated malignancy, that he had cancer, I can think of no better way of sapping his confidence—at least in me.
Cancer of the lung has been known to yield to deep X-ray therapy. Many cancers can be eradicated if discovered early. Why should we deptive a patient of all hope--for that is what it amounts to—in this particular disease? When the disease is established, nothing is to be gained by adding despair to the physical suffering. Relations, and those who are nursing such cases, frequently beg us not to tell. And quite rightly so.—Yours faithfully, A. E. MOORE Loen House. 26 Manor Park, Histon, Cambridge
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