Add to this that the attempting this impossibility does more to increase the poor Patient’s hurry and nervousness than anything else.

[Sidenote:  Partial measures such as “being always in the way” yourself, increase instead of saving the patient’s anxiety.  Because they must be only partial.]

It is never thought that the patient remembers these things if you do not.  He has not only to think whether the visit or letter may arrive, but whether you will be in the way at the particular day and hour when it may arrive.  So that your partial measures for “being in the way” yourself, only increase the necessity for his thought.  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 is 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.[13]

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?]