Being a GP is a performance – as perhaps are most jobs. But GPs have an audience in their patients, and for most of us there will always be speculation about what is going on in the minds of our doctors. What are they thinking as they pronounce and prescribe? What happens when they get sick themselves? Are they as stressed as we imagine, given their crowded waiting rooms, the ceaseless demand for their services, the lack of time and the NHS box-ticking bureaucracy? How do they manage what one imagines are squeezed private lives? Are they, once outside their surgeries, as faulty, neurotic, hypochondriacal as the rest of us?
But these are not questions I was expecting to have addressed in print, let alone with candour, informality, warmth and absence of taboo. This wonderfully readable and unusual book is not conventional in its approach, which is partly what makes it sympathetic. It is personal, conversational, unpredictable. Martin Scurr (distinguished physician and fellow of the Royal College of Physicians) and Jane Haynes, a psychotherapist (author of a wonderful memoir, Who Is It That Can Tell Me Who I Am?), are friends and ideal collaborators. Most of the book is set out in Q&A interviews. Haynes is the woman with the questions, and dogged about asking them. Smart and intrepid, she doesn’t miss a trick. She interviews more than half a dozen doctors, and we hear how and why they were drawn to medicine, learn about their family lives, their health problems, their attitude towards death and the dying (it is not a little alarming to read more than one anaesthetist admit to a fear of being put under). She reveals that many of the doctors are impatient patients. One doctor remarks: “We are doctors and not patients and so we are on the other side of the Berlin Wall.”
Naturally, not all doctors feel like this. And what emerges is the varying anxiety between one GP and the next – the spirit level seems to vary enormously. The Scurrs, father and son (Cosmo has gone into medicine too), might seem, on the face of it, bluff and emotionally unavailable compared with Haynes, but she makes sure they and we recognise that their emotions are alive and well. Cosmo, sentimental enough to weep at his daughter’s christening, is disconcertingly honest about his approach to having to give bad news: “I am afraid of receiving the bad news but not of having to give it.” Another doctor, “Natasha”, startlingly explains: “I feel most myself when I am working with people who are very distressed or vulnerable. Being a doctor provides a very privileged way into suffering.”
The doctors interviewed are satisfyingly different but all are interesting. There are examples of wounded healers that remind one of Luke’s line “Physician, heal thyself.” “Zoe”– wild, wacky, charismatic and depressed at times – is one of them. Her life, in one short conversation, seems a stop-you-in-your-tracks soap opera. And there is delightful “Ben”, who talks with sensitivity about growing up gay in working-class Manchester and gradually acknowledging his sexual identity through his career, initially working with HIV patients. It is he who charmingly admits, in a guilty whisper, that if someone were to say to him “‘you can go to the British Library and restore medieval books for the rest of our life’, I probably would do that”.
And then there is the remarkable Dr Mansur Ahmad, who grew up in India and still talks like the model student he once was. Each doctor, reassuringly, admits to issues, neuroses, failings. The book is nicely served with literary garnishes, especially Samuel Beckett’s perversely comforting – and in all senses grounding – pessimism: “You’re on earth. There’s no cure for that.”
The book itself is anything but defeatist. It eloquently makes the case for consistent GP care and persuades us (it would be a peculiar reader who needed converting) that the traditional GP relationship where a doctor knew you and your family well is too precious, useful and sustaining to sacrifice. This book makes a good companion piece to Atul Gawande’s Being Mortal, which argues the case for considering individual needs in old age before medical imperatives, and Henry Marsh’s Do No Harm, which honestly explores the anguish and occasional exultation of life as a brain surgeon, and, like Doctors Dissected, addresses the difficulty of telling people they cannot be cured. One doctor observes that people vary greatly in how much they want to know: “Some don’t want to know anything.”
It is fitting that a book that deplores a loss of personal connection between doctors and patients should make time to explore intimacy between its covers. And although this book is not as crude as a rallying cry, it leaves one wanting to be part of a crusade to win doctors more time to be everything they want – and need – to be.
Doctors Dissected is published by Quartet, £20. Click here to buy it for £16
- This article was amended on 31 January 2015 to correctly attribute the quote “Physician, heal thyself” to Luke (chapter 4, verse 23).