Throughout a distinguished career, spanning more than 50 years of psychiatric practice, advocacy, and leadership in health policy, Ralph Crawshaw has written prolifically. His humane and insightful essays and reviews, many of which have had substantial impact, have been published in first-rank general medical publications, including many in the “A Piece of My Mind” section of JAMA. As an architect of the Oregon Health Plan, director of the Oregon Health Decisions program, and Senior Scholar at the Center for Ethics and Health Policy of the Oregon Health Sciences University, with work funded by the Kellogg and Robert Wood Johnson foundations, among others, he has worked tirelessly, effectively, and influentially in the front lines of many of the ongoing battles for better health care. In short, he’s the real deal.
In this bountiful album of more than 80 essays, addresses, and occasional book reviews and film reviews, Crawshaw has brought together a productive lifetime’s worth of experiences and reflections. He addresses numerous aspects of the human condition, the courage necessary to be compassionate, how compassion is expressed, and the realities, challenges, and successes experienced by medical practitioners in their individual and collective attempts to provide humane and soulful care. As with any box of confections, each reader will be personally touched, affected, and delighted differently by individual pieces in the assortment. Several I particularly liked, whose titles will also illustrate the span of topics with which Crawshaw deals, are “The Foley Catheter” (his personal experiences), “The Bedpan Factor,” “The Psychology of the Hippocratic Oath,” “Nurturing Hate in Psychotherapy,” “Grass Roots Participation in Health Care Reform,” “A Modest Policy Proposal: The National Health Selective Disservice,” “Reflections of a Director on Resigning From a Mental Health Clinic,” “The Soul of Medicine.” “The Patient-Physician Covenant,” an often quoted piece reemphasizing the moral basis of medical practice, appearing in JAMA in 1995, is definitely worth reading. Crawshaw first-authored this article with a group of highly distinguished medical luminaries.
For physicians of any ilk—and certainly for psychiatrists—who seek professional and spiritual renewal, and who might benefit from being reminded and invigorated about why we do what we do, this book is just the thing to keep at the bedside for daily inspiration. The book will also be a perfect gift for young people thinking about or embarking on careers in medicine. I’ve already seen it included on several web sites as recommended reading. Warning: This book can kindle (or rekindle) passion about compassion.
