What Seems To Be The Problem?: The heartfelt medical memoir telling the true story of an NHS doctor's pioneering, holistic approach to care

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Compelling and essential . . . will appeal to everyone who enjoyed Adam Kay's This Is Going to Hurt' Philippa Perry

I have to say I was quite deeply affected by this book. In What Seems To Be The Problem Dr Laura Marshall-Andrews sets out her life's work so far. From her misery at not being able to continue to specialise in Paediatrics she starts life as a GP. Her journey leads her to setting up the Brighton Health and Wellbeing Centre where she and the rest of the staff deal with a clientele that includes some of the most challenging complex needs patients in the country. Reading this reminded me of The Compassion Project: A case for hope and humankindness from the town that beat loneliness, a book about how building a strong community in the town of Frome has improved health and wellbeing. This has seen hospital and GP visits go down, which has also reduced pressures on the NHS. Linking the two books together, if we could build strong communities, we can improve health and wellbeing. And if we adopt a holistic approach to healthcare that seeks to treat the whole person, then when someone does get ill, it will ensure they get the help they really need. They don't want to hear all that crap. I said, "Appendicitis," and that's what was typed into the computer. Later on the doctors caught up, but by then the antibiotics had been administered, so the actual popping was not the disaster it could have been. The compassion shown by her and her team was so uplifting but the cost to them personally of trying to fight against an out-dated and struggling system was also deeply upsetting. Penalty points for editing errors (spelling, grammar, punctuation, etc.), for children who act too mature or too young for their age (this is a bugbear of mine), or if there is something in the book that just really pisses me off for any reason.Laura and her team listen to patients, instead of simply throwing a diagnosis at them. Patients are treated as people, with compassion and kindness and that is extremely vital in all healthcare settings. What an amazing book! The author takes me on her tense yet full of laughter journey. Her ultimate goal is to make a change in primary care. She loves science and western medicine but she also believes in alternative therapy that may benefit patient better than just popping prescription pills. I enjoyed reading it, because author is real and open, honest and sincere. She was not afraid to highlight mistakes she made in her career.

Another quote, this one from Adam about Henry More, I hold onto in my heart: “Well, dead people can't sue, so I'm just going to go ahead and say it: Henry More was a total idiot.” With Mark replying, “So...not terribly good at his job, as far as philosophers go.” These cases show that an officer with the proper qualifications can testify as to reasonable speeds of the vehicles involved to an accident. Coming into the classroom, my knowledge of Design Thinking was insignificant. Case in point, when asked what I wanted to achieve from the weekend, I responded with the statement, “The definition of Design Thinking.”I was assured that the class was designed for everyone, “regardless of your title, role, profile, initiative or current way of working”.I was skeptical, and still, I remained open minded to the possibilities of the course and what it would mean to me. Q: Have you also received in-the-field training on how to investigate accidents while working for the [CHP]? I felt lesser but still significant disquiet over her prescribing of fentanyl lollipops to a young man who claimed that nothing else worked for him; for this, and perhaps for her unorthodox outlook in general, she finds herself summoned to a Performance Advisory Group — a disciplinary panel run by NHS England — a trial that she candidly recounts in the book.Officers whose duties include investigations of traffic accidents “are qualified experts and may properly testify concerning their opinions as to the various factors involved in such accidents, based upon their own observations.” ( Neumann, supra, 59 Cal.App.3d at p. 460 ; Hart v. Wielt (1970) 4 Cal.App.3d 224, 229; Risley v. Lenwell (1954) 129 Cal.App.2d 608, 631; Zelayeta v. Pacific Greyhound Lines (1951) 104 Cal.App.2d 716, 723-727.) A “traffic officer who has spent years investigating accidents in which he has been required to render official reports not only as to the facts of the accidents but also as to his opinion of their causes, including his opinion, where necessary, as to the point of impact, is an expert.” ( Hart, supra, 4 Cal.App.3d at p. 229; Kastner v. Los Angeles Met. Transit Authority (1965) 63 Cal.2d 52, 57.) Aside from point of impact, discussed above, officers may provide opinions on other factors involved in car accidents, such as path of travel and use of headlights. What is the full horizon of truth when it comes to managing patients? Marshall-Andrews was a GP trainee when she had an epiphany of sorts in the form of a patient named Julie. Julie was a 54-year-old bookshop owner who, on being diagnosed with terminal oesophageal cancer, eschewed standard medicine in favour of acupuncture, massage, and reflexology. Julie serves both as a catalyst to Marshall-Andrews’ journey into integrated medicine — ‘a way of caring for patients that sees them as unique individuals, not just as cases, and sets out to meet their emotional needs and those of their families’ — and also serves to open the book for the reader to join Marshall-Andrews from GP trainee to founder of, and long serving partner of, the Brighton Health and Wellbeing Centre, one of the country’s first integrated general practices. Right, I thought, yet another documentation of someone doing their job and wanting us all to read it etc, still, it drew me to it and was keen to see if this Dr was indeed different PLEASE PLEASE PLEASE make more of these, Audible. With exactly these two guys, in the exact same format, forever. The fact that they don't have a podcast where they talk about weird medical history facts is a CRIME.

