Wednesday 27 March 2024

A Visit to the Doctor

The other day, I had to go to the doctor's: I had a lump, where previously I had not, so thought it wise to get an expert view.

Needless to say, I consulted the internet, too, and decided it was probably a inguinal hernia, and therefore benign (so I liked that idea...). But I didn't look to see what cancers might cause similar symptoms, though that was, of course, my fear (not least as both my parents died of cancer, my father at a younger age than I am now.)

The doctor was very good: he asked if I had any ideas about what it might be, so I told hem. Then he examined me, and said my diagnosis was in fact correct. Which was a relief.

But it was only a relief because I believe that he is telling the truth - that based on his training and experience, he is sure that the lump is indeed an inguinal hernia.  

However, if he was practicing the new 'patient affirming care' that seems to be the fashion, at least in some aspects of medicine, that would be a problem. It might feel kind to tell me it's only a hernia, and that I am clever to have diagnosed it correctly; but if it is in fact a cancer, that is not a true act of kindness.

It would be equally bad the other way about, of course: if I had decided it was a cancer when it was in fact a hernia, and had demanded chemo and an operation - and he had affirmed my diagnosis and decisions and put me on the road to full cancer treatment. 

Absurd! you may say.

And yet, this is what seems to have happened at the Tavistock; and this is what many lobbyists and activists are continuing to demand now, for people who self-diagnose as trans. And just as I didn't want to look at what other explanations there might be for my lump, there is always a risk that others undertaking self-diagnosis may prefer to avoid explanations that they are less happy with...

The Tavistock's reputation, historically, was built on its exploratory approach: really working with patients to reach a deep understanding of the complexity of their lives and experiences. But at some time that was abandoned, and (according to one clinician, quoted in Hannah Barnes' Time To Think) the gender unit there took on the characteristics of its clients (in a bizarre example of parallel process) becoming strident advocates for puberty blockers etc on demand.

Given the large proportion of the Tavistock's patients who presented with complex conditions, (often including autism), this unquestioning affirmative approach seems appallingly negligent.

Yet it is understandable: there was a real desire to be kind and supportive to these troubled children. But love without truth is as dangerous, in its way, as truth without love. And I think that all those who enter this polarised conversation would do well to remember both halves of that proposition!

And I really, really hope that my doctor was being truthful!

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