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review 2017-05-12 22:03
A must read for doctors, care professionals and health and social care institutions. And anybody else
Attending: Medicine, Mindfulness, and Humanity - Ronald Epstein

Thanks to Net Galley and to Scribner for providing me with an ARC copy of this book that I freely chose to review.

If they asked me to provide a single word review of this book, I would write AMEN.

Ronald Epstein, the author and practising doctor with his own clinic, after years of studying a variety of disciplines (including music, meditation, Philosophy, Zen, Medicine…) and of trying to find the best way to maintain a practice sensitive to the needs of patients, compassionate, focused on well-being and avoiding suffering, rather than on billing, money and the business-side of things, published an article called ‘Mindful Practice’ in 1999. The article was very well received and resulted in the author becoming a speaker and offering training to other health professionals, emphasising the important of being mindful of one’s practice. In this book, the author shares his insight and knowledge to help other physicians avoid errors, burnout, and remember what Medicine should really be about. He offers plenty of background research and information (with abundant notes that take up more than a third of the book and a useful bibliography for those who want to check the original sources) interspersed with case stories that illustrate the topics. These include cases Dr Epstein had personal experience of (both as a physician and as a patient) and others that he’s accumulated over years of educating other professionals and talking to friends and colleagues. These cases not only reinforce the theoretical points but also add a practical and personal touch that can be lost in purely theoretical texts.

The book is written in a fluid and clear style, accessible and interesting also to those who might not work in healthcare, although it is particularly geared towards health professionals.  Due to the themes and subjects touched upon, this book would be useful to individuals and institutions heavily invested in helping people and dealing with the public, in particular, those offering care. Although many of the reflections are particularly pertinent to individuals, the emphasis on education and the fact that many of the qualities discussed, like compassion and resilience can be taught, are particularly important for organisations and institutions that manage human resources. As Dr Epstein explains, they would go a long way to help avoid professional burnout.

Although Attending mentions Zen, neurocognitive studies, philosophers’ books, mindfulness and meditation, the overall message does not require an in-depth knowledge of any of those subjects and I cannot imagine anybody who would not find something useful in this volume.

As a doctor and one who left the job a few years back less than enamoured with the way health care is organised, I kept nodding all the way through. I highlighted so many sentences and quotes that I cannot share them all, but I will choose a few ones that I felt were particularly pertinent:

Medicine is in crisis. Physicians and patients are disillusioned, frustrated by the fragmentation of the health care system. Patients cannot help but notice that I spend more and more time looking at computer screens and less time face-to-face. They experience the consequences of the commodification of medicine that has forced clinicians’ focus from the healing of patients to the mechanics of health care —productivity pressures, insurance regulations, actuarial tasks, and demoralizing metrics that measure what can be counted and not what really counts, sometimes ironically in the name of evidence-based and patient-centered care.

Maslach found that burnout consisted of three factors: emotional exhaustion, depersonalisation (treating people as objects), and a feeling of low personal accomplishment.

But now, in the age of the corporatization and widgetization of medicine, there is a new kind of burnout, a slow, relentless “deterioration of values, dignity, spirit and will” that comes from the structure of health care itself.

The problem is not only overwork; it’s a crisis of meaning, resilience, and community.

As I said, I think this book should be required reading for medical students, qualified doctors and also for other professionals working in healthcare and those who manage staff and organise the educational programmes of institutions, not only those providing healthcare but also any that deal with the public and its problems on a regular basis.

If I were to make a suggestion, it would be that the book could easily be made even more relevant to other disciplines by adding examples pertaining to other professions (not only nurses or paramedics but also social workers, counsellors, teachers…). It is clear from the content that although the principles can be applied individually, organisations would also do well adopting the ideals and attitudes highlighted by the research. Becoming attentive, compassionate, curious and mindful would help patients and staff increase their wellbeing and avoid burnout and complaints.

I recommend this book to all healthcare professionals, and those interested in how to improve healthcare and increase the resilience and wellbeing of staff. I think that anybody could potentially benefit from this book, and I’d recommend checking the sample if you think it might help you. I will definitely recommend it to some of my previous work colleagues.

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review 2017-05-12 20:21
Toni FGMAMTC's Reviews > The Subtle Art of Not Giving a F*ck: A Counterintuitive Approach to Living a Good Life
The Subtle Art of Not Giving a F*ck: A Counterintuitive Approach to Living a Good Life - Mark Manson

I recommend this one. It's about figuring out what is important to you. You can't be worried about having everything, doing everything, etc. It's okay to be average. TSAONGAF is entertaining and doesn't hold back from telling you like it is.

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url 2017-05-08 15:49
Bertrand Russell on Power-Knowledge vs. Love-Knowledge, the Two Faces of Science, and What Makes Life Satisfying

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review 2017-04-30 18:24
Run! It's too late after you embark
Moby-Dick - Andrew Delbanco, Tom Quirk,Herman Melville

It's not often lately that I find a read that threatens to leave me clueless as to what I'm reading. I'm not talking content here (I'll get to that later), but sheer language. Between the heavy intertextuallity, the word usage and sentences structure, I found myself having no idea what the last paragraph or three meant, and have to backtrack, more than I liked. I though I was over that shit. Conceit corrected.

 

Next, the characters feel like ghosts. Even the narrator sometimes loses substance, becoming something airlike and almost omniscient. They are Ahab's crew. If you want to get all metaphysical, traits of humanity that are driven by one over-consuming. It goes just as well as you could expect.


Last, the story. The thing itself could be spun in a third of the length without loosing anything from the plot. But, and here is where the ambitious bastard trips you, most of the meaning, theme and depth is stored in the fat. All those hazed-eyes inducing chapters? They actually have a point. Damned all those lit analysis classes, much of an overarching understanding of the novel hinges on the Jonah's sermon and the whiteness chapters.

So, is it worth it? Hell if I know. I powered through the thing, even liked it to some extent, and I'm still unconvinced. There is a certain brilliance in what it attempts. To me, the whole idea (and what it feels like to read it) can be encompassed in one passage in ch16: Ishmael goes to Peleg to ask to go whaling for a "desire to see the world" and Peleg tells him to look across the bow of the docked ship. There is nothing but water, says Ishamel, and Peleg answers that's the world he'll see a whaling. You can read a summary of the book as you can see the sea from the shore.The wisdom of going whaling is seriously challenged after all.

 

But it's not the same.

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review 2017-04-12 16:55
Paddle Your Own Canoe: One Man's Fundamentals for Delicious Living - Nick Offerman  
Paddle Your Own Canoe: One Man's Fundamentals for Delicious Living - Nick Offerman

Offerman is a lucky guy would had a good childhood, a good and meaningful college time, followed by the rest of his life, working hard at work and crafts he appreciates (which is mostly being silly, but also involves building canoes). He has a good work ethic and a seemingly kind heart, as well as a seriously advanced sense of humor. It's delightful to read a memoir by someone who understands that his life is very good and that he's lucky to have so many sources of pleasure.

On the downside, he has a very strong personality which won't appeal to all readers and which can become rather much of a muchness. Everyone's mileage is likely to vary a great deal.

Library copy

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