Book review: If you want good personal healthcare - see a vet, by David Zigmond
Dr David Zigmond beautifully explains what’s wrong with general practice, writes Dr Zoë Neill
This book is a cri de coeur from the very soul of general practice. That feeling you’ve had about why it all feels so wrong – the answer is here. Industrialised, standardised healthcare with guidelines, protocols and tick boxes has removed the immeasurable but invaluable from general practice. Zigmond (a GP and psychotherapist in Bermondsey) asserts that: ‘the underlying reservoir of alienation, resentment, mistrust and anomie [amongst doctors] remains largely unarticulated, and little understood.’
This book is a journal – vignettes from a lifetime of work in a small room – and is fascinating simply as a book of short stories, snapshot narratives on the lives of doctors and their patients. Inevitably, the themes emerge and coalesce around the central one: that humanity has been eroded out of the practice of medicine. We have lost our humanity: for our patients and for each other, our fellow clinicians. He laments the loss of humane care, ’Compassion may be powerful in effect, but it is fragile in viability: it needs a mindful and respectful space and ambience to survive.’ It is also letters, thoughts and conversations.
Above all, his book serves as a handbook. Its gentle persuasion shows, not tells, that just about everything we’re headed towards is unwise. He recalls the precious liminal space of our consulting rooms, our ability to ‘drink a person in’, detecting with a lifetime’s intuition what might be our role, and recognising that people are people, with complex histories. It is a rallying cry for continuity, for permission to care again. This book is the wisdom of a lifetime but most importantly, this book contains the language for revolt, the vocabulary to articulate your unease and express what really matters. We have all got it wrong, and Zigmond is very clear why.
Dr Zoë Neill is a portfolio GP in Leeds