ABSTRACT
Meanings arise from context. And it is precisely the relationship between an abstract concept and its meaning in the world which Henry James is thinking of in his repeated exhortations to himself and others to ‘dramatise’ ideas. In just the same way, the doctor’s understanding of a particular set of symptoms deepens as it is enriched by a lifetime’s experience, by the process of gathering in a lifetime’s worth of contexts. Building relationships is a kind of scenario is often used in communication skills courses, not just in the health professions but also in other walks of life, and it is usually dealt with under the general heading of ‘Difficult patients’ or ‘Dealing with aggression.’ With most ‘difficult patients’, the issue of the interpersonal relationship is likely to be prominent. Most people will develop a set way of saying something which seems to work for the patient, but which also works for the doctor.
