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Elder, A. (1992). Kenneth Sanders, Nine Lives: The Emotional Experience in General Practice, Strath Tay, Perthshire: Clunie Press, 1991, 156 pages, pb, £8.00. Free Associations, 3(3):466-470.

(1992). Free Associations, 3(3):466-470

Kenneth Sanders, Nine Lives: The Emotional Experience in General Practice, Strath Tay, Perthshire: Clunie Press, 1991, 156 pages, pb, £8.00

Review by:
Andrew Elder

My only regret about this excellent book is that it may not get the readership that it deserves, particularly amongst general practitioners, since it comes from a specialized psychoanalytic publisher. It is a thoroughly worthwhile book, exceptionally well written (by general as well as medical standards), and is an important read for anyone interested in the rich and protean world of general practice.

Kenneth Sanders worked for thirty or so years as a GP in north-west London. At the same time, a deepening interest in psychoanalysis led him to train and eventually practise as an analyst. Some readers will already have enjoyed his earlier volume A Matter of Interest, in which he unravels the connecting thread of ‘anxiety’ in a selection of patients encountered in general practice, described at different stages of their lives. In that book he draws on the primal experience of infancy and on Bion's theory of an early ‘protomental system’, in which there is no distinction between psyche and soma, to help understand some of the patients seen in his surgery.

The meat of this book is the description of the nine lives of the title. Each one is an absorbing account of a small group of intertwining lives — couples, families and neighbours — observed over time (in some cases over twenty years) by their family doctor. The description of the doctor's interactions with his patients — his own mixture of puzzlement, irritation, satisfaction and susceptibilities — is set against a backdrop of the changing social character of the north London suburbs between the 1950s and 1980s, delineating with great feeling the slow, centrifugal break-up of post-war patterns of urban life. But it is the author's quality of human observation that makes the book special.

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