A number of people have told me that my ‘clinical’ posts are aggressive, moaning, difficult, unconstructive, provocative, leaving no space for a discussion. I’d like to respond to these voices.

So, are my ‘clinical’ posts all that above? Yes, I think to some (perhaps even considerable) extent they are. Do I aim to make them so? No, not really. In fact, what you see are versions which are always significantly toned down, combed over to look as polite as I can manage. What you see is the bare minimum, the bottom line. I am also delighted to report that no one has ever said my posts are impolite. Strong, yes, impolite, no.

It’s time to explain. The way I see it is that when I am asked to be ‘constructive’, I am really asked to be respectful. After all, I am addressing the royalty, I mean, the doctors, the crème de la crème of the society, so, I should address them with a slightly bent knee, gratefully genuflecting as I write. After all, I can only be a source of useful information. My anger, my disappointment, my pain, my sorrow, my suffering apparently are not good enough. They should be mitigated in the posts, otherwise the posts are not constructive enough.

But there is more. You see, sometimes there is nothing constructive to say.  What exactly am I supposed to say about three nurses walking into my doctor’s surgery, without knocking, when I discuss the possibility of having cancer with him?! If they, he and the hospital do not understand how unacceptable it is, not only do I not want to be constructive, I have nothing to say to them all. I can only be angry! Or when I am told I look for an illness in myself, or when the doctor doesn’t even look at me as they type ‘the notes’. I really don’t think there is anything constructive to say. And no, I’m not really open to suggestions.

Under my last post, Dr John Launer wrote:

I used to find your blogs too provocative and non-constructive but have gradually come to appreciate them as representing an essential voice of patient protest and sometimes anger that we need to hear.

This is very important to me and I appreciate John’s comments very much. They point to another important aspect of being ‘constructive’. For me in order to be constructive, I need to be acknowledged as a partner. Not as a provider of stories, a source of ‘constructive’ information or patient opinion and feedback, with which you will do whatever you wish. In fact, I always think that my feedback first must be authorised as feedback; if it’s not ‘constructive’, it doesn’t count and can be dismissed.

And if anything, I want to be part of the conversation. But that can happen only if my anger and the rest of what I feel is acknowledged. Without the acknowledgement, without the conversation partnership, ‘constructive’ talking is moot. Who cares how constructive I am, if you can reject whatever I say, as my constructive post becomes ‘feedback’ rather than part of a discussion.  And as long as you can do whatever you wish with what I say, as long as I am just a provider of patient opinion, ‘constructive’ means genuflected, respectful. And I don’t particularly want to genuflect.

Now, I am not certain at all that this is the way. Perhaps speaking constructively, neck slightly bent down, is the way. The problem is that, for me, it’s not enough. Maybe it’s the insignificant pain which, after a while, just gets to you and you can’t speak constructively. And what’s left is simmering over into a blog post.