A patient once kissed my feet after I removed a speck of dirt from his eye. Removing splinters and earwax also produces excellent feedback. At the other extreme, if I deliver the best medical care for a respiratory infection or sore throat, I'm likely to feel discouraged when the patient delivers a tepid thanks as I leave. After all, he isn't feeling better, and I haven't done anything to cure him. Doctors addicted to gratitude give useless treatments (in this case, an antibiotic) to make sure the patient believes that the doctor has exercised great powers.

Doctor love helping patients. That's why most of us went to medical school. If we're doing our job, patients feel that we've done our best. Cures produce intense gratitude, but doctors cure only a minority of the ailments they see, and doctors who pretend otherwise inflict a great deal of harm.