Doctor, doctor!

A very grand woman goes to a psychoanalyst. He says: “Now I want you to say whatever comes into your head.” She replies: “I was just thinking what a common little man you are.”Surveys show support for alternative medicine is “more likely among well-educated, upper middle-class women” in the US and Australia, says Cosmos magazine.

Middle-class Samantha Upward complains that doctors use too many military metaphors, but talks about people “battling” cancer. She and her friend Eileen Weybridge from Surrey also “fight off” colds by taking paracetamol (which makes them feel better but does nothing to shorten the cold).

Sam supports alternative therapies and can’t follow the logic behind double-blind trials - she thinks they’re a conspiracy and can’t understand why doctors don’t prescribe placebos if they work so well. She says antibiotics “only suppress the symptoms” because she doesn’t read the instructions to finish the course even if you feel better. When she feels better, she stops taking the tablets and the symptoms come back (because the bugs that cause the symptoms haven’t all been killed and are now breeding again). She doesn’t mind revealing that she doesn’t know what “antibiotic” means. She’s very against treating symptoms because you should be treating the whole person and besides suffering is good for you.

She won’t do what doctors tell her, either, because she’s a member of the boss class and it’s her job to tell others what to do. No wonder she’s hopeless with computers, and can’t put IKEA furniture together or learn a skill.

Forty years ago, Upwards had a theory that all symptoms were caused by toxins working their way out of the system. So you should never take Imodium for diarrhoea. They used to be contemptuous of people who took “patent medicines” (probably over the counter aspirins). The were outraged by the idea that people could just go and buy something that would make their pain go away. Why weren’t these things being rationed by Upwards? Why weren’t Upwards in control?

When women writers for The Guardian have a baby they are the first person in the history of the world to undergo the experience: “All my life I’ve been used to being in control—at school, passing exams, university, relationships, planning my career!” And now they’re being bossed about by common nurses and midwives, and in the grip of a natural process.

When Sam’s friends are ill, they have to be positive because it’s faith that cures you. They have to have a story to tell about going to a homeopath and encouraging the body to heal itself because of course they “don’t want to take drugs all their lives”. (It may just be a story.)

Elderly Weybridges despise those who “go to the doctor for every little thing”. They decide their ailment is minor, and they refuse to understand that their taxes pay the doctor’s salary, and if nobody ever consulted him he’d be out of a job. Lower middle class Jen Teale doesn’t want to “bother” the doctor, and is afraid of wasting his time. But some Weybridges can turn any health chat into a discussion of waiting times. They join health insurance schemes like BUPA that promise waiting rooms like hotel lobbies and a whole hour with the doctor.

Sam agrees that doctors don't give you enough time. She can’t afford BUPA, but she’ll go to any alt. practitioner who’ll listen to her. The NHS is too democratic — anyone can get the same treatment — except that if you are a Guardian reader doctors tell you much too much about your ailment. Also doctors know better than you and may tell you to lose weight, drink less and give up smoking. They aren't paid to massage your ego, but you can always pay an alt. medic to do that. Homeopathy is better than the NHS because you get a half-hour chat about the uniqueness of you. Plus it’s a treatment you have chosen.

For Upwards, illness is a wonderful opportunity to feel guilty for being weak enough to be ill in the first place. Even though they love being in control, many Upwards can’t be ill unless someone in authority tells them they are. Or else they suffer from Reverse Munchausen’s Syndrome by Proxy - they won’t let anybody else be ill, either. They accuse each other of having "sniffles" rather than real flu, and may send their friends to psychotherapists to find out “why they chose to be ill”. Fatalists they are not.

Posh Stow Crats and Upwards loved the word “neurotic” and loved using it as a stick to beat each other with. Upwards in particular should never have been allowed near the word “psychosomatic” – what Stow Crats call “making a silly fuss”.

Gideon Upward refuses to go to bed when ill but hangs around the house waiting for any passing female to treat him like a baby, because that’s what his mother did. Jen infantilises any patient and uses words like “meddy” and “tummy” – or even “tum-tum”.

Jen eats probiotic yoghourt. Like the women in the ads, she uses the genteel euphemism “bloating” for constipation. She’s not ashamed of using Buttercup cough syrup, with its nauseating advertising jingle. Sam calls it “cough mixture”, Caroline Stow-Crat “cough medicine”.

Jen says self-righteously: “I don’t take tablets.” Caro calls them pills, Sam calls them “drugs”, and thinks they’re all the product of a conspiracy by pharmaceutical companies to medicalise life - and sometimes she’s right. Eileen refers to her “medication”. Caro still believes health myths that are 50 years out of date – Vitamin C cures colds, aspirins help you sleep, but you shouldn’t take painkillers because you’ll get “used to” them, and when you really need them they won’t work. Or do you become dependent on them? (This may be a folk memory of times when laudanum was available over the counter.) Very posh people fall for “marvellous little men” operating weird black boxes, and trust anyone with an address in Harley Street.

All classes go into work with terrible colds and give them to everybody else on the tube, train and bus and in the office, despite advice to the contrary. They hope their colleagues will tell them to go home and take some days off, but they have to prove their genuine illness first. If they call in sick, they put on a croaky voice even if they’ve got appendicitis or ingrowing toenails. This is so the colleague on the other end of the phone can say “Yes, you do sound a bit rough.” If Jen’s embarrassed to explain what’s wrong with her, she says she’s got a migraine. (If you don’t have an explanation, your colleagues will think you aren’t ill at all, so you have to be prepared with a) symptoms and b) how you are treating them. Of course it’s easy to make all this up. Cue anecdotes about employees who insisted on taking their entire quota of sick days as of right.)