This week I gave a research seminar in my department, the Centre for Language, Culture & Communication at Imperial College London, in which I synthesised some of the ‘lessons learned’ in the course of my research and how this has informed my teaching. It was streamed live, and Julian Lecoeur from ProlificTV has kindly made a recording available here.
In an interview for the Oldie magazine, oncologist Prof. Karol Sikora has recommended being as nice as possible to those that treat your health conditions. “If someone is particularly helpful be appreciative – everybody likes positive feedback,” he told John Sutherland. Sikora is promoting his new book The Street-wise Patient’s Guide to Surviving Cancer in which he advises patients to charm their doctors if they hope to persuade them that they are worth ruinously expensive cancer drugs. NHS staff are “dedicated and remarkably caring”, he said, “and they naturally respond well to pleasant patients.” His advice,though to “tell someone they have a lovely smile,” might come across as a bit obsequious though, not to mention downright creepy in some situations.
I recently paid a visit to the University College London Hospital (UCLH) archives in Euston to discuss gratitude and see some of the archive’s holdings. Annie Lindsay and Penny McMahon have charge of a vast amount of material. Some fascinating highlights are on public display in UCLH’s highly recommended heritage trail. Annie and Penny gave me an insight into the kinds of documents that are preserved. Patronage, of course, is well documented, and this has an enduring legacy in a number of wards in hospitals being named for their donors. Complaints are also kept on record although, interestingly, Annie pointed out that in the past this largely depended on the diligence of the superintendent in charge.
A few weeks ago I had the opportunity to present some of my work on the gratitude expressed in the Frimley correspondence to GP trainers and trainees from West Middlesex Hospital, whose two days away were delightfully themed around ‘happiness’. It was a nice way to hear some stories of gratitude from the frontline.
We had a lively discussion about whether patients are morally obliged to feel grateful. Lots of the delegates were uncomfortable about the word ‘moral’, although most agreed that patients had lots to be grateful for. The overwhelming majority felt that patients should be grateful for the NHS in general, rather than specific practitioners.
Cards displayed on the ward, chocolates in the common room… but there is an increasing trend to use Facebook as a collective noticeboard to proclaim gratitude. Showing Thanks is a recently established webpage for conveying gratitude to healthcare professionals involved in maternity care and childbirth. Mothers have been posting their stories on this Facebook site and then Rachel Ellie Gardner has taken it upon herself to let healthcare trusts know when a member of their staff has been thanked.
Anecdotally, we know that staff involved in obstetrics get a lot of gratitude. Even if a birth has been dramatic (and, let’s face it, most births have elements of trauma), the outcome is usually happy.
These amazingly creative cupcakes were made by the aunt of a young tonsillectomy patient for the surgical ward and theatre team. It meant a great deal to the staff. Dr Ruj Roplekar, who was one of the recipients, said, ‘I was delighted that someone had shown that degree of appreciation for all those involved in the care of someone she loved.’ When Ruj posted this image on Facebook, it was interesting to see that one of her fellow medics urged her to save the photo as evidence for the ARCP of the ISCP (that’s Annual Review of Competence Progression for the Intercollegiate Surgical Curricular Programme).
An article on the Guardian’s ‘Comment is free’ website is attracting a lot of attention. Within two days of posting, it has been ‘shared’ on social media nearly 27,000 times and attracted 650 comments. The article is a first-person account of experiencing a miscarriage. The couple received excellent, sympathetic care, undermined somewhat by an automated text the next day asking, ‘How likely are you to recommend our A&E department to your friends and family if they needed similar care or treatment?’ The text presented a 5-point Lickert scale and asked respondents to text back 1 to 5 on the basis of how likely there were to recommend that A&E.
Rina Dave has found a wonderful way to celebrate the healthcare professionals and her friends and family who are supporting her through he treatment for cancer. She has created large-scale photographs of caregivers, each personalised by an ‘accoutrement’ that gives a glimpse of their personalities. Read more about the exhibition, on display from 17 to 30 November 2014 in the main entrance of Imperial College.
I have been reading an influential essay by Arjun Appadurai, ‘Introduction: commodities and the politics of value’ from Appadurai, A. (ed.) (1986) The Social Life of Things: Commodities in Cultural Perspective. Cambridge: CUP, pp. 3–63.
Although focused on ‘commodities’ which implies an economic context that is missing (overly at least) from the NHS context, points in the essay have made me think about how one might frame a critical study of gratitude and the giving of gifts to healthcare professionals.
It is not customary to give gifts in the NHS (although this needs further research). Most anthropological studies of gift-giving are focused on the trajectory of gifts within relatively isolated, small-scale societies.
This is a lovely story of how patients queued for hours to thank Dr Richard Hughes on his retirement. An ‘event’ such as retirement provides a focal point for gratitude – it seems a shame that many doctors receive a show of appreciation only at the end of their careers. One of the characteristics of the way we express gratitude, in Western societies at least, is that it often signifies the ‘closure’ of a particular transaction. (The word ‘transaction’ here seems freighted with economic meaning, rather unfortunately, but the rhetoric of gratitude is saturated with economic metaphors.) This closing shapes the framing of the act of gratitude as a ‘reward’ for past service: in terminis res, as it were, rather than in medias res.
