If I Betray These Words
Moral Injury in Medicine and Why It's So Hard for Clinicians to Put Patients First
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Narrated by:
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Wendy Dean
About this listen
Through stories and solutions, leading physicians tackle the conundrum of how best to care for patients while being thwarted by the business side of healthcare
Moves "away from calling doctors’ difficulties 'burnout'—thus blaming doctors—to 'moral injury'—like soldiers floundering under unjust orders. A brilliant expansive book.”—Samuel Shem, Professor in Medicine at NYU Medical School, author of The House of God and Man's 4th Best Hospital
“Wendy Dean diagnoses the dangerous state of our healthcare system, illustrating the thumbscrews applied to medical professionals by their corporate overlords… Required reading for all stakeholders in healthcare.”—Danielle Ofri, MD, PhD, author of When We Do Harm; A Doctor Confronts Medical Error
Offering examples of how to make medicine better for the healers and those they serve, If I Betray These Words profiles clinicians across the country who are tough, resourceful, and resilient, but feel trapped between the patient-first values of their Hippocratic oath and the business imperatives of a broken healthcare system.
Doctors face real risks when they stand up for their patients and their oath; they may lose their license, their livelihood, and for some, even their lives.
There’s a growing sense, referred to as moral injury, that doctors have their hands tied—they know what patients need but can’t get it for them because of constraints imposed by healthcare systems run like big businesses.
Workforce distress in healthcare—moral injury—was a crisis long before the COVID-19 pandemic, but COVID highlighted the vulnerabilities in our healthcare systems and made it impossible to ignore the distress, with 1 in 5 American healthcare workers leaving the profession since 2020, and up to 47% of U.S. healthcare workers now planning to leave their positions by 2025.
If I Betray These Words confronts the threat and broken promises of moral injury—what it is; where it comes from; how it manifests; and who’s fighting back against it. We need better healthcare—for patients and for the workforce. It’s time to act.
©2023 Wendy Dean and Simon Talbot (P)2023 Steerforth Press LLCListeners also enjoyed...
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"A fierce denunciation of American medicine in which physicians are the heroes—mostly… An expert bottoms-up examination of our diseased health care system."—Kirkus Reviews (starred review)
“This is a great story of an adventurous and wide-ranging doctor dedicated to bringing the human into medicine. Having felt the whip of money and ‘administrators,’ in both large institutions and small hospitals, she and Simon Talbot moved away from calling doctors’ difficulties 'burnout'—thus blaming doctors—to 'moral injury'—like soldiers floundering under unjust orders. A brilliant, expansive book.”—Samuel Shem, MD, DPhil, Professor in Medicine at NYU Medical School, author of The House of God and Man's 4th Best Hospital
"A manifesto for our times! Wendy Dean diagnoses the dangerous state of our healthcare system, illustrating the thumbscrews applied to medical professionals by their corporate overlords. By making it impossible to do the right thing for patients, the profit-hungry system casually gouges the moral fiber of healthcare workers, threatening patient safety. Luckily, Dean lays out a path forward. Required reading for all stakeholders in healthcare."—Danielle Ofri, MD, PhD, author of When We Do Harm: A Doctor Confronts Medical Error
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Exceptional, thought-provoking, liberating!
- By Anne on 08-10-11
By: Jane Gross
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Changing the Way We Die
- Compassionate End-of-Life Care and the Hospice Movement
- By: Sheila Himmel, Fran Smith
- Narrated by: Coleen Marlo
- Length: 6 hrs and 49 mins
- Unabridged
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There’s a quiet revolution happening in the way we die. More than 1.5 million Americans a year die in hospice care - nearly 44 percent of all deaths - and a vast industry has sprung up to meet the growing demand. Once viewed as a New Age indulgence, hospice is now a $14 billion business and one of the most successful segments in health care. Changing the Way We Die, by award-winning journalists Fran Smith and Sheila Himmel, is the first book to take a broad, penetrating look at the hospice landscape.
