Review of “Attending” by Ronald Epstein

attendingDr. Ronald Epstein’s recently published book Attending: Medicine, Mindfulness, and Humanity is among the best books about how to teach the humanistic aspects of doctoring. Epstein weaves together an insightful collection of experiences that examine the clinician’s situation starting from inside her own mind and ending at the system in which she practices.

“Attending” is both a term for the senior physician on a care team as well as a state of attentiveness. Both definitions are important here – the book draws from theories of mindfulness, which Epstein brought to the attention of medical practitioners in a 1999 JAMA article. This book explains the difference between being attentive and being present and how both are involved in the makings of an excellent physician. Epstein also explores more abstract concepts like curiosity and intuition, explaining with engaging examples how these characteristics are invaluable to the best clinicians.

The book reads like an eloquent explanation of the modern challenges to good doctoring. He addresses a variety of issues, from the breakdowns in communication between physician and patient to the challenges of providing empathic care in systems that are built for financial optimization rather than for healing. He also addresses important contemporary topics such as burnout and medical errors, devoting careful thought to these hotly debated problems.

Epstein does not just explain the relevant issues; he also writes about ways these problems can be curtailed or avoided. He uses anecdotes from his own experience in medical school and training as well as experiences and lessons he has learned about from colleagues, friends, and patients. He draws also from his extensive reading, including quotes and concepts from various scholars, including the philosopher Michel Foucault and the poet Jalal ad-Din Rumi. The result is an enjoyable amalgamation of human experience, applied to the complicated challenges faced by humanistic clinicians in today’s era of healthcare.

Epstein highlights the importance of a sound mind throughout the book. He explains many aspects of mindfulness practice, citing specific characteristics that can be improved using mindfulness techniques. He also provides an opportunity for clinicians and other healthcare providers to sharpen these skills by teaching specific exercises in the book.

Written by an engaging communicator, Attending is an enjoyable foray into the mind of someone who has carefully considered the challenges to today’s practice of medicine. Epstein provides thoughtful replies to a variety of concepts using compelling narrative and engaging anecdotes. This book is an important read for anyone who wants to critically engage with the humanistic practice of medicine.

Ali Rae

Health Communications Fellow at the Gold Foundation Research Institute

Ali I. Rae is in his fourth year of pursuing an MD/MPH at Brown and Columbia Universities respectively, with a concentration in Medical Humanities and Ethics. He writes poetry and fiction, as well as nonfiction on research topics with special interest in medical education, health policy, and the neurosciences.