Every Man His Own Doctor ?
THE growth of medical science is beginning to affect not only the professional doctor but also his patients.
Everybody is interested in his own health, and the more straightforward parts of therapeutic knowledge are now, with the spread of semi-technical boOks and periodi- cals, becoming common property to most educated men and women. Again, most doctors nowadays talk far more freely and frankly to their patients about their symptoms and what they mean than they did twenty years ago. The result is inevitable. People are beginning to watch their own bodies ; to study their symptoms, estimate their tone and general fitness and, consequently, to prescribe for themselves, if only by varying their habit of life in some fashion—by taking more exercise, drinking more water, eating less meat or more fruit, and so on.
Now there is obviously much to be said both for and against this tendency—if it be granted that it does exist. On the one hand it is clear that if a man keeps scientific. watch on himself, notes the varying efficiency at which his body is doing its work, just as a good chauffeur will listen to his engine, no matter how smoothly it is running, then he has, other things being equal, a far better chance of maintaining a high level of health than has the careless fellow who never gives his body a thought.
After all, we all know a great deal more about our own bodies than we do about anybody else's. The best of doctors has in many instances to rely on what the patient tells him. True there are definite objective tests of health, such as the obvious ones of temperature, pulse, and complexion. Yet pain itself is the great indicator that something is wrong—the danger-signal of the body —and his pain can only he felt by the patient himself.
Theoretically the patient is often his own best doctor. But experience has certainly shown that there are very serious objections indeed to this theory. The gravest objection is to be found in the very fact that everybody is really passionately interested in his own health. So passionately, in fact, that very few are able to study it scientifically. One cannot bear to observe carefully and dispassionately the symptoms of one's own body lest one should detect the symptoms of disease. A fool's paradise, we most of us feel, in this matter is better than no paradise at all. Or, again, by a trick well know". to the psychologists we jump to the other extreme. We are so terrified of disease that we find symptoms where they do not really exist at all. So common is this neurosis that it has earned the special title of hypochondria. So prevalent has it been, so unable have been the majority of us to make a clear and accurate report of our own state of health, that doctors— in the past, at any rate—have come to the conclusion that the patient's own statements are the worst instead of the best guide to his physical condition.
From this has grown up the element of the mystery surrounding the doctor. The patient, it used to be held, must be excluded from all consideration of his own con- dition : blind trust in his physician should be his only preoccupation. The less he knows about his real state of health and what is necessary to it the better. This, no doubt, would be an admirable plan if doctors were infal- lible and omniscient. Unfortunately, however, they are neither. What is more, they are increasingly prone to admit it. The older generation of doctors, with their inscrutable air of wisdom, is passing away before a new generation of brisk young scientists who brutally inform their patients how little they, or anybody else; really know about pathology, and who demand the active and
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conscious co-operation of their patients in order to Om ' a cure.
The result has been, -inevitably, the awakening in the " laity " of a far more active interest in their own health than they have ever been allowed to display before. Every second person one meets nowadays has some theory or precept for health. Again, the Press is in- creasingly full of discussions on health, conducted by no means solely by doctors. A good example is the recent article in the Spectator on the dire effects of drinking tea and coffee. Why is it, the writer asks, that we arc at our worst in the morning after eight hours of perfect rest, and at our best in the evening when we have been most active ? Here is a fact which, the writer says, needs careful explanation and receives none. He thereupon ascribes it dogmatically- to the fact that these stimulants have a bad effect upon us. Though why this effect should act particularly in the morning is hardly clear. Yet the problem posed is surely an interesting and genuine one, however inadequate and unproven the solution may be Here, at any rate, is a layman thinking and thinking hard, and not altogether unscientifically, about the problems of health. He is symptomatic of his age.
More books on physiology and psychology, especially, Of course, the latter, are being read. than ever before. Whether the whole tendency is good or bad reinaiits to be seen. It all depends on the degree of self-detachment and avoidance of neurosis which the average man and woman can develop in the study of their own minds and
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