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Edited by Cecil Helman (pp 162; £19.95, paperback) 2003. Radcliffe Medical Press. ISBN 1 85775 9931
How do doctors see their patients and how do patients see their doctors? This book sets out to explore these questions via the works of well known medical authors including Conan Doyle, Cronin, Somerset Maugham, Chekhov, and Oliver Sacks and by those of patients including the authors Clive Sinclair, Ruth Picardie, and Renate Rubinstein. Fictional accounts are mixed with direct testimony. Much can be learnt from these accounts. And how attitudes to patients have changed! Conan Doyle’s Tales of Adventure and Medical Life are well known but not easy reading today. At first glance the paternalism is cloying and repulsive—on a second glance the concern and care for the whole patient is obvious. Conan Doyle was writing in an age of therapeutic impotence and was familiar with the slow decline and inevitable death that characterised so many diseases. He was also familiar with surgical heroics: less admired in this radio- and chemotherapeutic era. “There is nothing surgical which Hargrave has not the skill and audacity to do”. A higher standard of writing is set by Somerset Maugham. His short story Sanatorium is as good an example of this literary form as you are likely to find outside Kipling. The isolation from the world and the growing gap between patients and relatives presages Solzhenitsyn’s The Cancer Ward and yet ends on a note of hope. Cancer figures strongly in this book and the true accounts from the patients’ standpoint are rewarding. Ruth Picardie’s two pages (extracted from Before I Say Goodbye) moved me to tears: read it and weep.
The editor, a doctor, social anthropologist, and author, has contributed an outstanding introduction: all doctors and medical students should read this. He addresses the most difficult issues: telling bad news, the disillusionment of doctors and patients, how to handle uncertainty. He quotes Johnson in support of being told the truth (he could have quoted JBS Haldane too) and gives us some splendid quotations: “If you can’t be a king, be a doctor” (Indian proverb), “one has a greater sense of intellectual degradation after an interview with a doctor, than from any other human experience” (Alice James), as well as the better known ones from Hippocrates and Hutchinson.
Books of short stories make good bedside table books. This is one that any doctor would benefit from reading—and it is an ideal gift for a student or young doctor. It puts the whole patient first—isn’t that what medicine is all about? Buy it.