There have been a plethora of books written in recent years by doctors and other health professionals about the cases they treat and how they cope with the challenges of a job involving potentially life and death decisions. Chicken Unga Fever, by Dr Phil Whitaker, provides a series of snapshots of the working life of a GP. It is a collection of the author’s ‘Health Matters’ columns from the New Statesman magazine, where they have appeared fortnightly for the past five years. Each entry is short – typically a couple of pages in length – and the book is best dipped into rather than read in a sitting. What emerges is a gentle and humane view of the nation’s health from the perspective of a front line doctor who is expected to recognise every ill within a ten minute consultation and offer effective treatment.
Doctors are human and will sometimes make mistakes – an increasingly litigious culture can thus detrimentally affect outcomes as they strive to protect themselves professionally. When rare disorders are encountered they may take some time to diagnose – no doctor can remember every possible symptom and illness. In Britain they work within a system that demands ever more time and cost savings, encountering patients who will already have consulted Dr Google without understanding background and context. With the recent marked increase in obesity, patients are not always able or willing to help themselves.
Some of the cases included are heartbreaking to read – not so much in the experiences of the dying but rather their treatment of those who love and support them when confronted by their imminent mortality. There are interesting musings on medical myths – how science may not always provide the sought after cure. I found it surprising that a doctor would have faith in chiropractors or acupuncture but psychosomatic illnesses are becoming more widespread so perhaps such treatments can prove beneficial for those who believe in them. It was no surprise to learn that a balanced diet, adequate rest and regular exercise can be effective as longer term solutions for many ills.
“If someone is in poor health then there are likely to be myriad contributors. Some, like genes or age, we can do little about. But what we eat, how much rest and recreation we grant ourselves, what exercise we take, our sense of security and autonomy, and our levels of deprivation, are all important determinants that can be addressed – some at a personal level, others socio-politically. The success of scientific medicine has led to the belief that there’s a pill to solve every ill. Our medical forebears would be astounded by the efficacy of our drugs, but equally bemused by our inability to take care of ourselves.”
There is discussion of many issues – from well meaning but ultimately nagging government health promotions that put patients off consulting doctors, to unnecessary testing as a means of reassuring the patient that all possible avenues are being explored but which can lead to false positives that end up doing more harm than good. These false positives also occur when private companies become involved in screening programmes – the more tests they do the more money they make. Modern tests such as MRI and CT scans can spot potentially scary lumps and bumps that the body may successfully cope with given time. Not all precancerous cells become malignant, or develop quickly. Interventions are not always in the patient’s best interests.
The details of the various consultations are presented in calm and measured language. Patients are treated with compassion and respect. Doctors may be best placed to know how to most effectively allocate scarce resources but patients will not always appreciate decisions made that do not provide them with the care they seek. The over prescribing of antibiotics is a case in point, and one that will likely cause future problems for the patient.
The author talks of his more personal experiences as a doctor – such as when called to treat a patient on a holiday flight, or at a child’s school event. He also comments on the equipment and therefore treatments offered in other countries, comparing Zambia and then the USA with Britain’s facilities.
“I want our health service to be as good as it can be, but the juxtaposition with what I was witnessing in Zambia felt raw. UK medical students undertake electives abroad to gain valuable perspectives on healthcare elsewhere in the world. Perhaps it’s time our politicians did likewise.”
Although garnering the occasional mention this is not a political book. The short entries offer an overview of the day to day life of a GP in today’s NHS – the importance of trust and teamwork. It makes for sobering but also comforting reading. The media may love to paint a bleak picture of current UK healthcare, mostly still available to all despite the current government’s endeavours. With continual medical advances I would posit that this is one area that few would wish to revert to ‘the good old days’.
My copy of this book was provided gratis by the publisher, Salt.