Kirsti's Reviews > How Doctors Think

How Doctors Think by Jerome Groopman
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's review
Jan 25, 2009

really liked it
bookshelves: nonfiction, science
Read in February, 2009

Things that you should find worrisome if a doctor says them to you or a loved one:

* "We see this sometimes" when said about a case that has some atypical features. The doctor is basically telling you that s/he has stopped thinking.

* "There's nothing wrong with you." Even if your problems are psychogenic, they're still problems, and you are still suffering.

Things you can say to your doctor to help him/her with your case:

- "What's the worst this could be?"

- "Is it possible that I have more than one problem?"

- "Let me tell you what is really frightening me."

- "Can I tell you the story again as if you'd never heard it? Is it possible that I left out something important that I don't realize is important?"

- "When you say 'improvement,' do you mean 'cure'?"

- "How likely is this test to have a false positive rating? What about a false negative rating?"

- "Are you doing this procedure because you are confident it will work, or are you doing it because you don't know what else to do?"

- "Do you need more time to think about this? Do you want to call or e-mail me, or should I schedule another appointment?"

Other interesting information from this book:

• Studies show that the sicker you are, the more likely your doctor is to dislike you. Sad but true.

• Patients seen as "noncompliant" are also generally disliked. Doctors notice an apparent refusal to follow diet, exercise, and medication regimes but do not always realize that other factors (such as illiteracy) may be the reason for noncompliance.

• Other studies show that a doctor will interrupt a patient describing symptoms within 18 seconds.

• People tend to think that ER doctors can give a complete physical exam and tell them that they're completely healthy, but ER doctors are more focused on making sure that whatever may be wrong with you does not kill you in the next three days.

Excellent and thoughtful book, but I subtracted one star for a minor problem: Dr. Groopman always uses "he" when referring to doctors in general. This made me crazy because he's trying to note differences in older and younger doctors, and I think a rather substantial difference is that about half of younger doctors are female. Also, many of the most successful and thoughtful doctors he interviews are female. Also, HE IS MARRIED TO A FEMALE DOCTOR. Arrgh. (He refers to patients in general as "they.") This kind of sexism is so easy to edit out, but nobody bothered, and it rankles that nobody at the publishing company advised him that well over half the book-buying audience is female.

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Comments (showing 1-12 of 12) (12 new)

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message 1: by Jen (new)

Jen I love how you pull quotes out of books. I got this book for my mom for Christmas. I'll have to ask her what who thought of it.

Kirsti Thanks, Jen! I just posted an EVEN QUOTIER review of a different book.
The quotations in my review of How Doctors Think are often paraphrases.

message 3: by Galia (new) - added it

Galia Allison this was very helpful thank you

Kirsti Galia wrote: "this was very helpful thank you"

Oh, good! I'm glad you liked it.

message 5: by Kaethe (new) - added it

Kaethe Your minor problem would bug me, too. I prefer the convention of alternating between hypothetical hes and shes.

Kirsti Thanks, Kaethe. It's good to know I'm not the only one who finds this irritating.

message 7: by Kaethe (new) - added it

Kaethe I remember reading a magazine article and seeing for the first time that all the pronouns we she. [It was probably a Mademoiselle of Glamour or something] Rocked my entire world-view.

Charles I get dizzy when pronouns alternate, although assuming that all doctors are "he" is annoying and, perhaps worse, incorrect. (I happen to be a "he" doctor.) (Did you know that there are more women medical students than men?)

I'm not sure that I agree that it is always easy to edit this away. I now allow myself to use "they" as a third person singular, as I find "he or she" to be contrived and prolix; s/he to be stilted, at best, and simply incorrect, at worst. "Fire fighter" for "fireman," "Caution: Construction Zone" for "Men Working," etc., etc., should be used in careful and intelligent writing; even "God" or "Almighty" for "Heavenly Father" or "Lord." But there are times where good intentions and gender sensitivity is slave to language limitations. Of COURSE we should be unbiased and inclusive. I find it, not occasionally, challenging. Perhaps it is my weakness.

Much has already been written, and here I throw another log onto the inferno. It is not a problem with intent, just with execution.

Incidentally, although I read HDT several years ago when it first came out, I found it to be replete with things felt (among physicians) to be generally true, and therefore not particularly insightful. It got a better buzz in the non-physician press.

message 9: by Liz (new) - rated it 4 stars

Liz I agree! She she she!!

Kirsti Some authors alternate "he" and "she" in different sections or chapters, which is not quite as dizzying as shifting each sentence and not quite as clunky as using "he or she" each time.

message 11: by Amanda (new) - added it

Amanda Liked purely for the he/she comment.

Ashleigh Great review Jen. I like how you pulled out the important points. I also have found it irritating that he only uses "he" when referring to physicians. half of us are women, and we have been fighting this subtle bias for a long time.

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