BOOK REVIEW : If I Betray these Words : Moral Injury in Medicine and Why it ’ s So Hard for Clinicians to Put Patients First by Wendy Dean , MD with Simon Talbot , MD Steerforth – April 4 , 2023
In July 2018 , STATNews published an article co-authored by Drs . Dean and Talbot which explored the concept of moral injury in health care . Moral injury was first described in military combatants . It is defined as occurring when someone feels that they must act against deeply held moral beliefs . For physicians and other health care professionals these beliefs are the oaths that we took to put our patients first . The term professional burnout has been in use for several years . I always found this term to be derogatory particularly as it related to physicians , nurses and other health care professionals . The implication was that we could just not hack it in the modern world of medicine . Moral injury in medicine acknowledges the symptoms manifested in burnout but attributes these symptoms not to any physical inability to hack it , but to the moral dilemma faced by medical professionals who are unable to do their job because of external constraints over which they have no control .
24 LOUISVILLE MEDICINE reviewed by ELIZABETH AMIN , MD
The book that has resulted from the research that the authors have undertaken is compelling reading . The introduction details the specific event that prompted the development of the book . There are 13 chapters , each one dedicated to a specific physician whom Dr . Dean interviewed extensively ; visiting many of them in their home and / or work environments . The physicians ’ stories are fleshed out with details of their lives before medical school . The individuals and circumstances that influenced them are detailed , and so are the choices made during and after medical school . We read of the struggles they faced , as they became aware that the system was preventing them from practicing medicine as they had envisioned , as they had promised themselves they would do when they took their oath . The epilogue sums up the realities of current medical practice . Dr . Dean is no Pollyanna , but she sees ( and offers ) a way out of distress . It is not for the faint of heart .
Some of the 13 subjects that Dr . Dean describes allowed her to use their real names though others preferred name changes . The