Doctors do cry… Editor: Ashish Goel, Hyderabad: Paras Medical Publisher. 2005. 170 pages. Paperback. Rs. 150.00 ISBN:81-8191-086-9

Dr Goel is a senior registrar in the department of emergency medicine at the All India Institute of Medical Sciences, New Delhi. He conceived this book during discussions with the late Mr Arvind Kothari of Paras publishing house. The book is therefore dedicated to Mr Kothari.

In his prefatory note Dr Goel explains that the goal was to show doctors as human beings who laugh and cry. Pondering tears, Dr Goel is reminded of lines from an Indian movie song: ‘Mere water are tears when shed/ Eventually become pearls only if held…’

Dr Goel stretched his hands out and obtained contributory essays and tales from authors in India, Israel, Canada and the United States. He hopes to continue this series and invites contributions for subsequent editions.

The list of contributors features postal and email addresses of each author, enabling the reader to make direct contact if desired. Physicians, surgeons (including cardiac surgeon Dr Ratna Magotra), a pathologist, a haematologist, a medical historian and a neurologist are included. It is especially fortunate that Dr Goel was able to persuade Dr Himmat Bawaskar to write of his unique experiences in rural and semi-rural settings.

The essay ‘On physician crying’ by Dr Paul Rousseau, a palliative care expert, sets the tone by expanding on the theme of the volume. Commenting on the traditional tendency of the physician to maintain a professional attitude, hiding emotion or grieving in secret, he shows us the other side of the coin. Expressions of empathy, compassion, caring benefit both patient and physician. Under certain circumstances, crying may be an appropriate manner of confronting the mayhem and sadness of disease and death.

Subsequent chapters elaborate on variations on the theme, providing real-life accounts, personal experiences and dramatic happenings in settings such as those of the intensive care unit. The documented feelings of patients provide much food for thought.

I referred to Dr Bawaskar above. His essay provides a first-hand account of a sensitive and intelligent physician studying the ill-understood medical complications following scorpion stings only to encounter neglect by supercilious colleagues. Those aware of his tribulations know of the grudging acceptance of his findings by Indian contemporaries only after they were recognised and applauded by senior British and other foreign cardiologists and medical journals.

There is much to learn from these essays, uneven though they are. Without exception, they are full of humanity, sincerity and feeling for the plight of the patient and his family. What can such a book achieve? I feel the cover provides an answer. The falling drop not only causes a rebound off the surface on which it has fallen but also sets off a series of widening ripples.

Note

Whilst I failed to notice this, a respected colleague pointed out to me that Howard Fillit’s essay, entitled ‘Sara and George and justice’, placed at the end of this book, was published earlier in the Annals of Internal Medicine. When I looked for acknowledgement of this earlier publication, I found none and also realised that Fillit’s name and affiliations are not included under ‘Contributors’.

On the face of it, it appears that Dr Goel has reprinted this essay from the Annals without acknowledging the source. If this be so, this is far from ethical.

Dr Pandya’s comments were forwarded to Dr Goel with a request for a clarification on how the contributions were obtained, whether permission was sought and obtained to publish the above-mentioned article (as well as any others that may have been reprinted from journals or books), and why such acknowledgement has not been included in the text. Dr Goel’s response is below:

There are a total of three essays in the book which have been published as reprints. One is ‘On physician crying’. A letter of permission for reprinting this is in my possession. The essay was a last-minute addition and permission arrived the day the book was being printed. Hence acknowledgements could not be made in the book. The second reprint is ‘Sara and George and justice’. All attempts to contact the author, Dr Fillit, in person have come to naught. The third reprint is the story by van Jign Hersenen, ‘A teenager who wanted to die’. I have electronic permission on my mail from the author for this story. All three were to be duly acknowledged in the second edition.