Please Don't Break My Other Leg! A Guide to Empathising with Patients
BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7380.109/a (Published 11 January 2003) Cite this as: BMJ 2003;326:109All rapid responses
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The Editor
BMJ.com
Dr Abi Berger informs the reader more about himself than the book in
his review of PLEASE DON'T BREAK MY OTHER LEG! a GUIDE TO EMPATHISING WITH
PATIENTS. He confesses that he did not read the whole book, fell asleep
while listening to a patient and lost his idealism as a young doctor. The
book clearly started to make him self critical which was the objective.
The book is based on more than 500 accounts taken from patients and
doctors, a method encouraged by the British Medical Journal and now known
as Narrative Based Medicine (Greenhalgh, 1999). It is not a double blind
randomised controlled trial and this may distract a scientifically trained
doctor from its importance. Is it necessary for every junior doctor to
learn from personal errors to the detriment of individual patients rather
than from documented mistakes of others? Is Dr Berger advocating the
abandonment of clinical teaching and textbooks?
His phrase "good enough doctors" is derived from the field of child
abuse where "good enough parenting" provides the borderline between barely
adequate and culpable incompetence. As he is the Scientific Editor of the
BMJ, I am confident that he would expect 100% accuracy in communication
amongst doctors. For communication between doctors and patients, however,
Dr Berger advocates "good enough" as the standard we should be aiming for.
Despite his defensive approach, he clearly acknowledges that younger
staff will be receptive to fresh ideas to improve patient care, but older
practitioners may find it painful to give up their long established
paternalism.
Valerie Mirvis
Competing interests:
Author of book
Competing interests: No competing interests
Puzzlement from Across the Pond
The Editor:
I was deeply disappointed with Abi Berger's review of Valerie
Mirvis's new book, Please Don't Break My Other Leg! A Guide to Empathising
with Patients. He spent most of his essay
describing his own shortcomings in the area of empathy, regarding them as
inevitable consequences of "off" hours or days.
Dr. Berger admits to not having read enough of the work to appreciate
its breadth and depth, as well as its usefulness in everyday practice. He
seems to take personal exception to the suggestions of more than 500
professionals and patients
who contributed to Ms. Mirvis's book.
He likewise appears to suggest that every physician or other
practitioner can learn only through a prolonged trial and error process.
Surely the expert insights and experiences of others can assist him--and
the rest of us--in more carefully monitoring our words and our actions so
that we "first,
do no harm."
Sincerely yours,
Paula Van Gelder, M.A., M.L.S.
Los Angeles, CA, USA
Competing interests:
Contributor to book
Competing interests: No competing interests