This brings us to another caution.  Never speak to an invalid from behind, nor from the door, nor from any distance from him, nor when he is doing anything.

The official politeness of servants in these things is so grateful to invalids, that many prefer, without knowing why, having none but servants about them.

[Sidenote:  These things not fancy.]

These things are not fancy.  If we consider that, with sick as with well, every thought decomposes some nervous matter,—­that decomposition as well as re-composition of nervous matter is always going on, and more quickly with the sick than with the well,—­that, to obtrude abruptly another thought upon the brain while it is in the act of destroying nervous matter by thinking, is calling upon it to make a new exertion,—­if we consider these things, which are facts, not fancies, we shall remember that we are doing positive injury by interrupting, by “startling a fanciful” person, as it is called.  Alas! it is no fancy.

[Sidenote:  Interruption damaging to sick.]

If the invalid is forced, by his avocations, to continue occupations requiring much thinking, the injury is doubly great.  In feeding a patient suffering under delirium or stupor you may suffocate him, by giving him his food suddenly, but if you rub his lips gently with a spoon and thus attract his attention, he will swallow the food unconsciously, but with perfect safety.  Thus it is with the brain.  If you offer it a thought, especially one requiring a decision, abruptly, you do it a real not fanciful injury.  Never speak to a sick person suddenly; but, at the same time, do not keep his expectation on the tiptoe.

[Sidenote:  And to well.]

This rule, indeed, applies to the well quite as much as to the sick.  I have never known persons who exposed themselves for years to constant interruption who did not muddle away their intellects by it at last.  The process with them may be accomplished without pain.  With the sick, pain gives warning of the injury.

[Sidenote:  Keeping a patient standing.]

Do not meet or overtake a patient who is moving about in order to speak to him, or to give him any message or letter.  You might just as well give him a box on the ear.  I have seen a patient fall flat on the ground who was standing when his nurse came into the room.  This was an accident which might have happened to the most careful nurse.  But the other is done with intention.  A patient in such a state is not going to the East Indies.  If you would wait ten seconds, or walk ten yards further, any promenade he could make would be over.  You do not know the effort it is to a patient to remain standing for even a quarter of a minute to listen to you.  If I had not seen the thing done by the kindest nurses and friends, I should have thought this caution quite superfluous.[16]

[Sidenote:  Patients dread surprise.]