Whereas, if you could but arrange that the thing should always be done whether you are there or not, he need never think at all about it.

For the above reasons, whatever a patient can do for himself, it is better, i.e. less anxiety, for him to do for himself, unless the person in charge has the spirit of management.

It is evidently much less exertion for a patient to answer a letter for himself by return of post, than to have four conversations, wait five days, have six anxieties before it is off his mind, before the person who has to answer it has done so.

Apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion.  Remember, he is face to face with his enemy all the time, internally wrestling with him, having long imaginary conversations with him.  You are thinking of something else.  “Rid him of his adversary quickly,” is a first rule with the sick.[3]

For the same reasons, always tell a patient and tell him beforehand when you are going out and when you will be back, whether it is for a day, an hour, or ten minutes.  You fancy perhaps that it is better for him if he does not find out your going at all, better for him if you do not make yourself “of too much importance” to him; or else you cannot bear to give him the pain or the anxiety of the temporary separation.

No such thing.  You ought to go, we will suppose.  Health or duty requires it.  Then say so to the patient openly.  If you go without his knowing it, and he finds it out, he never will feel secure again that the things which depend upon you will be done when you are away, and in nine cases out of ten he will be right.  If you go out without telling him when you will be back, he can take no measures nor precautions as to the things which concern you both, or which you do for him.

[Sidenote:  What is the cause of half the accidents which happen?]

If you look into the reports of trials or accidents, and especially of suicides, or into the medical history of fatal cases, it is almost incredible how often the whole thing turns upon something which has happened because “he,” or still oftener “she,” “was not there.”  But it is still more incredible how often, how almost always this is accepted as a sufficient reason, a justification; why, the very fact of the thing having happened is the proof of its not being a justification.  The person in charge was quite right not to be “there,” he was called away for quite sufficient reason, or he was away for a daily recurring and unavoidable cause; yet no provision was made to supply his absence.  The fault was not in his “being away,” but in there being no management to supplement his “being away.”  When the sun is under a total eclipse or during his nightly absence, we light candles.  But it would seem as if it did not occur to us that we must also supplement the person in charge of sick or of children, whether under an occasional eclipse or during a regular absence.