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What makes a real doctor?

By Brian Holden - posted Tuesday, 29 March 2011

As you peer into this painting by Samuel Luke Fildes, you will be almost sucked into the humble room. It is a disturbing picture because lying across pillows on two mismatching chairs, that child could be your own - if luck had not determined that you are alive in the 21st century, and in this country. The painting hangs in the Tate Gallery in London. It is titled The Doctor.

The distraught working class parents are well clear of this educated man's space. He belonged to the social class which they referred to as "quality". But, what can this man do? The mother is praying as she has never prayed before. Even in the shadows, Fildes has captured the despair on the father's face.


The child is dying, and the mid-19th century physician feels helpless. He has experienced this scene many times before. The regular loss of children is the way nature works - but he hates the way nature works - and it is the reason he became a physician. As he stares at the stressed child, he is angry at the rudimentary science at his disposal.

These are the times when there are few doctors and many of the propertied class have ailments. So, why is he giving a free service? It is because he is a real doctor. Nevertheless, he is going have to stand up and tell the parents that there is nothing more that he can do for their child who is so innocent, so beautiful and so deserving of life.

Implied in the painting is that the child will be dead within a day or so. Nothing in a human's emotional experience can be a traumatic as placing the small body of one's child into a hole in the ground. But, in the thinking of the parents, that may not be the end of it. They may meet their child again in some form or other in the afterlife. In the days when almost every parent lost at least one child, the value of that hope is beyond measure.

Those days are behind us - but, not really. About 30,000 children die each day. And then there are those who are crippled. In rural Asia I saw shocking facial disfigurements. The victims have no hope of having their affliction repaired.

If, in the developing world, you were the parent of a child without a nose, how would you feel if you knew that the technology and skill which could give your child a normal life was being devoted to augmenting breasts? What would you, as the parent of child who, even at the age of three years, is already feeling to be repulsive, think of doctors who justify that cosmetic surgery on the self-absorbed with the claim that they are the generators of happiness?

The practice of medicine never was supposed to be a means of making the normal better than normal. Those who advanced the art and science of healing over the centuries, did so for the sole purpose of alleviating human suffering. They did not envisage their achievements being exploited.


But, questionable integrity is not limited to cosmetic surgeons. Most of us have experienced the entrepreneurial doctor in a stylish group practice carrying a multi-million dollar debt, and who cannot hide his eagerness to get rid of you and onto the next injection of dollars sitting in the waiting room.

Then there are those harassed in their workplaces who, following their lodging of a formal grievance, have to face the psychiatrist engaged by an insurance company. This doctor (known in medico-legal circles as a hired gun) has the objective of ensuring that any compensation claim fails due to the claimant's "personal adjustment problems".

Nevertheless, many doctors enable medicine to still sit on the top rung as the noble profession. Some are working killing hours in emergency departments or as lone practitioners in country towns. Some are standing next to operating tables for eight or more hours in a state of intense concentration. Some have opted for the almost crushing responsibility of pediatrics as a specialty. Some are teaching and performing research in universities, while being paid less than half they would be earning in private practice.

And, we have Australian doctors today who are every bit as magnificent as the man depicted in the painting. These people (assisted by equally magnificent nurses) are working in squalor and personal danger - somewhere in the developing world.

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About the Author

Brian Holden has been retired since 1988. He advises that if you can keep physically and mentally active, retirement can be the best time of your life.

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