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HEART AND MIND: THE SPECIALIST - GRAVE PROGNOSES

It is easy to see why grave prognoses are so favoured in the profession. They cover the physician both ways. If the patient recovers, it is proof of the physician' s brilliance — he brought the patient back from death's door. And if the patient succumbs, at least he and his folk were well warned of the probability. But sometimes the patient does not accept the physician's word; he neither submits to the proffered treatment nor gives way to the threatened alternative. Instead, he pushes aside the limits arbitrarily put up for him and sets his course for the far horizons. Unfortunately, those who have sufficient self-assurance to behave in this way are a small minority. Even more unfortunately, friends and relatives seldom support the rebel; they would rather see him quietly deteriorate in a conventional and respectable way than upset the kind doctor by wilful behaviour. (For several years after his own death sentence at the age of 17, James C. Thomson encountered just such discouragement, which later made him particularly senstive to this problem of his own patients.)

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