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Unheard

The Medical Practice of Silencing

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Unheard

By: Dr Rageshri Dhairyawan
Narrated by: Dr Rageshri Dhairyawan
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About this listen

 LONGLISTED FOR THE BREAD & ROSES AWARD

Have you ever felt unheard by your doctor? Been frustrated that they haven't understood your symptoms, that they have neglected your concerns?

When Dr Rageshri Dhairyawan was admitted to hospital as a patient she didn't receive the pain medication that she told them she needed, despite her being a senior doctor. It was in that moment she understood that something was deeply wrong with our healthcare system. Doctors aren't listening, and it is making us ill.

In Unheard, Dr Dhairyawan takes us on a journey through history to show how not listening to patients has been ingrained in medicine from its inception. Western medicine has been built on the assumption that power should always lie with the doctor, and that patients should be powerless to decisions made about their body if it is done to make them well. This, alongside the prejudices of society, has led to dramatic gaps in medical knowledge because for centuries people have not been heard.

Dr Dhairyawan offers a way to reshape our health system for a future where active and engaged listening is the new frontier in a timely, shocking and engaging exposé of the medical world.©2024 Dr Rageshri Dhairyawan (P)2024 Orion Publishing Group Limited History & Commentary Medical Medicine & Health Care Industry Physician & Patient Professionals & Academics Medicine Health Care Health
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Dhairyawan harnesses her combined and varied authority as patient, doctor, researcher, activist, listener, woman of colour to powerful effect in this vital book. It is moving, insightful, and motivating. As a patient I wish every doctor would read it. As an academic (in another discipline) I wish every colleague would read it. But it is much more than a handbook for professionals: it will equally appeal to patients, current and future — everyone in other words. It is also a deep reflection on the current moment, as institutions of every kind reflect on their histories and purposes and try to refit themselves for the world we live in.

A vital book

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This is an important book for all of us working in healthcare. It is the reflections and shared understanding of a mid-career Physician who has also been at the receiving end of healthcare. Rageshri talks about the medical practice of silencing, of not listening to the patient, especially when the power imbalance is greater. She centres this around the concept of epistemic injustice, patients not being recognised as 'knowers'. She talks about Miranda Fricker's description of two kinds of epistemic injustice: testimonial injustice (not believing) and hermeneutical injustice (not being able to interpret). She offers many other areas of thought throughout the book: patient consultations which may be transactional and relationship- based, the role of humanities and what we may learn from wider human understanding, balancing evidence-based medicine with compassion and care, thinking beyond representation and the myth of objectivity. While I have understood some of this in my journey as a physician increasingly understanding and aspiring to provide a bio-psycho-social model, this book offers me the language to articulate the thought and communicate it to those I deliver care and those who work with me. We need much humility and the ability to live with less certainty about our own knowledge to not be silencers.

An important read

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I am confident that listening to Unheard will make me a better health researcher. I'm grateful to have read it so early in my career.

This book is vital reading/listening for anyone interested in health/medicine, whether studying it, practising it &/or researching it. It's great.

Important and timely

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I was initially very enthusiastic about this when I started but after a while I found the constant framing of most discussions about structural racism and sexism a bit grating. These are without doubt enormous problems in healthcare but there is so much more to the problem of poor patient communication and power imbalances. I felt that the author was telling her own story rather than providing a broader and more comprehensive discussion of the issues. Some people may really enjoy that - and clearly many have done - but I personally found it frustrating.

Ok but very much centred around structural racism and sexism

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