“Dottoré, I don't want to take the medicine. Shouldn’t I be free to decide that for myself?”
This question holds everything I resent the most about my work.
At this point, I know I have to look the patient in the eye, and without flinching, answer:
“No.”
In 99% of the cases, the patient will reply: “I’m well enough — I’m not taking it.”
And I will have to double down, firmly: “No, you’re not well, and you need to follow the treatment.”
“And why’s that?”
And here comes the kicker.
I usually say, “Because it is precisely the illness that makes you think you are well, and that instead, it is others who are sick.”
This first response, professional as it may be, is usually the least effective. It usually elicits something laconic in the line of, “You’ve got that right. It’s the others who are crazy: I’m doing just fine.”
“If you were alone in the world, and didn't have a job and or a family, then you wouldn't have to be accountable to anyone. But this is not the case. Because of your illness, your partner and children are suffering, and you are no longer able to work.”
At this point, even the most tenacious patient begins to waver. But some won’t give in just yet and start to stall. “So you’d rather have me take these pills that hurt me? I just need to rest a bit and drink some chamomile tea.”
“Sure, you can drink chamomile if your stomach is hurting. You haven't slept for 15 days. You’ve gambled 10,000 euros at the lottery. You think everyone is out to hurt you, you hear voices in your head and you walk around with a knife. Do you really think a chamomile tea is enough?”
I won’t bore you further.
Usually, this goes on for a long time. Sometimes it ends well and sometimes, unfortunately, very badly.
What is certain is that having to convince a person that they are sick, and forcing them to get treatment is really a shitty job.
And by the way, to hell with chamomile and whoever invented it …
____________________________
Learn more about Worldcrunch's exclusive Dottoré! series here.