Review of If I Betray These Words by Wendy Dean with Simon Talbot.

Abstract

This is a book about physician burnout [1]. Drs. Dean and Talbot prefer the term “moral injury” to “burnout” when discussing the affliction which affects so many physicians today. Since I represent a classic case of burnout, I was eager to read this book. As I read each chapter, I wanted to engage the author in conversation. My mind was filled with anecdotes from my own practice. I had arguments and comments that I longed to share with her. This, I think, is the main value of the book. It is a fantastic stimulus for dialogue about a topic that is crucial to healthcare in our world today. Most of us enter medical school feeling a calling to serve others, to comfort and heal those who are sick. We think of medicine as a noble calling, a moral life. We expect to make sacrifices that include grueling hours of training and interrupted family life. The personal price, we believe, will be more than balanced by the satisfaction of grateful patients restored to health. Unselfish humanitarianism is the core of our role as physicians. On the other hand, the modern American healthcare system operates, to an overwhelming extent, as a business. Success is measured in dollars. Healthcare is no longer mission-driven with humanitarian goals.