Med Humanities 28:55-56 doi:10.1136/mh.28.1.55
  • Book review

What Are You Feeling Doctor? Identifying and Avoiding Defensive Patterns in the Consultation • Friends in Low Places • Letters from the Clinic: Letter Writing in Clinical Practice for Mental Health Professionals

J Salinsky, P Sackin. Radcliffe Medical Press, 2000, £19.95, pp 174. ISBN 1 85775 407 • J Willis. Radcliffe Medical Press, 2001, £19.95, pp 214. ISBN 1 85775 404 2 • D Steinberg. Routledge, 2000, £15.99, pp 130. ISBN 0 415 20504 2

`Medicine: only an attempt to rationalise magic.' (Steinberg page 115)

The doctor or healer has always been regarded as a magician. And still is, despite the attempts of contemporary scientific medicine to shake this off. Wise doctors and health care staff accept this multicoloured mantle, along with the stethoscope of power, the healing touch, and the chronicler's pen.

These three books celebrate the magic of medicine in general practice and psychiatry. They open doors to understanding the ways feeling, insight, unarticulated judgment based on skill and prior knowledge, understanding of the narrative (or story) nature of medical and therapeutic consultation, politics, and creativity, can enhance technical experience, knowledge, and skill.

Let's start with feeling—a word boldly placed in Salinsky and Sackin's title. It concerns a group of general practitioners experienced in the Balint method. In “Balint” work, groups of doctors discuss their feelings around specific patients in specific consultations. They focus on what bothers them, not what might bother just any practitioner. The group depicted in this book, however, moves above and beyond traditional “Balint” work, and discusses, and attempts to understand, the personal roots of their anxiety or distress (or anger, hurt, fear . . . .). They steer a course between the Scylla of therapy, and the Charybdis of cosiness. The focus of the group is to understand their own defences better—neither an easy nor a comfortable task. And then they have the courage and public-spiritedness to share their struggles and insights. “Wow”, I hear you mutter. Wow indeed. Read it.

Doctors are trained to develop defences, many of which are essential. How otherwise could they deal daily with the kinds of situations and issues which hurtle others into post traumatic stress disorder? It wouldn't do to smack a supremely irritating child either, or always cry at …