"How Doctors Think" by Jerome Groopman
Dr Samar Mahmood thinks like a doctor, but did he like the book?
Fans of fiction and non-fiction alike will find something unexpectedly endearing about this book, about a physician practising in the USA. It homes in on real-life medical errors and successes and studies the thought processes involved. The tone is authoritative, but it has the right mix of humour, irony and humanity.
The catchy title and realistic portrayal of the medical world hook the reader from the start. As an F1 nearing the end of my first year, I found the chapters on the transition from medical school to the hospital, the appropriate terminology for patients and “self-inflicted” health problems, particularly relevant for a junior doctor. Groopman is spot-on when he identifies the struggles faced by junior doctors.
He notes: “You hear this kind of criticism – that each new generation of young doctors is not as insightful or competent as its forebears”. But what sets How Doctors Think apart from other books is that it takes these issues to task, and suggests how they can be addressed for medical and non-medical people alike. Almost like a “Handbook of Hospital Politics and Lifestyle”.
A plethora of interesting medical cases and their management are presented. Groopman discusses not only the fact that medical errors do occur, but also why they do. Examples include “cherry-picking”, where the clinician only focuses on certain features of a patient’s history because it’s easier to do so, and “availability”, which describes the tendency to label a patient with a particular diagnosis, simply because previous patients with the same or similar symptoms have had that diagnosis.
Reading it as a doctor can be slightly unnerving, especially knowing that patients could read the same pages, and pick up on the potential for error. It is reassuring that Groopman doesn’t make doctors out to be the bad guys; he is sympathetic to their cause. The pressures faced by medics to come to a quick decision and administer appropriate treatment are portrayed in a very realistic and supportive way.
Even the most cynical patient will find themselves able to empathise with their healthcare professional, whilst the most frightened junior doctor will find some solace in knowing that he is not the first doctor to be clueless when it comes to managing an acutely sick patient in the middle of the night.
Dr Samar Mahmood is an F1 in Derby.