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Sadly, not very engaging.
- By Debra S. Long on 06-16-18
By: Sheila Himmel, and others
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Teeth
- The Story of Beauty, Inequality, and the Struggle for Oral Health in America
- By: Mary Otto
- Narrated by: Suehyla El'Attar
- Length: 9 hrs and 37 mins
- Unabridged
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Teeth takes listeners on a disturbing journey into America's silent epidemic of oral disease, exposing the hidden connections between tooth decay and stunted job prospects, low educational achievement, social mobility, and the troubling state of our public health.
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Content everyone should know; dismal narration
- By Elaine on 08-04-17
By: Mary Otto
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Reinventing American Health Care
- How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System
- By: Ezekiel J. Emanuel
- Narrated by: William Dufris
- Length: 11 hrs and 57 mins
- Unabridged
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Ezekiel J. Emanuel, a professor of medical ethics and health policy at the University of Pennsylvania who also served as a special adviser to the White House on health-care reform, has written a brilliant diagnostic explanation of why health care in America has become such a divisive social issue, how money and medicine have their own American story, and why reform has bedeviled presidents of the left and right for more than one hundred years.
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The book lacks integrity
- By Richard M. Shaner on 06-02-16
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Epic Measures
- One Doctor. Seven Billion Patients.
- By: Jeremy N. Smith
- Narrated by: Patrick Lawlor
- Length: 10 hrs and 12 mins
- Unabridged
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Moneyball meets medicine in this remarkable chronicle of one of the greatest scientific quests of our time - the groundbreaking program to answer the most essential question for humanity: How do we live and die? - and the visionary mastermind behind it.
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Fabulously insightful read!
- By Dr. Jack E. Fincham on 10-08-15
By: Jeremy N. Smith
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The Nordic Theory of Everything
- In Search of a Better Life
- By: Anu Partanen
- Narrated by: Abby Craden
- Length: 10 hrs and 28 mins
- Unabridged
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Moving to America in 2008, Finnish journalist Anu Partanen quickly went from confident, successful professional to wary, self-doubting mess. She found that navigating the basics of everyday life - from buying a cell phone and filing taxes to education and childcare - was much more complicated and stressful than anything she encountered in her homeland. At first she attributed her crippling anxiety to the difficulty of adapting to a freewheeling new culture. But as she got to know Americans better, she discovered they shared her deep apprehension.
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A non-radical perspective on two societies
- By kwdayboise (Kim Day) on 06-20-17
By: Anu Partanen
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It Shouldn't Be This Hard to Serve Your Country
- Our Broken Government and the Plight of Veterans
- By: David Shulkin
- Narrated by: Daniel Thomas May, David Shulkin
- Length: 11 hrs and 21 mins
- Unabridged
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Known in health care circles for his ability to fix ailing hospitals, Dr. David Shulkin was originally brought into government by President Obama, in an attempt to save the broken Department of Veterans Affairs. When President Trump made him VA secretary, Dr. Shulkin was as shocked as anyone. Yet this surprise was trivial compared to what Shulkin encountered as the VA secretary: a team of political appointees devoted to stopping anyone - including the secretary himself - who stood in the way of privatizing the organization and implementing their agenda.
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A Powerful Account by an Impressive Public Servant
- By Tom on 12-10-19
By: David Shulkin
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Get What's Yours for Medicare
- Maximize Your Coverage, Minimize Your Costs
- By: Philip Moeller
- Narrated by: James Foster
- Length: 7 hrs and 27 mins
- Unabridged
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A coauthor of the New York Times bestselling guide to Social Security Get What's Yours authors an essential companion to explain Medicare, the nation's other major benefit for older Americans. Learn how to maximize your health coverage and save money.
