Eds Stefan Slater, Robin Downie, Giles Gordon, Richard Smith
Royal College of Physicians and Surgeons of Glasgow, £6, pp 101 
ISBN 0 953 5833 09
Books available from the college
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Rating: ★★★
In medicine today, culture is “in,” culture is sexy. The British Journal of General Practice includes new poetry and articles on doctors in literature. Last year's spring symposium of the Royal College of General Practitioners was on the theme of “The Art and Science of General Practice.” Narrative based medicine, which suggests (to me anyway) the primacy of the patient's story as the starting point for the doctor-patient relationship, is now acknowledged as a necessary counterpoint to evidence based medicine, which often starts with the diagnosis of disease. Patients' stories are not fiction, but they are always interpretative, one of the qualities of fiction and literature.
This interest extends not just to literature but to all of contemporary culture. A recent copy of the Lancet contains an interview with a New York artist, Fred Tomaselli, who uses drugs and other pharmaceutical items in his collages. At conferences, distinguished doctors give lectures named after other distinguished doctors and use art and literature, past and present, to set medicine in the context of life today. In April, among the celebrations to mark the 400th anniversary of the Royal College of Physicians and Surgeons of Glasgow, the college held a two day conference on “Medicine and Literature.” The meeting was fully subscribed and, by all accounts, highly entertaining and stimulating. In addition, the organisers put out a call for short stories from doctors and medical students, and published them as The Magic Bullet and Other Medical Stories. Ten years ago, I do not think that this would have happened.
These are all examples of the paradigm shift from pseudoscientific certainty to post-normal science, which acknowledges that all scientifically derived knowledge is provisional and must be balanced in decision making with other valid views of the world. The full implications of this shift for the doctor-patient relationship are still unfolding, and many patients and doctors find the new uncertainties of medicine difficult and unsettling.
Creativity in the consultation, in research, and in writing is the answer—perhaps, in the end, the only human answer. This volume of 16 stories illustrates this. They show a huge variety of styles and influences from Asimov to Garcia Marquez. Some are too sentimental for my taste, and some are descriptions, not stories. However, they show humanity, empathy with patients, and rage against the horror of disease and war. These are qualities that we need at the heart and the head of our profession.