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Advances in medicine


When it's better not to tell the truth
Harold Lambert Physician
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I'll tell you a phrase I... I use quite often, which I said to patients, 'I'd like to tell you what's in my mind about your illness'. Now, that was true, but it wasn't completely true so if I had a... I pretty well thought I knew what was going on but, you know, you have these sort of ticking off orders of probability in your mind, and somewhere at the bottom end was some horrible cancer, which I was pretty sure they didn't have, I didn't mention it, of course. So it was true, but it wasn't the whole truth.

[Q] Right. Right.

Yeah. And I did lie. When I saw more dying patients I lied to them, too, when I sensed that they didn't want to have that kind of conversation.

[Q] Lie in the, in the... do you remember it?

Well, I remember the very first time actually. It's funny, these individual things. I was the house surgeon on the surgical unit and a man was dying of cancer of the pancreas with secondaries and I went on the night round, which you know in those days when people did night rounds, now they're so busy, poor devils, they couldn't possibly, they're rushing from one person to another. It was the really big time for knowing what was going on. And he, he could just lift his head off the pillow. He said, 'I will be all right, won't I doctor?' And I took a deep breath and I said, 'You'll be fine. What does the ethicist say about that?

[Q] What does the practical doctor in you say about it? Would you change that now or...

No. No, I wouldn't. No, I wouldn't. No, no. And the hospice movement, although it's tremendously valuable I mean, hugely changing you do detect sometimes there's a bit of an agenda: this is the moment when we have everything out. Well, some people want it, and some people don't.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: patients, cancer, doctors, hospice, death

Duration: 1 minute, 46 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008