|Genre||Memoir (229 pp.)|
|Keywords||Acculturation, Aging, Alternative Medicine, Art of Medicine, Caregivers, Chronic Illness/Chronic Disease, Colonialism, Cross-Cultural Issues, Disease and Health, Doctor-Patient Relationship, Empathy, Family Relationships, Freedom, History of Medicine, History of Science, Hospitalization, Human Worth, Illness and the Family, Individuality, Loneliness, Medical Advances, Medical Education, Medical Ethics, Medical Research, Narrative as Method, Nature, Patient Experience, Physical Examination, Physician Experience, Poverty, Professionalism, Psychiatry, Psycho-social Medicine, Science, Society, Suffering, Surgery, Survival, Technology, Time, Trauma, Urban Violence|
Because this lucid, rich, and incisive book has not, as yet, been published in the United States, it has not acquired the readership it deserves. For those teaching Medical Humanities or those interested in broader or more global stories and perspectives about physician training, practice, and experiences, Helman’s most recent publication should be considered.
Part One (“Setting Out”) begins in South Africa where Helman’s family, comprised of a dozen doctors, has lived for generations and where his own medical studies occurred. As a child, he accompanied his father on rounds while other children spent holidays at the beach. Before long he discovered how hospitals, during the madness of Apartheid, were to “some extent a distorted mirror-image of the world outside” (3). Appalled by the differences in care and treatment, the keenly aware young man kept notes. His vivid observations of the harsh context of social injustices provide an unequivocal, eloquent, and disturbing critique of medicine then and there. His acute observations of physician behaviors and indigent populations in the city and in the bush contribute, as readers discover in later chapters, to the author’s expanded and compelling interests in cultural anthropology.
Part Two (“The Family Doctor”) leads to London. “After all the heat and light and space of Africa, London—with its low leaden sky and constant drizzle—was like living inside a Tupperware box, one stored deep inside a refrigerator” (47). In the 60s Helman’s migration required an adjustment to a world of technology and order, where as a family practitioner, he had become, in fact, a suburban shaman. In any society, patients wanted “relief from discomfort, relief from anxiety, a relationship of compassion and care, some explanation of what has gone wrong, and why, and a sense of order or meaning imposed on the apparent chaos of their personal suffering to help them make sense of it and to cope with it” (xvi).
Gradually Helman saw connections between the role of family physician and traditional healer: both involved an understanding of “not only a body’s internal equilibrium but also the equilibrium of the patient’s relationships with the world he or she lives in and how treatment should aim not only to treat the diseased organ but also to restore the patient’s life that equilibrium of relationships” (xvii). His encounters with patients and the stories they reveal suggest how important these often overlooked connections are and why they ought to be included in medical training and practice.
By the time readers reach Part Three ("States of the Art”), the author has moved into broader realms of thinking, in which medicine and illnesses are examined anthropologically. After 27 years of clinical practice Helman’s white coat and stethoscope are placed on a hook. Now, as a credentialed anthropologist at University College London, his larger lens allows for sustained scrutiny of the complexities, ambiguities, and nuances in such chapters as “Grand Rounds,” “Hospitals,” “Placebos,” “Third Worlds.” Helman’s range of experiences, multi-disciplinary training, intellectual conclusions, and abundant common sense argues for techno-doctors to learn from holistic practitioners. Whether devastating or humorous, the critiques reflect not just care provision but shared human capacities: the insights are thoughtful and fresh and very worthwhile.
|Commentary||This collection of essays by Helman is very readable, entertaining, and engaging. It won the 2007 Medical Journalists Association Book Award in the general readership section. Helman's criticisms of the profession whether in South Africa, London, the United States (where he completed research), and on-board a cruise (where he served as physician) are more than we might have obtained from tighter-lipped professionals. Helman sprinkles his love of literature with references to Fyodor Mikhailovich Dostoevski, Sir Arthur Conan Doyle, William Carlos Williams, Oliver Sacks, Roy Porter, Umberto Eco and others so that readers know that they are being guided by a very well-educated writer. Individual chapters can be selected for study by students who will identify very quickly the author’s grounding in medicine and also the tantalizing influence of anthropology.|
|Publisher||Double Storey Books/ Juta|
|Place Published||Mercury Crescent, Wetton, Cape Town, South Africa|
|Alternate Publisher||Hammersmith Press|
|Place Published||United Kingdom|
The South African version of this book, to which the cited page numbers refer, is not available outside of that country but Suburban Shaman was published in 2006 in the United Kingdom by Hammersmith Press (http://www.hammersmithpress.co.uk/suburbansham). The UK version can be purchased in the United States.
|Annotated by||Nixon, Lois LaCivita|
|Date of Entry||01/12/07|