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J R Soc Med. 2005 November; 98(11): 518.
PMCID: PMC1276006

Doctors as Patients

Reviewed by Sean A Spence

Editor: Petre Jones
200 pp Price £24.95 ISBN 1-85775-887-0 (h/b)
Oxford: Radcliffe Publishing .

Few will read this book for enjoyment, though some might read it as a lifeline in time of trouble. Doctors as Patients emerges from the Doctors’ Support Network [www.dsn.org.uk], a self-help organization run by and for doctors who have experienced mental illness. The proceeds go to the organization and its history is recounted here (in Chapter 27). In 28 chapters, a third of them authored or co-authored by the editor, accounts are provided either of the phenomenology of mental illness itself (most often an affective or eating disorder) or the practical information that a suffering medic might need (e.g. on employment law and antidiscriminatory legislation). Though the book contains contributions from 24 authors, two are identified solely by their initials and nine as simply ‘Anon’. These features are perhaps indicative enough of the book’s central thesis—that there is something different about being a doctor in difficulty. There is also a noticeable preponderance of general practitioners, giving rise to pertinent chapters on the business aspects of practices and partnerships.

Though the authors emphasize the value of support and mutual respect, and the importance of knowing that others ‘are there’ for one, what emerges most forcibly is the central loneliness that afflicts those who are ill. Whether it is consequent upon that shame associated with such illness, the blow to the career anticipated, or all the sheer complexity of the hoops to be jumped through in order to receive adequate treatment (from those whom one might trust), the feeling identified by many of these doctors is the rejection coming down the track—from colleagues, friends and maybe even family. And, at the end of the line, there is the General Medical Council with an impersonal letter and its seeming conflation of (mental) illness with immorality.

Yet it would seem that by the time others are kicking the professional when they are down, they (the professional) have already started to dissect themselves:

‘When a doctor questions their ability to practise medicine, they are not only questioning their ability to earn a living, they are questioning who they are, their identity, and everything they believe about themselves.’—Lizzie Miller, p. 147

Indeed, the book is a pot-pourri of autobiographical accounts of suffering and partial redemptions, notes to the wise for others (e.g. always have adequate health insurance) and notes to the self in case of future danger:

‘My warning signs...

  • Bursting into tears between patients
  • Crying in the car between home visits
  • Feeling that I cannot think in a straight line
  • Finding decisions almost impossible to make
  • Thinking about self-harm and finding where the scalpels are kept’—Anon. p. 110

This is not a perfect book; the organization of the chapters bounces in all directions, typos accrue towards the end, and some voices are perhaps a little too prominent, but it contains some terrific poetry (most of it too extended for citation here), including Anon’s ‘The rope’ (p. 95) and Joanne Watson’s ‘Weekend on call’ (p. 97). Some of those writing, like the Anon who authored ‘Lithium’ (p. 99) appear to be doing so post-medicine: Here are the last two of eight stanzas.

‘And the job is a role I took on, long ago. It is not who I am, Just the person you know.

So keep your pills And let me go free. No longer a doctor But created to be.’

This is a book you’ll hope you never need.


Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press