The doctor orders you to LISTEN

ALSO HUMAN: THE INNER LIVES OF DOCTORS by Caroline Elton (Heinemann €21)

DOCTORS are people, too. They possess the same virtues, faults, fears and desires of the rest of us but it’s easy for patients to forget this obvious truth. Caroline Elton’s revelatory, sometimes disturbing, book is a welcome reminder of this.

Elton is a psychologist who has long experience of listening to the problems of doctors and medical students and introduces us to some of the many she has counselled over the years. (Their names are changed.)

There is Zoe, who becomes unhappy with the long, thankless hours of work at night and at weekends and the impact on her personal life. ‘I don’t want to be finishing late, eating kebabs and going home to an empty house,’ she remarks.

Only years later, now a consultant, does she tell Elton how traumatised she was by the death of a child on her watch. She was cleared of all fault but deeply affected by it. This had contributed to her earlier unhappiness but she had felt unable to talk about it.

Lola’s life started to unravel when she began specialist training as an oncologist.

Her choice of speciality was influenced by her father’s death from cancer, but that was also what made it difficult for her to continue. As she admitted to Elton, the first patient she saw on the oncology ward was a middle-aged Chinese man, bald from chemotherapy, who reminded her of her father. Lola eventually retrained as a GP.

Not all those inspired by family history to become doctors suffer difficulties like Lola.

Elton also tells the story of a woman whose 12-year-old brother died of an asthma attack. She became a consultant in respiratory medicine, treating people with breathing difficulties — including asthma.

But there are plenty of examples of doctors overwhelmed by their responsibilities. We want medics to be empathetic but they must also develop detachment to function properly.

Some, though, take detachment to the other extreme. Consultants don’t always emerge covered in glory. Elton quotes tales of emotional insensitivity so grotesque they are almost comic. ‘I have a patient just like you,’ one says to a woman in hospital. ‘She looks like you; same age and has the exact same tumour.’ ‘How’s she doing?’, the patient asks. ‘She’s dying,’ the consultant replies.

Old prejudices die hard, it seems, in the medical profession. Sexism survives unabashed. In Ireland last year, just 7% of surgical consultants were women. Would-be doctors from working-class backgrounds also find the odds stacked against them. A survey of first-year foundation doctors found 31% had attended feepaying school.

These are difficult topics and Elton does well to address them. For patients and doctors alike, this book is required reading.