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Telling Admissions 5

When a doctor becomes a patient, the wall that separates the two is shown to be permeable, and the very idea of what it means to be a patient comes under scrutiny. For the psychiatrist Patrick Wakeling, becoming a psychiatric ‘patient’ in the 1970s meant being “helpless…a passive, inert lump of problems, some intractable”.1

Being depressed - severely so, I mean, is to have avoided the challenge; to have thrown in the towel without even having faced up to the contest. It’s like saying, ‘You take over, I can’t do anything. I’m a patient. I’m depressed.’2

Yet it is far from clear that the retention of the word ‘patient’ necessarily implies a paternalistic model of treatment; or that a move towards the terminology of ‘user’, ‘client’, ‘consumer’ or even ‘customer’, such as has been witnessed within the National Health Service in recent decades, has been responsible for any real improvement in “attitudes of doctors and nurses to people who come to them for help”.3 Any decision to seek or to accept assistance from others commonly involves a degree of vulnerability, but should not be seen as itself a sign of weakness. As Wakeling acutely observes in respect of his own experience of depression, “the paradox consists in using the feeling of not coping to know that I am”.4 It seems clear from his account of recovery that the decisive factor was his own active participation in the process, no matter the level of outside professional engagement - “progress ha[d] to be on my terms and in my own good time”.5

Wakeling also registered valuable professional gains from the experience: “insight into the predicament of those in the hands of doctors and nurses which I could not possibly have obtained in any other way” and the recognition that “to be a good psychiatrist requires the same honesty and courage expected of the good patient”.6