On Becoming a Healer

Book Title: On Becoming a Healer

Author: Saul J. Weiner

Publication Information: Baltimore, MD, Johns Hopkins University Press, 2020, 194 pp., $26.95, paperback

In an exceptional and timely publication, Saul Weiner, MD, offers an antidote to practicing medicine in this era of burnout: engage with patients on a personal level with boundary clarity.

Dr Weiner was mentored throughout his life, and most particularly starting in medical school, by his physician-godfather Dr Simon Auster, an insightful family physician and psychiatrist by training. Much of the book relates conversations or principles arising from their insightful conversations. “While I had someone to guide me during my medical education, few physicians in training are so fortunate. Without help finding their way, they are socialized to the norms of the profession, modeling their behavior on what they observe.” (p 12)

Dr Weiner asserts that doctors are disengaged, part of a learned process cooked into physician training. He writes,

…I came to see that doctors hide behind their white coats while patients want to connect with a real person who cares about them.” (pp. 12-13)

Dr Weiner encourages physicians to break down the social construct that separates physicians and patients and accept that we are, in fact, very similar. One bad accident or unfortunate diagnosis makes a doctor a patient. He described patients this way: “Some are jerks, some are nice, some are lost, and some are confused—just like the doctors who care for them.” (p 102) But just as doctors learned through training to be disengaged in patient interactions, they can learn through self-reflection to be engaged.

Dr Weiner discusses boundary clarity and defines it as knowing yourself and being comfortable with yourself; knowing where you as a physician end, and where the patient begins. Acknowledging the importance of boundary clarity, the author presents several figures illustrating the physician-patient interaction. In the figure displaying the most ideal interaction, he points out

…that the boundaries of the two individuals are in contact, indicating that each of them is experiencing directly who the other one is. This is a natural state that occurs anytime two individuals are open to engagement. (p 86)

Further describing the topic he adds,

Boundary clarity is …what enables a physician to respond to suffering based on their patient’s needs rather than their own discomfort. (p 88)

The book addresses physician burnout in several ways. As physicians, we know the problem to be multifactorial. A few of these factors include increased pressures from electronic medical records and administration, less time to do more, feeling like a cog in a wheel, and meeting patient expectations. Dr Weiner adds this thought-provoking idea:

It’s tiresome putting on a façade all day. It’s also less fulfilling not to open oneself to the experience of real connection. (p 85)

With sufficient grounding and curiosity, each of us can find the courage and honesty to acknowledge, at least to ourselves, where we are developmentally in our journey to becoming healers. (p 72)

Dr Weiner includes questions for reflection and discussion at the end of each chapter to reinforce the chapter’s main principles, and to help readers begin to introspectively assess their own qualities. Healing interactions, caring, and physicians as technicians vs healers are deep themes that permeate the book and offer the reader plenty of opportunity to consider their own perspectives on being a physician, and helping patients as engaged healers.