Family Practice Vol. 20, No. 4, 495-496
© Oxford University Press 2003
Book Review |
Doctors and patients: an anthology.
Cecil Helman (ed.). (171 pages, £19.95.) Radcliffe Medical Press Ltd, 2003. ISBN 1-857-75993-1.
Retired GP, London
Being offered this book for review just before Christmas was more of a pleasure than a task—an unexpected present any doctor might be pleased to find in his or her stocking. It is a collection of medical writings—excerpts from autobiography, novels or journalistic essays and short stories —selected and edited by Cecil Helman, with a general introduction and a short comment on each piece and its author. He describes the anthology as "a celebration . . . of a unique and archetypal relationship, a healing bond between doctor and patient".
With so wide a choice from medical literature available, literary quality need never be in doubt. The pieces are arranged in three groups according to the principal perspective of the writer—‘Doctors’, ‘Patients’ and ‘Clinical Encounters’—though any piece inevitably includes aspects of each of these (shades of ‘The Doctor, his Patient and the Illness’?)
As an anthology this book has many merits, not least the relative brevity of the pieces, mainly between five and 10 pages long, some even shorter. Nonetheless, within this short span, most offer thought-provoking new ideas and memorable aphorisms encapsulating older ones. For example, this from a woman journalist with multiple sclerosis "Almost every sufferer of a chronic disease . . . despises his first specialist . . . because he was the bearer of bad news." And from a nightmare short story by Kafka "Writing a prescription is easy but coming to an understanding with patients is hard".
From Conan Doyle comes an account of a post-prandial conversation between three doctors—GP, psychiatrist and surgeon—telling each other stories, any one of which could have served as the starting point for a clinical or Balint-style case discussion. As one says, "There’s no need for fiction in medicine, for the facts will always beat anything you can fancy".
The patients’ stories on the other hand, coming from the ‘sharp end’, often convey a salutary, even shaming, lesson about the failure of doctors, especially in the face of serious illness, to engage with the patient in an honest and brave way. Ruth Picardie, with a secondary brain tumour talks of ‘living in limbo’—"Do I get a 4-month or 12-month prescription pre-payment certificate?" Rachel Naomi Remen, writing as both doctor and patient, quotes someone as saying that there are two kinds of people in the world, those who are alive and those who are afraid, and many of those who are afraid are doctors. As she herself writes "We all long for mastery . . . sooner or later we come to the edge of all we can control and find life, waiting there for us. Fear is the stumbling block to life’s agenda".
The book would have earned its keep for these few short accounts alone, but there are many other gems inside which equally deserve to be ‘read, marked, learned and inwardly digested.’
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