I fist punched the air when she fought for a patient to stay on X drug because it had a huge positive impact on her life yet the higher ups wanted her switched to a drug that was not effective because of the cost. They argued about no evidence yet here is this human being gone from a miserable existence to being happier, healthier and managing to contribute to society. The doc also examines this, the cost of her health issues if she went on the ineffective drug, hospital admission costs, appointments, benefits etc huge costs which would be more than the medication. However the people who overview medication prescribing, costs to the surgery/budget wanted this lady on the cheaper, not effective or working for her because studies show, 1 person experience doesn't not provide conclusive evidence. I am so so glad she put the foot down but it shouldn't have to be like this. When it comes to patient care cost should not be a factor, I shudder at the healthcare systems in other countries but some of this stuff in this book also highlights it isn't just other countries. Really glad read these memoirs, and re taught me the lesson ‘never judge a book by it’s cover’ ( or blurb ) While Marshall-Andrews’ passion, innovation, and vision are evident and laudable there were some points in the book that I — as a risk averse and ‘traditional’ medic — found uncomfortable. Marshall-Andrews’ commitment to honouring patient choice is admirable but in my mind should not trump patient safety. Q: With this accident with tire marks you saw in the road, have you formed an opinion as to which vehicle made those tire marks?Personal knowledge and opinions however, can still be provided by the officer at trial. In certain circumstances, the officer’s recollection can be refreshed by the report, and in even more strict circumstances, the report can be read into evidence. ( Sherrell, supra, 116 Cal.App.3d Supp. at p. 32-33 [providing compliance with Evidence Code § 1237 must be met to read the report into evidence].) In any event, an officer’s opinion that one party was “‘most responsible’ for the accident is a legal conclusion and not a proper subject for expert opinion.” ( Carlton v. Department of Motor Vehicles (1988) 203 Cal.App.3d 1428, 1432.) What I am increasingly aware of the longer I practice medicine is that traditional models of care are not working.” The audiobook was beautifully narrated and captured the wide variety of emotions expressed throughout. While I am counting this towards my total for a year I do feel like this one is a podcast in all but name. In saying that I thought it was brilliant, and I am delighted to have spent my time with it. The "authors" (presenters) take on six different body parts 1. The Brain, 2. The Penis, 3. The Lungs, 4. The Womb, 5. The Heart, 6. The Gut. Discussions start in the past, from how people originally thought these worked (The brain was largely ignored for a long time) - how wrong early doctors and scientists were, as well as how early some people figured things out only to be ignored (for over 600 years in one case....!!). They move into where we are in respective fields now with new and emerging tech, and then onto where Adam thinks we might be headed in the future. The book wasn't predictable in terms of relying on tired tropes, clichés, themes, stereotypes, etc. ✅