Soma and psyche.

A telephone call seems so much easier, quicker, and cheaper than a letter; but we should not be fooled. Most doctors are impossible to reach. How often are we told "You called him and then he called back and you were out." And it doesn't take long to exceed the 16p of a first class letter when a London caller is left in the void between the switchboard and the department of radiology in the Widdicombe Royal Infirmary. By the time the call has been put through to the department of radiotherapy it would have been cheaper to send a telegram (if they had not been abolished). In reality phones are always more annoying and frustrating and expensive and often slower than letters. They are also much more likely to lead to mistakes and misunderstandings; and they are a dreadful intrusion. After a few years as an editor you can gut the contents of a letter and have it in the bin within seconds if it is libellous, obscene, boring, or scientifically invalid: phone calls take so much longer and in the end anything that is meant for publication has to be confirmed in writing. So please don't call us, and we won't call you-unless it's essential, which is not often. You write to us, and we'll write to you-first class if necessary, but most things can wait. Indeed, many letters are best left unposted for 24 hours, read again in the cool light of the morning, and then scrapped. And you can't do that with a phone call. Honesty after death Doctors nowadays are not always comfortable in the presence of death. In hospital too often the dying patient is passed by on the ward round with no more than a token greeting; in general practice too often the emphasis is on the control of symptoms rather than answering the patient's questions and responding to his fears. Some advances have been made; we have learned to deal with stillbirth rather more compassionately, and the hospice movement has helped doctors and nurses to understand the needs of patients dying of cancer. These, however , are predictable, acceptable deaths in which the health professionals can reassure themselves that everything possible had been done and that the patient's dying implied no criticism of their competence. Unexpected death is much more threatening for the doctor. He may know (or suspect) that the death …