Book Book

Please Don't Break My Other Leg! A Guide to Empathising with Patients

BMJ 2003; 326 doi: (Published 11 January 2003) Cite this as: BMJ 2003;326:109
  1. Abi Berger (aberger{at}
  1. BMJ

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    Valerie Mirvis

    University Press of America, $33/£21.95/€37.66, pp 230

    ISBN 0 7618 2119 8

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    I'd like to report that I read this book from cover to cover and absorbed every bit of good advice that exudes from its pages. But I didn't. It was partly because there's so much to take in (and a lot of it makes painful reading for us professionals), but partly because frankly I found much of its anecdotal style rather too “holier than thou” to digest with ease.

    Being able to empathise depends on communication skills (both verbal and body language). These can be taught and learnt, but this also depends quite a lot on someone's personality. But the ability to empathise also depends on a person's state of mind at the time and how well his or her day is going. I'll never forget the day I rudely fell asleep at 3 am on the bed of a patient whose history I was in the middle of taking. Little is made, here, about considerations such as these.

    There are clearly those who behave impeccably, say all the right things, and have total insight into the effect that they have on their patients (and colleagues). And then again, there are those of us (the majority, I suspect) who have “off” days, say daft (and even dangerous) things under stress, and are considerably more human. Having read this book, I know I'm one of the latter, but I feel all right about it. I sometimes hear myself making unhelpful comments and instantly regret it, but I know that I'll try harder next time. But I think that probably comes from having tucked a few years of experience under my belt.

    Medical students may well be horrified by some of the examples in the book, but give them a few years of sleep deprivation and the cynicism born of being chronically overstretched, and their views may change. Let them mature as doctors, and the perfection aspired to in the early days could well be tempered by the realisation that few of us get it right all of the time, but most of us still try our best. Indeed most of us are “good enough doctors” (or nurses or counsellors).

    I am sure it was not the author's intention, but I think that this book has more to offer to “non-professional” visitors of sick people. Or perhaps it's simply that the book's message about the ways in which professionals sometimes behave was not news to me.

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