This book brings together some of the most interesting general practice writers and researchers from the UK and Europe with a collection of seven essays that explore the nature of the person, or self, and our attempts to attend to it in clinical consultations. Deborah Swinglehurst’s chapter describes her research into the ways in which electronic patient records demand our attention and interrupt consultations. Her findings will be immediately familiar to frustrated patients and clinicians. Her methodology — linguistic ethnography — is a great example of how scholarship can reveal what happens in the swampy lowlands of general practice.
Defining the person (or self) on which we aspire to centre care proves to be challenging. Like the generalists they are, the authors draw on a rich mix of neuroscience, history, philosophy, clinical practice, and social sciences research to think deeply about theory and practice. Clinical vignettes provide material to work with, and, although some sections of the book venture into the theoretical high ground, others like Joanne Reeve’s chapter are full of practical suggestions.
I would have liked more on what happens when we have different selves that we are ashamed of, a problem that plagues perfectionists and addicts, doctors and patients alike. I would also have liked to read more from patients’ perspectives, especially given that the book begins by introducing epistemic justice — the ability for patients to give their own account and explain its meaning and significance. A more explicit account of empathy could have helped show how epistemic justice can be achieved in practice. With the book being priced so high I fear that it will reach too few reflective GPs or trainees, and even fewer patients.
Where the book succeeds is in challenging the reader to think seriously about the ways in which power and assumptions are everywhere in everyday practice. This critical reflection makes us engaged and resilient.
- © British Journal of General Practice 2018