DOCTORS AND PATIENTS

A physician's thoughtful but defensive attempt to explain himself and his profession. Berczeller (an internist who retired in 1992 after practicing for 36 years in N.Y.C.) recognizes that many patients regard their doctors with a mixture of fear, suspicion, and resentment. His aim here is to improve relations between patients and doctors by reporting ``the view from the inside,'' recalling incidents from his own career that reveal how physicians feel and think—about their patients, disease, and themselves. The author considers a number of especially sensitive areas, including money (patients wouldn't think that doctors overcharge, he says, if they understood what physicians really do); sex (doctors have feelings, too); and death (doctors' responses to patients' deaths are often misinterpreted). Berczeller relates stories and opinions about patients' families (interfering relatives can be destructive); communicating bad news (excessive frankness can take away hope); consultations and second opinions (overuse of specialists fragments patient care); and the risks and rewards of combining friendship with doctoring. Related to the last is the question of doctors' relationship with VIPs, and Berczeller provides a disarming account of his own awestruck attitude when Artur Rubinstein unexpectedly became his patient. The author's views on malpractice are noncontroversial: He contends that some doctors are guilty of ignorance and negligence but that some patients have unrealistic expectations of what medicine can do. Berczeller concludes with comments on finding the right doctor—a goal, he points out, that's quite different from finding a good one. Diverting and instructive, though offering little that's surprising or new.