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Very Negative and Overwhelming
- By A.C.W. on 04-08-20
By: Philip Moeller
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A Collective Bargain
- Unions, Organizing, and the Fight for Democracy
- By: Jane McAlevey
- Narrated by: Jane McAlevey
- Length: 9 hrs and 21 mins
- Unabridged
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In A Collective Bargain, longtime labor organizer, environmental activist, and political campaigner Jane McAlevey makes the case that unions are a key institution capable of taking effective action against today’s super-rich corporate class. Since the 1930s, when unions flourished under New Deal protections, corporations have waged a stealthy and ruthless war against the labor movement. And they’ve been winning.
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Disappointing
- By Ellen on 01-26-20
By: Jane McAlevey
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To Repair the World
- Paul Farmer Speaks to the Next Generation
- By: Paul Farmer, Bill Clinton - foreword, Jonathan Weigel - editor
- Narrated by: Joe Barrett, David Ledoux, Kevin T. Collins
- Length: 8 hrs and 58 mins
- Unabridged
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Here, for the first time, is a collection of short speeches by the charismatic doctor and social activist Paul Farmer. One of the most passionate and influential voices for global health equity and social justice, Farmer encourages young people to tackle the greatest challenges of our times. Engaging, often humorous, and always inspiring, these speeches bring to light the brilliance and force of Farmer's vision in a single, accessible volume.
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Resist the Impoverishment of Aspiration
- By Susie on 05-14-13
By: Paul Farmer, and others
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The Social Transformation of American Medicine
- The Rise of a Sovereign Profession and the Making of a Vast Industry
- By: Paul Starr
- Narrated by: Sean Runnette
- Length: 24 hrs and 5 mins
- Unabridged
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Considered the definitive history of the American healthcare system, The Social Transformation of American Medicine examines how the roles of doctors, hospitals, health plans, and government programs have evolved over the last two and a half centuries. Updated with a new preface and an epilogue analyzing developments since the early 1980s, this new edition is a must-listen for anyone concerned about the future of our fraught healthcare system.
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Fascinating Survey of Healthcare in Amerixa
- By Rob on 06-24-19
By: Paul Starr
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The Desperate Hours
- One Hospital's Fight to Save a City on the Pandemic's Front Lines
- By: Marie Brenner
- Narrated by: Kirsten Potter
- Length: 15 hrs and 41 mins
- Unabridged
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In the spring of 2020, COVID-19 arrived in New York City. Before long, America’s largest metropolis was at war against a virus that mercilessly swept through its five boroughs. In The Desperate Hours, award-winning journalist Marie Brenner, having been granted unprecedented 18-month access to the entire New York-Presbyterian hospital system, tells the story of the doctors, nurses, residents, researchers, and suppliers who tried to save lives across Manhattan, Queens, and Brooklyn and the northern periphery of the city.
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Way too much politics
- By Josh on 07-18-22
By: Marie Brenner
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Haiti After the Earthquake
- By: Paul Farmer
- Narrated by: Meryl Streep, Edoardo Ballerini, Edwidge Danticat
- Length: 14 hrs and 7 mins
- Unabridged
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On January 12, 2010, a major earthquake struck near Port-au-Prince, Haiti. Hundreds of thousands of people died, and the greater part of the capital was demolished. Dr. Paul Farmer, U.N. deputy special envoy to Haiti, who had worked in the country for nearly thirty years treating infectious diseases like tuberculosis and AIDS, and former President Bill Clinton, the U.N. special envoy to Haiti, had just begun to work on an extensive development plan to improve living conditions in Haiti.
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If you read one book about Haiti make it this one
- By Bryan on 06-07-12
By: Paul Farmer
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Doctored
- The Disillusionment of an American Physician
- By: Sandeep Jauhar
- Narrated by: Patrick Lawlor
- Length: 10 hrs and 38 mins
- Unabridged
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Hoping for the stability he needs to start a family, Sandeep Jauhar, an attending cardiologist, accepts a position at a massive teaching hospital on the outskirts of Queens. With a decade's worth of elite medical training behind him, he is eager to settle down and reap the rewards of countless sleepless nights. Instead, he is confronted with sobering truths. Doctors' morale is low and getting lower.
