“Doctors need to bring something of themselves to their patients, to make a personal connection, if medicine is to be a healing science,” writes an anonymous obituarist, somewhat portentously, at the end of an obituary of Oliver Sacks. But if you’re a nurse you might be disciplined for such a human healing action.
A nurse told me this story at the end of my lecture, Death: the Upside, at the Edinburgh Festival. She comes from a culture more comfortable than ours with death and speaking directly. She’d been looking after a young man who was dying. It was her duty, so she told me, to ask his wife whether once dead the man should be buried or cremated. The wife was understandably distressed. In an attempt to help the nurse described that she found being able to visit her father’s grave a great comfort. She wasn’t dictating the couple’s choice but offering a piece of her own experience.
The wife complained. Her grief, like most grief, probably included anger. She perhaps complained about many things. That would be understandable.
What wasn’t understandable was that the nurse was disciplined, although perhaps death was important here as well. The health system had let a young man die. It had failed. Those in charge may unconsciously have sought a scapegoat.
The nurse didn’t spell out her punishment, but it seemed to involve a spell away from work. But what bothered her—and perhaps prompted her to share her story with me—was that it was thought wrong to offer something of herself. “You must offer nothing of yourself. You are a professional. It is not professional to share stories from your personal experience,” say the authorities through such an action.
What could be more absurd? Healers, as the obituary writer says, share something of themselves, as Oliver Sacks clearly did. Technocrats don’t, but people don’t want technocratic nurses; they want human nurses, with all the flaws and fallibility that are part of being human, to help them through their suffering.
Richard Smith was the editor of The BMJ until 2004. He is now chair of the board of trustees of icddr,b [formerly International Centre for Diarrhoeal Disease Research, Bangladesh], and chair of the board of Patients Know Best. He is also a trustee of C3 Collaborating for Health.