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5th September 1967.
Dear Margaret Torrie,
One more word following my letter of yesterday. I have just read a paper by Tom Main (not published) which reviews the nature
of psycho-analysis, and there is something in it which expressed an idea that I wanted to include in my letter to you yesterday. It has to do with the doctor's dilemma, by which I am not referring to Bernard Shaw's version so much as to the awkward fact that the doctor who wants to be free in his technique needs to be uninvolved emotionally. This is the quotation from Tom Main:
“This problem—how to experience the creature of study as separate from oneself, outside oneself, different from oneself, an object of study and not a subject of experience, is far from easy. How to observe it coolly, how to record the behaviour objectively without being moved by compassion or hatred, without dread or gratitude, without distaste or sympathy, without identifying with it? These problems particularly occupy all workers who are concerned to observe and record human behaviour. Without some solution to them the surgeon (for instance) whose daily work concerns suffering, terror and pain, mutilation and death, blood and faeces and urine, could not work with cool skill. Like the biological scientist he must detach himself from the creature he deals with, defend his own objectivity, and persistently avoid any great identification with his patient's sufferings; for he has to be concerned primarily with their bodies.”
I am reminded of a curious thing about myself right back in the twenties. After being an Out-patient Physician at Paddington Green I became entitled to beds. This was very exciting, because the doctor in charge of cases in the hospital has status. Having beds means that one has arrived. Hardly knowing why, I refused to step up. I got permission to use beds where necessary but I handed the in-patients over to my junior. I knew at the time why I was doing this. I said to myself: the distress of babies and small ch