The Clay Pedestal: A Renowned Cardiologist Reexamines the Doctor-Patient Relationship

Would that the entire medical profession be possessed of a like-minded attitude regarding treatments, honesty with patients, and a true "bedside manner," as Dr. Thomas A. Preston. This is a "must have," for everyone who ever went to see, or will go to see, a medical man for treatment.Anna Marie FritzAuthor of "The Dream Garden" crystaldreamspub.com

Thomas Preston's book called to me from a table in the Hospital library one afternoon. When I found the chief of medicine's name among the more recent borowwers in the library card sleeve I couldn't resist reading the entire book. I was an internal medicine resident struggling with the social pressures of caring for the sick and dying during my first year of residency; this book put that experience in perspective. This book improved my skills as a physician with such admonishments as: 'if you don't enjoy taking care of patients, change your practice so that you enjoy it. Patient's can tell. You will provide better care if you enjoy your work. Make sure you enjoy what you are doing, patients notice''the key to being a good physician is giving a damn.''patients come to you for two reasons, they will tell one of them.'It is filled with wisdom, and an explanation of the history of medicine's influence on some of the arcane and irritating aspects of medical education, and patient care.For those familiar with House of God, this book is an antidote for the cynicism, and hypocrisy we find in seemingly immutable customs of the ages. It is a serious, very readable, account of several past quack treamtents promoted by the 'scientific' western medical community. The reasons for the success of these treatments, and their failures are examined. This examination shows us the difference between healing and curing, between killing the disease and caring for the patient and in the process the reader may enjoy the pleasure a child knows when a joke is played on the teacher.If you function in a healthcare setting, this book is worth its price and the time you will spend reading it.Chris Anderson MD FRCPC

It took 17 years as an MD before Dr Preston faced that the MD's loyalty is to the profession rather than the patient. He now questions whether the down side of medications and operations is so great that it almost completely offsets the good done -- which would explain why people who live in areas with twice the rate of medical intervention do not live longer.

This superb book is a critical examination of the cultural aspects of the doctor-patient relationship and how these may operate to benefit or harm the patient. He discusses the reasons that well-meaning physicians behave in an arrogant and dictatorial manner, express more certainty than they really feel, manipulate their patients, rely on "clinical judgment" rather than scientific evidence, overtreat, etc. This is not a doctor-trashing book, as he sees much of this as being outside the ability of an individual physician to change given the pressures of medical culture. I recommend his fascinating analysis without reservation.