It is true that hypochondriacs very often do that behind a nurse’s back which they would not do before her face.  Many such I have had as patients who scarcely ate anything at their regular meals; but if you concealed food for them in a drawer, they would take it at night or in secret.  But this is from quite a different motive.  They do it from the wish to conceal.  Whereas the real patient will often boast to his nurse or doctor, if these do not shake their heads at him, of how much he has done, or eaten, or walked.  To return to real disease.

[Sidenote:  Conciseness necessary with Sick.]

Conciseness and decision are, above all things, necessary with the sick.  Let your thought expressed to them be concisely and decidedly expressed.  What doubt and hesitation there may be in your own mind must never be communicated to theirs, not even (I would rather say especially not) in little things.  Let your doubt be to yourself, your decision to them.  People who think outside their heads, the whole process of whose thought appears, like Homer’s, in the act of secretion, who tell everything that led them towards this conclusion and away from that, ought never to be with the sick.

[Sidenote:  Irresolution most painful to them.]

Irresolution is what all patients most dread.  Rather than meet this in others, they will collect all their data, and make up their minds for themselves.  A change of mind in others, whether it is regarding an operation, or re-writing a letter, always injures the patient more than the being called upon to make up his mind to the most dreaded or difficult decision.  Farther than this, in very many cases, the imagination in disease is far more active and vivid than it is in health.  If you propose to the patient change of air to one place one hour, and to another the next, he has, in each case, immediately constituted himself in imagination the tenant of the place, gone over the whole premises in idea, and you have tired him as much by displacing his imagination, as if you had actually carried him over both places.

Above all leave the sick room quickly and come into it quickly, not suddenly, not with a rush.  But don’t let the patient be wearily waiting for when you will be out of the room or when you will be in it.  Conciseness and decision in your movements, as well as your words, are necessary in the sick room, as necessary as absence of hurry and bustle.  To possess yourself entirely will ensure you from either failing—­either loitering or hurrying.

[Sidenote:  What a patient must not have to see to.]

If a patient has to see, not only to his own but also to his nurse’s punctuality, or perseverance, or readiness, or calmness, to any or all of these things, he is far better without that nurse than with her—­however valuable and handy her services may otherwise be to him, and however incapable he may be of rendering them to himself.

[Sidenote:  Reading aloud.]