Proper Doctoring: A Book for Patients and their Doctors (New York Review Books (Paperback))

Proper Doctoring: A Book for Patients and their Doctors (New York Review Books (Paperback))

David Mendel

Language: English

Pages: 264

ISBN: 1590176219

Format: PDF / Kindle (mobi) / ePub


 “People come to us for help. They come for health and strength.” With these simple words David Mendel begins Proper Doctoring, a book about what it means (and takes) to be a good doctor, and for that reason very much a book for patients as well as doctors—which is to say a book for everyone. In crisp, clear prose, he introduces readers to the craft of medicine and shows how to practice it. Discussing matters ranging from the most basic—how doctors should dress and how they should speak to patients—to the taking of medical histories, the etiquette of examinations, and the difficulties of diagnosis, Mendel moves on to consider how the doctor can best serve patients who suffer from prolonged illness or face death. Throughout he keeps in sight the fundamental moral fact that the relationship between doctor and patient is a human one before it is a professional one. As he writes with characteristic concision, “The trained and experienced doctor puts himself, or his nearest and dearest, in the patient’s position, and asks himself what he would do if he were advising himself or his family. No other advice is acceptable; no other is justifiable.”

Proper Doctoring is a book that is admirably direct, as well as wise, witty, deeply humane, and, frankly, indispensable.

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Video Games The vogue for videotape recording of consultations is further evidence of how unconscious some people are of their own performance. The broadcaster Alistair Cooke said that it took him twenty years of practice before he learned to behave naturally in front of the microphone—and the video camera is even more disturbing. The patient too knows that he is being recorded and he behaves unnaturally. In this totally bogus set-up both “actors” will be on their best behaviour, and yet

experimentation. The patient’s faith in the doctor who prescribed the drugs is impaired if they are all stopped, and they should only be stopped when they are clearly inferior to some newer drug. I have heard housemen explaining at the bedside that the patient’s previous medication was hopelessly inadequate, and such statements, whether correct or not, are antitherapeutic. DISCHARGE FROM HOSPITAL Discharge is a crucial event for the patient. Each patient should be privately interviewed by

the individual patient is an all-or-none phenomenon: the patient either gets the complication, or he doesn’t. It is difficult to ascribe weights to the possibilities that he will be better but he may be dead, particularly when the disease for which he is being treated does not threaten his life. In estimating the risk, it is easy to forget that for both medical and surgical treatment the skill of the author of the series may not be the same as your own. A further difficulty in weighing up is

understand that now you are going to prescribe what you think best in the light of your observation of his response. Learning from Experience If the patient is harmed by taking your advice, you may feel that what has occurred is one of the known complications which you took into account when recommending the treatment, and that if presented with the same problem again, your advice would be exactly the same. If, however, the complication is unexpected, it will have to be put in the balance

the follow-up visit gives contributes to the treatment; secondly it enables the clinician to assess the patient’s progress. Patients should not be seen too frequently because it makes them think that they are more ill than they actually are. Over-attendance may induce a feeling of dependence on the doctor which is inappropriate to the severity of the illness. The doctor’s time is better spent on those patients who need him. The date of the follow-up visit is determined by the nature of the

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