The doctor in literature—satisfaction or resentment?

Abstract

THE DOCTOR IN LITERATURE: SATISFACTION OR RESENTMENT? Solomon Posen Oxford, England: Radcliffe, 2005, 320 pp., $55.00 (hardcover) human race is a spectrum from saints to scoundrels. None of us in medicine is exempt from judgments of where stand in the spectrum. But what, indeed, are the judgments of the world in which work? And why are thus seen? Edward J. Huth, Emeritus Editor, Annals of Internal Medicine Through selected literary works from novels, short stories, and plays, Dr. Solomon Posen collects a full range of judgment on the professional medical doctor from the past to the present that illuminates Huth's concise foreword in Dr. Posen's book, Doctor in Literature: Satisfaction or Resentment? These citations from more than 600 works of literature run the gamut from W. Somerset Maugham to Arthur Kopit to Sylvia Plath. Some authors of medical fiction were themselves trained as physicians, such as Chekhov, William Carlos Williams, and Maugham. Others came from medical families, such as George Bernard Shaw, Marcel Proust, and Ernest Hemingway. Regardless of the writer's background or attitude, the citations describe medical practice as it is portrayed and experienced through the author's characters rather than as it should be. Described as an encyclopedia and a catalogue by some reviewers in the medical Held and as a reference work by others, author Posen refers to his volume of work as an annotated anthology serving multifold purposes: to serve as an indexed reference of literature describing doctor-patient interactions and doctors' personal lives, to analyze recurring themes in the portrayal of medical doctors, and to provide pleasure for the medical and nonmedical reading audience. By selecting a chapter from the table of contents (chapter 1, The Physician's Fee, chapter 2, Time, chapter 3, The Bedside Manner, chapter 4, The History and Physical Examination; Investigations; the Diagnosis, chapter 5, Explanations; the Medium and the Message; the Truth, chapter 6, Treatment: Successes and Failures. chapter 7, The 'correct' degree of detachment, chapter 8, 'It's all a cruel hoax,' chapter 9, The Ward Round, chapter 10, The Physician's Social Status, chapter 11, The Physician in Court) and citations from the indexed reference system (the bibliography, the name index, and the subject index), I will examine Posen's success in achieving his objectives. SELECTION 1: FROM THE TABLE OF CONTENTS (PP. III-VI) Chapter 3: The Bedside Manner Posen divides this chapter into 10 sections: Helpful or Harmful? Dress; Voice; Facial Expressions; Gestures, Inappropriate Phrases; Stale Jokes, The Brutal Style, Insensitive Behavior; Purposeless Remarks; Fun at the Patient's Expense, Favorable Accounts of the Bedside Manner, The Dying Patient, The Perfect Bedside Manner, Summary, References. Judging from the overabundance of pejorative words in the subheadings, I am not surprised that chapter 3 reveals that most authors write negatively about physician conduct and bedside manner in literature. Supported by 112 references, Dr. Posen also infers that the doctor's substandard communication skills and bedside jargon often lead to patient resentment. For example, in Carson McCullers's Clock Without Hands, Judge Clane returns home from Johns Hopkins hospital and complains to a friend about his physician's use of the first person plural when discussing his prescribed diet: Don't you loathe it when doctors use the word we when it applies only and solely to yourself? He could go home and gobble fifty biscuits and ten baked Alaskas ... while me, I'm starving on a diet. Regrettably, the pronoun is only one expression that provokes patients. words luck, dear, and little can be similarly irritating and misleading. Indeed, the doctor-patient interactions at the bedside appear ineffectual in this chapter. …