Intended for healthcare professionals


When sociology informs medicine: the consultant neurologist

BMJ 2023; 382 doi: (Published 29 August 2023) Cite this as: BMJ 2023;382:p1770
  1. Kathy Oxtoby
  1. BMJ

Consultant neurologist Bridget MacDonald talks to Kathy Oxtoby about how she incorporates sociology and anthropology into her medical practice

Bridget MacDonald enjoys demystifying neurology for the patients she cares for and the doctors she trains. “I love being able to explain things in a way that people understand and that diffuses their anxieties,” she says.

As a consultant neurologist with a special interest in epilepsy at Croydon University Hospital and St George’s Hospital in London, she is inspired by those in her care. “My patients have taught me so much—how they deal with their disabilities, how they make the best of what they’ve been dealt and enjoy what there is to enjoy in life.”

MacDonald has always been interested in medicine. “My mother was a midwife who brought me up with stories that taught me much about medicine.” She was also inspired by her childhood GP—“I can still picture his waiting room,” she says.

At the age of 8, while at a ballet class, MacDonald announced she was going to be a doctor. “I’d been told off by my ballet teacher for not practising and was told I wouldn’t become a ballerina. My response was: ‘I’m going to be a brain surgeon’.”

She went on to attend medical school in 1983 at Guy’s and St Thomas’ in London, where she was taught sociology by David Armstrong, a reader in sociology, and John Weinman, a reader in psychology. “They got me thinking about social inequality, the power dynamics in medicine, and how to be aware of much wider problems in practice,” MacDonald says. “Sociology and anthropology really inform my practice. How people think about their place in society, cultures, and family structures and belief systems all impact on how we practise medicine.”

She liked every topic she studied at medical school, but her experience of neurology, learning from consultant neurologist Mike O’Brien while at Guy’s, was superb. “He thought, he taught, he elegantly examined people. He was clever in both knowledge base and in ‘nouse.’ You can fall in love with a specialty through the people who you see do it,” she says. “He inspired me to want to be like that.”

MacDonald became a consultant in 2001, after completing her specialty training at King’s College London as well as a doctorate in epidemiology and epilepsy at the National Institute for Neurology.

Her current role includes acting as an educational supervisor for neurological science at St George’s. It’s important to her to look after the junior doctors she teaches, by setting up structures to support them. “They need space to learn widely,” she says. “It’s not just about learning how to do a medical intervention, but also about life and humanities—a broader education.”

A senior member of the Association for Medical Humanities—which promotes the development of the medical and health humanities—MacDonald continues to enjoy the topics that first inspired her as a medical student. These include sociology and ethics as well as art house movies and poetry. She also likes making her own clothes, cooking, and has revisited her childhood interest in dance, though this time around her dance classes are contemporary.

She takes pleasure in widening the horizons of those around her by introducing them to different pursuits she thinks might bring them joy. “I like opening people’s minds—opening doors to say, ‘Oh look, you could do this, this would interest you.’ That’s nice.”

Nominated by Theresa Tran

“Bridget MacDonald was my clinical supervisor during my stroke and neurology rotation. She is remarkable in her whole approach to appraisal and feedback. She gets in touch early in the attachment, and devotes time to really getting to know you.

“A conversation with her is always memorable. Her passion goes beyond medicine to asking the deeper questions, such as who we are as doctors and what sort of society we’re trying to serve. She is as likely to recommend a book on the injustices of the US healthcare system as a neurology textbook.

“Bridget gave me support when I needed it. I, and so many other junior doctors, owe her a great debt of gratitude for her immense humanity. Her secrets are not difficult—she gives everyone the time they need, she listens wholeheartedly, and then brings her own uniquely broad wisdom to bear.”

  • Theresa Tran is a palliative medicine registrar, Royal Marsden Hospital, London