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Frank, inside perspective on the follies of unintended consequences in medical reform
- By JW on 02-25-18
By: Sandeep Jauhar
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What listeners say about If I Betray These Words
Average customer ratingsReviews - Please select the tabs below to change the source of reviews.
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- Calico Ducheneaux
- 05-11-23
Life changing
What a journey. Thank you for giving us a voice and putting into words what so many of us feel but cannot articulate.
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- thi cao
- 11-15-23
A must read!
Very insightful and intelligent journey that should be taken by all in healthcare and legislation. We need to do better in order to serve our patients.
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- Mary D. Tipton
- 06-04-23
Must read for all patients (that’s everyone!)
I don’t think I have ever listened to a book and then immediately started it over AGAIN.
But…. this book.
This book I read twice.
It is the sometimes tragic story of my life, my passion, my 22 year career as a physician; it describes the internal conflict I feel daily.
A conflict so intense it makes me ill.
A conflict between my desire to put patients needs first and my inability to do so.
This pain I feel now has a name = Moral Injury.
Moral Injury describes the plight of tough, resourceful, and resilient clinicians who feel trapped between the patient-first values of their Hippocratic oath and the business imperatives of a broken healthcare system.
⭐️If you want to understand why you can’t find a doctor to see or listen to you…. Read this book.
⭐️If you wonder why healthcare is so expensive… read this book.
⭐️If you are frustrated that your doctor can only spend 15 minutes with you and seems rushed and looks at the computer the whole visit…. Read this book.
⭐️If you wonder why physicians have high suicide rates… read this book.
I believe things will get worse before they get better. It will take all of us to fight for a system that allows physicians to put patients first.
“One day we will all be patients. Don’t we want our health systems to put us and those who care for us first?” - Dr Wendy Dean
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- Jason Jones
- 08-23-23
Important
Few things are as important in the U.S. right now as the state and trajectory of healthcare. If you want to understand where we are, this will be one of the most accessible and informative books you can read. From this understanding, please help us find a better path.
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- Andrea Callister
- 05-18-23
Richly insightful and thought provoking
As a neurology resident, I recommend to anyone wanting to understand modern healthcare challenges
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- sam
- 04-26-23
Great!
I really didn’t expect this to be so gripping and hold my interest. But it did. Wendy Dean does an amazing job at illustrating the system failures of medicine. It is well researched, well written and enjoyable to listen to. Really superb.
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- lipomaman
- 05-14-23
Important for Health in America
A vitally important look into what ails our healthcare system and why it’s gotten harder to get quality physician care, why physician’s die by suicide more than any other profession, and why legislative changes to date have failed to restore quality, reduce costs, or relieve strain on physicians. Wendy Dean’s book is concise, poignant and rooted in the desire to bring CARING for patients back to the center of healthcare.
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- JHenderson
- 11-01-23
Required Reading - necessary transformation
I’m so thankful to the authors for standing in the gap for patients and health care workers who have so often been abandoned by the government and health systems they work for in the name of profit. This should be required reading in every boardroom, C suite, MBA and MHA program in the country. Unfortunately, that would require for those who inhabit those spaces to recognize that patient care is the priority. Hopefully we can all work together to bring that truth back to the light it deserves. This book is an inspiration and a blueprint for those of us who care.
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- Anonymous User
- 12-13-23
Relatable
Appreciated the author’s giving words to use to better understand the struggles we health care workers face on a daily basis.
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- Nicole
- 06-06-23
An important read for all physicians
Dr. Dean puts into words the trauma and injury physicians have been subject to in recent decades as healthcare has become focused on bottom lines over patient outcomes and care. So often the medical system asks so much of doctors without remembering that doctors are people who also need people to care for them as they care for their communities. Dr. Dean reminds us to focus on the care and support of physicians as we work to improve and heal the practice of medicine now and in the future. Thank you for your work. Thank you for getting out this info and opening peoples eyes to this often misunderstood problem. Keep kicking!
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