Books: Starting to Shrink

Starting to Shrink starts with every doctor’s worst nightmare — a letter from the GMC about an upcoming hearing. In this case, Douglas Barker, a senior house officer in psychiatry, has been accused of having a sexual relationship with a patient.

The story is set in the early 1980s, and follows Douglas through his first year as a psychiatry trainee in Scotland. Much of what Douglas experiences is very relatable to anyone who has been through postgraduate medical training — an educational supervisor who he doesn’t see eye-to-eye with; a diagnosis that could have been picked up earlier and the guilt that goes with this; and the kinship formed between other trainees and ward staff. However, from the opening chapter it is clear that Douglas is also going to have to contend with a GMC investigation, and whether the allegations against him are true remains to be seen until the very end.

As a female reader, I have to say I didn’t find Douglas to be an overly likeable character. He comes across as somewhat misogynistic, has a reputation among his peers as a ‘womaniser’, and it was very noticeable that almost every female character who appeared in the book was described in relation to how attractive Douglas found her. Perhaps this was intentional, to sow the seed in the reader’s mind throughout that Douglas may well be guilty, but it failed to endear him to me.

In the ‘#metoo’ era, the case against Douglas is very topical, and the GMC investigation is well described, as is the fear and anxiety that come with it. The book is by a retired psychiatrist, and is very well written, with interesting psychiatric cases scattered among the main story. However, the view of women held by the protagonist is off-putting, and continues even post-hearing, indicating a lack of insight that I’m sure the GMC wouldn’t approve of!

• © British Journal of General Practice 2020