ABSTRACT
Carol McKenzie's story reminds people that there are circumstances when the flipping of Michael Crichton's switch, bringing much-needed focus and self-control, is of benefit to both patient and doctor. Activating Crichton's switch appears to flip the doctor into outwardly directed close-up mode, so that the attention becomes fully taken up with detail to the exclusion of context and self-awareness. Given how many young doctors experience Crichton clicks in circumstances of high stress, the task of brutalising the humanity out of them should be easy. At all events, one of the corollaries of having an effective Crichton's switch is that the 'bubble of calm concentration' and the big picture view of illness in all its complexity are both available to the self-aware practitioner. Without the switch there can be no variability in the medical gaze; and without that variability of gaze - that capacity to understand the multidimensional nature of human distress - the doctor's professional trustworthiness is diminished.
