Dr No has a close non-medical friend – a salesman – who is forever trying to sell Dr No the idea that medicine is really just like any other job. All that special pleading, all that vocation nonsense, is so much hot air, he says. Other jobs have just the same stresses and rewards. Medics have no ‘special case’.
Dr No begs to differ. Dr No suspects that most doctors have an affair with medicine, and that that adds an intensity to the relationship that most jobs lack. He is not convinced that those who sell stationery for a living – as his friend does – have affairs with selling, let alone selling stationery. If they do, then there must be an eroticism to ring binders that has quite passed Dr No by.
Sometimes the medical affair turns into a marriage; and like all marriages, some are happy, and some are not. But – whatever the ups and downs – the bond is close, and the dependency binding. Divorce is rare. Even if marriage does not prevail, then the affair will remain, sometimes tempestuous, sometimes mundane, but always ever present.
The glue that holds doctors and medicine together is an ancient glue that has stood the test of time. But, just as in affairs and marriage in wider society, changes are afoot in the relationship between doctors and medicine. The glue is being tested by an interloper, a ‘third person in the marriage’, as Princess Diana famously put it. That third person is the modern NHS.
That third person – who is in fact the State in disguise – has, of course, been present in some shape or form for some time; and, as in all three party relationships, the going has not always been easy. But we have rubbed along together, and made the best of our quarrels and disputes. Until now, that is.
The third person has developed ideas above its station. It has mutated into a management Medusa that seeks to dominate each and every aspect of the relationship between the doctor and his job. Even his job has begun to change beyond recognition, straining the ancient glue to its very limits. There will be endless rows, and recriminations, and many a tear will be shed.
Separations will occur; and yet even after each more severe estrangement, medicine and Medusa will return, to woo the doctor once more. But relationships, even the strongest, can only take so much strain. How many doctors, facing an ever more pressing, insistent, and ultimately tiresome mistress, will one day draw a short breath and say lightly but softly:
‘My dear, I don’t give a damn.’?