Is it a demonstration of compassion for a doctor to attend the funerals of his or her patients?
Is it considerate of a compassionate doctor's patients to be having funerals at all?
The first question -- the second one being unanswerable -- has been raging in the pages of the New England Journal of Medicine, where this extreme example of follow-up care is being treated as a moral question.
It is not a moral question, Miss Manners wishes to point out. It is an etiquette question. There are so many aspects of medicine that lend themselves to moral anguish that Miss Manners will thank the profession to allow her to prevail within her own little specialty.
The points being made by, uh, nonspecialists, in favor of doctors attending such funerals include:
That it gives the bereaved a chance to discuss the final illness with the doctor.
That it demonstrates that the doctor valued the patient.
That it "forces the physician to acknowledge death. It forces him or her to face the sadness and pain, the guilt and the frustration of losing a patient."
Arguments made against include:
That the doctors would probably really be going in the hope of collecting appreciation for their own dedication.
That the added duty, "however noble," would be yet another slice of qj time that the doctor would have to take out of his or her own family life.
We are presumably not speaking here of the old family doctor who lives down the road a piece and is fond of reminiscing, just when you think you have achieved grown-up dignity, about how you, and your parents before you, squalled when he brought you into the world.
Of course anyone who has had a personal interest in someone who has died ought to attend the funeral, in order to pay respects to the deceased and to make known that feeling to the bereaved, as well as to demonstrate sympathy with them.
The dilemma, rather, seems to be that of the doctor whose connection to the patient was a limited professional one, probably chiefly in attending the last illness.
Does he have certain obligations of form to the family? Certainly. The manner in which the news of the death is conveyed is an extremely delicate matter, and he is certainly obliged, then and again later if it seems necessary, to inform the family, in detail if they wish, that everything that could have been done was.
But does he have an obligation to attend the funeral for this or any other social purpose? Miss Manners says no.
She doubts that any physician would be motivated by the hope of collecting glory for himself on such an occasion, but believes that such egotism would carry its own punishment. A well-meaning but grieving family is just as likely to have highly unpleasant associations with the person who did not, after all, deliver the miracle for which they hoped.
Nor does Miss Manners believe that doctors are in need of becoming emotionally sensitized to the fact of death. The ability to act with detachment -- otherwise known as medical-school humor -- is essential to the profession, which nevertheless does not seem to encourage the carefree approach of, "Oh, well, win some, lose some."
The real point, Miss Manners believes, is that which probably seems the least sympathetic of all -- doctors, too, have private lives to maintain. She might add that in these lives, too, there will be the usual human lot of illness and death, as well as less tragic duties, and the usual time pressures in attending to them. (Doctors may think they have worse schedules than anyone else, but the rest of us all think so about ourselves.)
This is no time to go around inventing new social duties for any profession. The test of the doctor's professional dedication is how much he does for the patient while he can, not whether he is willing to enter the patient's private life, even at its close.
Q. What are the proper hours in which phone calls to friends can be made? I called a friend at 9:30 p.m. and was informed that was socially improper. Please tell me who was in the wrong.
A. A telephone call is always an intrusion; why is Miss Manners having such a difficult time getting that across? Few people are ever doing nothing except hoping that the telephone will ring, and unfortunately, those people's telephones never do.
As a general rule, one does not call before 9 a.m. or after 9 p.m., nor during the dinner hour.
Aha, you say, but what time is dinner?
The answer is that it is best to know the habits of one's friends (for example, people on the night shift may be happy to get calls at midnight, but frightfully upset at noon) and to be prepared to get off the line quickly at any time that may, for any reason, be inconvenient for the person called.
Q. When a drink is sipped through a straw, is the glass left on the table or picked up each time one takes a sip?
A. Pick it up. The exercise works off the calories from the drink.
Q. What do you think of men who make little or no effort to chat with any widows or unattached ladies present and who mainly chat with each other? These women are friends or acquaintances of the men and are not threatening to their wives.
What about a guest who, soon after arriving, sits in one place, says that she or he is tired and does not want to circulate, yet slips into an obvious pout and goes home irritated at being isolated?
What I am talking about may not be obligations of party guests to their hosts but simply a measure of thoughtfulness that can make a big difference in the success of a party where conversation is the main attraction.
I know that guests should be on the receiving end of comfort and entertainment, but isn't there a sense in which they should expect to give, too? I salute that special, discerning guest who shows a gracious interest in others and who deliberately tries to converse with everyone, especially those who may appear shy or alone.
Is such an attitude too much to hope for in these wary, me-first times?
A. Now, now, don't give up. Miss Manners gets upset when she hears people consider resigning themselves to "these days," when she is out working so hard to make these days more pleasant for everyone.
Yes, guests have obligations. Thousands of them, beginning with answering their invitations and ending with thanking the hosts and reciprocating.
Certainly one of them is to contribute, through attitude and behavior, to the success of the party. People who do not expect to have a good time have no business taking up space at parties.
They must talk, if the point of the party is conversation (or listen if it is music, or dance if it is dancing), and must assume that all other guests are worth talking to or the hosts would not have invited them.
However, they do have some choice about whom they pick. A guest should not talk only to people he already knows or only to people of the same gender, but is allowed leeway in finding compatible souls.
Seeing to it that strays are taken care of (although Miss Manners resents single ladies being presumed to be socially helpless) is actually the host's job. A guest who makes an effort to do this is a treasure, but the obligation is only to accept in conversation any stray a host hands over, no matter how unlikely the host's claim that "you two should know each other; you have so much in common."
Q. When I arrived in my boyfriend's apartment recently, at his invitation, he greeted me at the door with a request to "leave for about 15 minutes" because he was involved with an unexpected telephone call from "another girl" who was "in crisis" and he preferred to respond to her immediately and "in private."
Was I wrong to feel offended? I left promptly, but I did not return.
A. Miss Manners believes you did the right thing. She only asks that in any follow-up he might initiate, you not denounce his rudeness but say innocently, "I just thought it was best to leave because it was obviously a busy time for you."
That way you are not stuck with the rudeness if it turns out that what he was actually doing was persuading a desperate person standing on an outside window ledge not to jump.