Through the use of familiar case vignettes the authors quickly capture the attention of those interested in liaison psychiatry and this book is a must for trainees at all levels. Drawing on Lawrence Goldie's experience of bringing psychoanalytic psychotherapy to specialist cancer care, a holistic approach is described which is applicable to many of the clinical scenarios common to the practice of liaison psychiatry across all hospital specialties.
The authors focus on the importance of the patient's narrative, the needs of patients and their families and carers, and the very real difficulties encountered when entering the sick role in hospital. They explore the cultural and communication gaps between naive young hospital doctors and their often mature patients with much greater life experience. The different factors motivating physicians, surgeons and patients are highlighted. How taking the time to talk can help patients and professionals adjust to the emotional challenge of life-threatening illness is also emphasised. Changes in the health service over the past 30 years have altered the care environment, presenting patients and their families with a bewildering journey through a large technological experience. Goldie reminds us of the importance of listening to and talking to as well as at our patients.
The patient stories are the book's strength and it should have wider appeal to trainees in oncology and palliative care provided they can cope with the explicit criticism of their disciplines’ historical approach to cancer care. Although I found myself nodding in agreement with much of the sentiment, I felt uncomfortable with the generality of the criticism.
This book is a timely reminder to all of us in psychiatry to slow down and not allow service pressures to erode the therapeutic value of time spent in conversation with patients and carers at a pace and level that enables their adjustment to the life event that is hospital admission.
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