Book Review - The Patient Doctor

The Patient Doctor

Dr Ben Bravery Hachette Australia 332pp

by Robin Osborne

At the time of publishing the author of this wonderful memoir of medicine from both sides of the treatment fence – hence the cleverly apt title – was in his final stages of psychiatric training, having completed hospital rotations in the usual fields, including surgery, emergency care, oncology and geriatrics.

As he explains, ‘When it came to taking medical histories from patients, I was always most interested in what we call the ‘social history’. This is the part that allows us to learn more about the patient as a person.

‘Sadly, many doctors tend to reduce this to asking about exercise and whether a patient smokes cigarettes. It can be so much more than this. What about the patient’s home life? Did they live pay cheque to pay cheque? Had they any prior bad experiences in hospital?’

In regard to the last question the author unequivocally responds in the affirmative, having experienced a range of unsatisfactory experiences as a patient as well as many disillusioning ones as a medical intern, bullying by senior doctors being at the top of the list.

What Bravery describes as ‘not your typical cancer memoir’ begins in Beijing where he worked as a zoologist on projects for the Australian and Chinese governments and became ‘something of an expert’ on topics such as what types of male panda urine was most likely to attract females.

One day, at age 28, he noticed blood in the toilet bowl but, unwisely of course, ignored it. Not long afterwards, on a short visit home, he underwent a colonoscopy at the insistence of his feisty, Ballinaborn mother, and received a diagnosis of advanced bowel cancer. To put it mildly, his life changed dramatically.

‘The leap from zoologist to cancer patient was not my choice,’ he writes, ‘but the leap from cancer patient to doctor was. That decision – what it’s like on both sides of the hospital curtain, and how medicine can be made better for patients and doctors – is the point of this book.’

It is an exhausting journey through surgery, radiotherapy and chemotherapy, to the logistics of stoma bags and the awkwardness of managing post-operative demands – not least when one decides to continue jogging! Then there was the long slog through med school, bullying again being common, and clinical placements as a mature age student.

Throughout seemingly endless appointments and admissions Bravery is ably support by Sana, a TV presenter he met in China and almost instantly fell in love with. Their relationship is central to the story, as is their (spoiler alert) ultimately successful attempt to fall pregnant through IVF after wisely freezing his eggs eight years prior to the radiation that would render him infertile. The difficult birth of their son is the final breathtaking hospital event in the story.

Damning the much-vaunted concept of patient-centred care as ‘great marketing’, he says that as a patient he rarely felt at the centre, and ‘For a great deal of my care, I felt like a bystander watching things happen around me… I felt like a passenger in someone else’s people mover, a bit closer to the action and moving along with everyone else, but with no idea of where we were going or how long it was going to take.’

He found things were similar on the other side of curtain, too, although he feels there is hope if the system can prioritise the values that make us human – ‘communication, respect, empathy, compassion, kindness and balance.’

GP practice or Hospital Department” by the students this year. He is pictured here with two registrars who also nominated him for a teaching award. Marc is clearly a dedicated and much valued teacher.

In the future we are exploring with the Regional Training Hub at Lismore Base (where folk are working to develop local specialist training pathways), and the SIM center, (where learners can experience all the adrenaline rush and alarm of a real emergency, without putting any actual person at risk), how we can better support practices and supervisors that support our students. Offering state of the art training appears to be popular and we will continue to develop these possibilities.

We need to sincerely thank your practice managers (PMs) without whom these placements would not be possible. We do sometimes hear that an individual doctor would like to be involved in medical student training, but the practice as a whole feels the timing is not right. Please encourage discussion at the practice level.

We are willing to look at all possible scheduling rosters and variations in order to make it work for your practice. You have no idea how much you have to offer. We do, as do the students and they tell us. And again, let them contribute. They want to.

To those who have not yet been involved or who have taken a break, please contact us if you want to (re-) engage. We would love to hear from you. (See below for contact details.)

And speaking of PMs, no matter what your political persuasion, there does now exist an opportunity to lobby different folk and in a different way for the future of our profession.

Let’s do it.

Let’s work together.

Let’s make it better for our community and for the ones following in our footsteps.

For more information and to register your interest please contact Dr Christine Ahern. M 0412 673 278 – please text first

Email christine.ahern@sydney.edu.au

Dr Christine Ahern is Academic Coordinator (GP & Community) at the University Centre for Rural Health (UCRH)