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his questions flippantly or rudely, and never for a moment allow him to think that your attention is wandering or that you are not giving him your undivided attention.

By your sympathetic manner he may unbosom himself to you, and impart to you particulars regarding himself and his family which he would never think of repeating to any other living person. It is in this way that the family doctor often becomes the depository of family secrets, the firm friend and the trusted adviser.

During sickness there is often a weakening and breaking down of the natural restraint of the patient's feelings. There is a desire to confide in the one person who alone can afford bodily help. Thus a much more intimate relationship exists usually between the medical attendant and his patient than there is between him or her and any other person outside the immediate family circle, the clergyman not even excepted.

Adroitness in managing the feelings of persons with whom you are brought into contact, the nice perception of seeing and doing exactly what is best in the circumstances is of supreme importance during one's whole professional life. Tact in dealing with a patient's crotchets or foibles; tact in letting him think that he is having his own way; tact in interpreting his thoughts and enunciating them as your own; tact in dealing with his relatives and friends; tact in carrying through some object which is not quite appreciated by your patient and yet is for his benefit, and in a hundred other ways you will find that this ready wit will stand you in good stead. It

has been truly said that the tactful man is the wealthy man.

Kindliness of nature is reflected in the manner and behaviour of the individual. True politeness springs from kindly thought, and this at once shows itself in one's manner. This applies not only to us in our professional work amongst women, but with equal truth to our work amongst men. A quiet, courteous, and yet firm bearing towards one's patients and their friends is by no means to be confounded with a suave, cringing or ingratiating manner. The first is to be cultivated, the latter to be condemned.

The doctor who puts patient, nurse and friends about by his abrupt and sudden incursion into the sick room, by his loud questions and peremptory orders and by his abrupt departure, may have given excellent advice, but has conveyed it in a very inappropriate manner. ("I do not much dislike the matter, but the manner of his speech.")

On the other hand, another doctor may create an excellent first impression by his quiet entry, his interested conversation and by his definite orders. The latter leaves behind him a sense of satisfaction and security, which is absent in the former. "Manners maketh the man," and this is most certainly true of the doctor.

Politeness is the art of rendering to every one, without effort, that which is his due socially. It is the outward expression of good breeding. Though no one is more often exposed to misinterpretation of speech, misconstruction of motive and (perhaps unintentional) insult than the doctor, yet he must at all times and on every occasion exhibit politeness,

not only to his patient, but, and what is often much more difficult and trying, to his patient's relatives and friends. Is it possible to imagine a more pitiful scene than a dispute between the patient or his relatives and the doctor? This may soon lead to hot temper, angry words, vituperation and calumny. If the doctor should so far forget himself and his professional standing as to take part in such an altercation, his influence for good will be entirely gone in that family, to say the least. It is most likely that he will receive a curt communication stating that his services will no longer be required.

Another habit which must sedulously be avoided is that unpleasant one of contradiction. It is a fault by no means infrequently present in doctors and others who are full of their own importance and belief in their own learning. In ordinary life we try to avoid as much as possible persons so afflicted. How much more aggravating must it be to a patient, perhaps confined to bed, to have almost every statement he may make subjected to analysis and disapproval. Were he being subjected to psychoanalysis he would bear up against it, no doubt, but it is quite otherwise when exercised by the ordinary medical attendant. This contentious habit can be overcome by exercising the virtue of tolerance, even though we may not agree with many of the statements of our patients.

On the other hand, there is nothing so nauseating as a servile acquiescence in everything that the patient may say. This is sometimes done by young men under the impression that they are pleasing their patients, and they fear that if they say anything con

trary to their opinions it may tell against them. Nothing could be further from the truth. Every one likes a man who has reasonable and decided opinions and sticks to them.

One must avoid loquacity, a habit of disputation, and on the other hand, taciturnity. No medical man can now hope to impress people by the fewness of his words. The day of oracular speech is over. In days gone by the practitioner tried to cloke his ignorance by his silence, and his patients feared to ask him questions. The well-dressed Dr. Jobling, with his habit of smacking his lips and saying "Ah!” at intervals, while patients detailed their symptoms, and which habit inspired great confidence, would, I fear, not impress the public now. The tendency is rather the other way, and both patients and their friends assail the doctor with all manner of questions as to the illness, its cause, progress, treatment and ultimate results with no little skill, and it requires all his dialectical ability to avoid telling them too much or to prevent them from drawing their own, probably false, conclusions. Though we should tell the truth as far as we are able to judge, yet we ought not to indulge in prophecy as to our patients' illnesses, as, for example, the ultimate ending of the case. Hardly any doctor of experience will do so, as there are so many diverse endings to disease. Many apparently hopeless cases recover, whilst others in which we expected no grave results prove fatal. Be content, therefore, with giving an immediate prognosis and leave the subsequent events on the lap of the gods.

Avoid a frivolous manner. Patients are often offended by what they deem to be levity on the part

of their medical attendant. Sickness, in however mild a form it may occur, is always a source of anxiety and trouble; it is therefore very unbeseeming for the doctor to treat it lightly and in an apparently unsympathetic spirit. I do not for a moment mean that the doctor ought always to be serious and grave. A cheerful countenance and an inspiriting word will do much to help our patient in the way of bearing his trouble more easily, and so will indirectly favour his recovery. The few words of encouragement which you may have let fall accidentally will be remembered long after you have gone and will do much to brighten his lot. While an inadvertent word of undue gravity or even a facial expression of solemnity may lead him to think that you take a very grave view of his case, will do much to depress him and may undo much of the good of your treatment.

True sympathy makes us try to feel as the patient feels, to do to him as you would wish him to do to you were you in his place. If this frame of mind be yours, you will neither conduct yourself with an undue lightness of spirit nor will your manner be such as to depress your patient. I have known patients dismiss their medical attendant because he was too serious and did not cheer them up; his visits depressed them and were looked forward to with apprehension. Your professional visit should have a therapeutic action; there ought to be an energising psychical influence which emanates from you to your patient; the giving of medicine is but a part of your duty as a physician; your sole object is to cure your patient, and this can often be done by mental effort on your part.

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