The Conundrum of Happiness
The most amazing thing happened in the office this week. I made one of my unhappy patients happy.
I don’t mean to imply that he was suffering from some politically incorrect disorder such as misogyny, nor do I wish to suggest that, not unlike a large slab of cheese inadvertantly stored in a warm cupboard, he possessed a rather malodorous personality. I’m sure that ordinarily he was brimming with the milk of human kindness , full of Falstaffian mirth, a man with nothing but the deepest appreciation for the circle of life, etc. When I met him, however, not only had his cup not runneth over with love, I had to fight the urge to pull the nearest fire alarm and dive out the window. As I sat across from him and his scowling family never in a million years would I have thought that someday he would look like a happy camper, let alone a happy camper always be. It could not be denied though - within just a week or two of our meeting he now radiated exuberance. Where before he would shuffle in from the waiting room he now practically skipped about, which is not necessarily an unusual sight in a medical oncologist’s office. After all, we strive to include a little merriment in the workday - keeps us from having to constantly wash our tear-stained clothing. My patient therefore now fit right in with myself and the rest of my staff as we let out a ha-ha-ha, ho-ho-ho and a couple of tra-la-las while struggling to keep our patients from becoming the umpteenth addition to the Spoon River Anthology.
Say, did I mention how I released the happiness hidden within this gentleman? As a public service to all those who work with cancer patients I shall be delighted to reveal this trade secret. Before I do though, let us catalog all the possible remedies that the clever reader may be contemplating were used by the calculating author as he contrived to cure the downcast patient:
No, I didn’t soothe him with purring words of empathy. Counseling patients is important but not always effective.
No, I didn’t overwhelm him with reflective listening, even though listening is more important than talking.
No, I didn’t guarantee that his cancer would respond to treatment. No mortal can predict the future let alone figure out why all those Nigerians want to send me money.
No, I didn’t tickle his funny bone with the latest doctor jokes.
What I did was to remember a very important law from a key medical book that every student considering a career in medicine should read. Law number four, to be specific: The patient is the one with the disease.
The patient, sitting before me with the disease, was suffering from two frustrating symptoms: dyspnea and pain that, unknown at the time, were actually the source of his misery. Myself being the person commanded to solve these problems I therefore placed him on appropriate pain medications, arranged to have his large pleural effusion drained and started his chemotherapy. My patient’s cheerfulness had rotted from the effects of his cancer. If I wanted a happy patient I needed to grab a plow and start sowing.
If there is a lesson in this vignette it is that when it comes to helping the sick, all the fancy office furniture, nattily-dressed assistants, self-congratulatory advertisements - all the gum-flapping-hand-holding-soulful-eye-gazing office encounters don’t compare one bit with the doctor who can solve the patient’s problem. As the father of modern medicine, Sir William Osler put it:
“To know just what has to be done, then to do it, comprises the whole philosophy of practical life.”
Most elegantly put - or as my patients say, “You want me to be happy, Doc? Then make me feel better!”
