Being With and Saying Goodbye

Andrew West studied medicine at the universities of Cambridge, Leeds, and Oxford, and went on to work in medicine and psychiatry in Oxford and New Zealand. He now works as a child and adolescent psychiatrist in the National Health Service.

'The contemporary paradox of care is that even as medical science has advanced, so care - that compassionate engagement that is the mainspring of medicine - has receded. Andrew West offers a passionate, personal and, yes, often controversial response to this paradox. Yet Being With and Saying Goodbye is at the same time always deeply practical. Informed by a lifetime of experience in the author's own field of child and adolescent psychiatry, the "therapeutic attitude" for which he argues has much to offer caring clinicians in every area of medicine.'- Professor Bill Fulford, St Catherine's College, Oxford'I would advise all child psychiatrists, and other associated professionals, to read this book from cover to cover, notebook or highlighter at hand, then to always keep it close at hand. You will find yourself apprentice to a wise and humane mentor, who will offer cogent advice on every aspect of your relationship with your patients, at the same time pushing you to think about the values that inform your work and challenging you to think anew about the nature of evidence and what really makes a difference. This is a timely, important book because the attitude so beautifully described and illustrated is in danger of being squeezed out of us. Reading it will help you survive through diffi cult times whilst rekindling the hope that things could and should be done better.'- Penelope Campling, medical psychotherapist and co-author of Intelligent Kindness: Reforming the Culture of Healthcare'Andrew West writes a personal account of being a child and adolescent psychiatrist. In a brilliant conversation with the reader he goes "between the lines" to give a unique view of the expectations, pressures, obstacles and satisfactions of therapeutic clinical work with young people and their families. This is no autobiography, but a series of engrossing narratives of real experiences in modern practice. Anyone working in the field of child and adolescent health, education or social services will come away inspired and refreshed by Andrew's candour, his ironic humour and superb writing.'- Dr Sebastian Kraemer, Honorary Consultant, Tavistock Clinic'This book inspires hope that we can recover a kind of professionalism that has been undermined by our current target-driven culture. Andrew West's subtle, precise writing brilliantly describes the importance of qualities that can't be measured and monetised, such as "being with" people in an attentive, non-judgemental frame of mind. His vision is compelling. A book that should be read by all those involved in commissioning services as well as by practitioners.'- Sue Gerhardt, author of Why Love Matters

• Introduction , Being and being with , The intrusion of reality , The nature of evidence , Uncertainty, the mother (or father) of hope , Thinking , Greeting and engagement , Assessment and diagnosis , Treatment , Saying goodbye , Epilogue , A Two-page Prescription for Being with and Saying Goodbye in Child and Adolescent Mental Health Services