How to become a good doctor

It’s been a busy month, and I have a backlog of books to post about. I’ll start with the first of a couple of non-fiction titles from recent reading: one about the process of becoming a doctor, the other about failing to protect the British people during the pandemic.

 Sophie Harrison, The Cure for Good Intentions: A doctor’s story, Fleet hardback, 2021. 248 pp.

Sophie Harrison, The Cure for Good Intentions front coverThe author graduated in 1995 with a degree in English, then, after a few jobs, became an editor at Grantamagazine. On an exotic beach she had an epiphany and decided at the age of 28 to become a doctor. A junior doctor she met gave her a tip for her medical school interview: when asked why she wanted to become a doctor, not to say ‘Because I want to help people’ – everyone says that. But that was the answer she gave.

Her training began in 2003. This book is her entertaining and illuminating account of that process, from F1 through to qualification, rotating through different specialties. When she decided to become a GP, her colleagues were incredulous: that was for those not good enough to become specialist surgeons or whatever.

I was alerted to this book by hearing Harrison interviewed on the BBC Radio 4 language programme ‘Word of Mouth’, in which she told Michael Rosen about those sections of the book dealing with the language used by clinicians. These were the most interesting parts of the book for me – though there are many fascinating sections about her other experiences.

Medical students were advised to talk to patients

in what we believed to be everyday speech, although it was in fact another language again: infantile, nursery-inflected. We called abdomens ‘tummies’ and warned ‘this might feel a little chilly’. We used soothing, neutered verbs. I learnt to ask patients to ‘pop’ off their clothes before ‘hopping’ up onto the bed, where I would just ‘slip’ this nameless thing I was holding up their noses or down their throats or up their ‘tail end’.

There was also the slangy practitioners’ jargon that often veered into dark humour (a kind of coping mechanism). And the specialised, obscure technical language of medical science, as Harrison shows from her anatomy classes:

 Once I had known that the thigh bone connected to the hip bone. Now I discovered that the iliofemoral ligament arises from the anterior inferior iliac spine and then bifurcates before inserting into the intertrochanteric line of the femur.

 Other chapters deal with Harrison’s learning about our bodies’ internal organs, end of life, observations, the heart, surgery and medicines (especially opiate addiction), women and babies (and her own experience of an emergency caesarean), and pain and how to describe and assess it meaningfully (you can’t).

The final chapter deals briefly with the Covid pandemic. Doctors, like the rest of us, had to learn quickly a whole new way of speaking and acting, with attendant acronyms: PPE, WFH. When a new consignment of boxes of protective aprons arrived at her GP surgery, a nurse exclaimed: ‘These are bin liners!’ Another practice had scrubs donated by patients, who had sewn together old sheets and duvet covers. In my next post I’ll discuss a highly critical account of the British government’s hopelessly inept response to this crisis, and its continuous stream of boastful misinformation about the horrific reality on what they liked to call ‘the front line’.

Ultimately in The Cure for Good Intentions it’s the author’s stories about people and the ailing, imperfect bodies we’re all born with that provide the energy and hope in this engaging account. We’re all going to get sick and decline at some stage – as we all know only too well during this pandemic – and we all fear this inevitable process. Thank goodness we have caring, humane doctors like Sophie Harrison to look after us when we do.

The final paragraph sums up what she learnt going through medical training and acquiring the new idiolects of the doctor’s world:

I had learnt, at least, that medicine was not about finding new ways to express yourself, or how nicely you could put together a sentence. It was about trying to understand what others meant, not just the words they said.

 

 

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10 thoughts on “How to become a good doctor

  1. I would feel a whole lot more relaxed about ‘getting sick and declining at some stage’ if doctors would just let us do it.
    It’s the endless treadmill of tests, and medication, and ICU even for very, very old people who should just be allowed to die, that worries me…

    • Good point, Lisa. There’s been some fuss in the media here lately about the related topic of people putting their dogs and other pets through expensive and intrusive vet treatment, with insufficient attention to the animals’ quality of life.

    • There will surely come a reckoning to hold this government accountable for the way it’s conducted itself during this pandemic. Their mistakes and lies go way beyond ‘it was an unprecedented event’ and ‘any government would have struggled’. No, most didn’t or learned from their mistakes.

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