If symptoms
persist.. .
THERE ARE many diseases, but only two kinds of suffering: self-inflicted and undeserved. Needless to say, the former is much the commoner kind, at least in the conditions of freedom which our population is fortunate enough to enjoy. Man flees good sense and happiness as a hare the hounds.
I do not mean by self-inflicted suffer- ing the manifold diseases which may be brought about by the bad habits of patients, nor am I one of those modern health fascists who would charge smok- ers vastly more for their treatment (if they are to be treated at all) than their virtuous cousins, the non-smokers. No: I am talking about good old-fashioned self-destructive behaviour, or at least behaviour which would destroy the self if the state would let it, which is the near- est anyone can get to it in these weak piping times of pity.
Last week I was consulted by an alco- holic in his early forties, whose condition was deplorable: he was filthy and neglected, his hands shook, he was mal- nourished, and he whimpered in distress. He begged me to admit him to hospital, not that he might overcome his weakness but that he might not die of hypother- mia. Having spent all his money on drink, his gas and electricity supplies had been cut off for non-payment of bills.
It wasn't cold yet, and he wouldn't die of hypothermia; he had been admitted several times to hospital before, to no avail. He said his flat was in a state of chaos; there was nothing to eat and the filth was general. He could not possibly return until he was 'better'.
By better he meant, of course, until a social worker had secured reconnection of the gas and electricity supplies. He believed — rightly — that there was a level below which the state would not let him fall, whatever he did: he could drink his Scotch and have his gas.
To shield a man from the conse- quences of his own actions is to assume great power over him, and, philosophi- cally, I am opposed to doing so. But it is hard to put a philosophy into practice, and of course I admitted the man to hos- pital, cowered by his threat to jump off the roof if I did not. The vast apparatus of compassion was at once set in motion,
and taxpayers among my readers will be proud to know that they have now cleared his debts.
Continually to do things to which one is philosophically opposed leads — at least in my case — to a certain ill- humour, and in the afternoon I upbraid- ed a patient for arriving half an hour late for her appointment. To my shame, I discovered that she was nearly blind and had had difficulty in finding my office. My shame only increased as she related her life story.
She was in her mid-thirties. Her moth- er, to whom she was deeply attached, died five years ago; her husband desert- ed her shortly thereafter for another woman. The following year., her three children were killed in a bus crash; and the year after that, she had a mastectomy for cancer of the breast. Now her eye- sight was inexorably failing. It was too much for one person to bear. For the rest of the day I felt pangs of guilt whenever I recalled the way I had chastised her, which alternated with a lingering irritation over my pusillani- mous treatment of the first patient. The question is, was my suffering self-infl- icted?
Theodore Dalrymple
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