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Review: SECRETS FROM THE BLACK BAG

Susan Woldenberg Butler
RCGP 2005

£15.00 UK

By Louise Hallam
Contact the author via Chris Johnstone by e-mail at christopher.johnstone@ntlworld.com

Some of you may remember reading extracts from this quirky collection of thirty two short narrative tales in the BGJP last year. I have no back copies of the journal to hand but the imagery and evocativeness of the contrasting deaths of two children made the stories instantly memorable. Alec Logan, deputy editor of our esteemed co-journal, is credited in the acknowledgment for his superb editing and as such definitely had first lick of the lolly in choosing these two tales to tempt further reading.

However there are still thirty other reasons to buy this book as each story will resonate with family doctors everywhere.

Susan Woldenberg Butler is originally from the States and is now based in Tasmania with her ex-GP now public-health doctor husband. She has gathered an eclectic yet familiar series of patient tales based in primary care from Pakistan to Tanganyika, Scotland and New Zealand. The stories are written in a multitude of different styles and voices and this, though occasionally patchy, chimes with the thirty-odd patient tales we tend to see and hear each day. The stories typically represent general practice as seen from the perspective of the isolated, single-handed GP and I wonder whether this book will stand as an epitaph to this increasingly endangered species in these days of merging “supersize-me” surgeries.

The accounts are fictionalised, as are the names of the contributors. I wondered whether the real Noose Grimely would appreciate the gentle teasing contained in his baptism.

As one scrolls down the contents page reading titles like “Nothing agrees with me, doctor”, and “Since you’re here, doctor” – though perhaps not, “Make my wife pregnant, doctor” – one can picture patient’s faces forming behind these innocuous phrases.

There are also stories by doctor’s wives, the original Desperate Housewives perhaps. Mrs Grimely describes the inescapable reality thus –“We’re not women in general, we’re the doctor’s wife.” Her story pulls empathy from your pores while making you laugh out loud at her descriptive humour and honesty.

The games patients play with doctors are echoed in the games played out between the doctor and his other half with diversionary tactics, flattery, projection and distraction all covered.

There is much distilled wisdom in this book gleaned from thousands of hours of reflective consulting, almost 101 Commandments of General Practice. For example: Ferreting out the hidden may do more harm than good. Consider the context and the levels of tension and anxiety. Do not try to do too much, too fast. A private life is a good thing. It is a book to digest slowly, to reflect on thoughtfully, certainly to enjoy.

From my own black bag my most memorable tale concerns going out as a trainee with my then trainer, now the editor of a reputable medical magazine, and as we approached the house of a notorious serial visit requester I remarked with the wonderful innocence of youth what a privilege it was to be allowed to visit people at home. He looked at me askance, eventually muttering faintly , “Yes”.

The final word though sees me quoting Alec Logan in his elegant foreword describing general practice: “Where the science that is medicine bumps thrillingly against human fear, passion, despair and hope.” That says it all.

Other hoolet online articles by Louise Hallam can be found at:
hoolet edition 49 - Review: Secrets from the Black Bag
hoolet edition 30 - Review: The Constant Gardener

Other hoolet reviews by Louise Hallam:
Secrets from the Black Bag

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.