The Doctor's Dilemma by George Bernard Shaw

This has some similarities to the much more widely read book The Citadel by A.J. Cronin (1937), which is often cited as influential in the creation of the National Health Service (NHS). In Shaw's play,^{Reference Shaw1} the main character is Sir Colenso Ridgeon, a doctor working in private practice. He has recently discovered an effective treatment for tuberculosis, which was a widespread, untreatable and lethal disease at the time. Only having resources, however, to treat ten patients, he selects ten individuals on the basis of his estimation of their ‘worthiness’. Later he is approached by an attractive young woman, who begs him to treat her husband, and also by an impoverished medical colleague working with the poor. He realises that he can, at a stretch, treat one more patient and the choice is thus between a very rich and influential man who is a womaniser and his poor but highly effective philanthropic colleague. This is the essential ‘doctor's dilemma’.

Despite some negativity towards the medical profession, this play, which I read in an edition also containing Shaw's long essay ‘Preface on Doctors’ along with The Citadel, started me wondering if I might achieve more by being a doctor rather than a nurse. I was discouraged from this thought by teachers, medicine still being seen as a profession for men and nursing as a better option for women and girls.

Later in my teens, mother gave me a book about the Hunter brothers and this served to spark my interest again.

Brother Surgeons by Garet Rogers

This is a novel^{Reference Innes, Dover and Fairhurst3} but based on the true story of John and William Hunter. Both qualified from Glasgow University in the first half of the 18th century. William, the elder brother, was a surgeon and John, the younger, was a physician and anatomist. Arriving in London, both were shocked at the barbaric practices as well as reliance on non-scientific dogma. St George's Hospital was the mainstay of their academic pursuits. The novel, published in 1957, explores possible rivalries and disputes between the two brothers. The relentless pursuit of scientific enquiry runs through the book although the inhumanities and barbarism of 18th-century London and Britain are shocking to a modern-day reader. The basic tenet, however, of relying on systematic scientific observation rather than arbitrary beliefs resonates to this day.

We moved to Glasgow and I attended a large comprehensive school there for a year. The headmaster summoned me to his room and told me I was to apply to study medicine. Without much thought, I found myself starting at the University of Glasgow at the age of 17.

My favourite book from medical school that I still use today (now in its 14th edition)^{Reference Innes, Dover and Fairhurst3} is my next choice.

Macleod's Clinical Examination by Innes, Dover & Fairhurst

I loved and still treasure my original copy of this book. This is despite my 1973 version (the third edition) not mentioning the assessment for mental illness. Its pragmatic, descriptive approach to history taking attracted me. Rather than saying that an individual has pain in their abdomen, this book explains that you need to enquire about all facets of this pain. It is such a vitally important message, which is even more important in psychiatry. Psychiatric symptoms often appear nebulous and much of the terminology is used in everyday parlance.

Long before approaching graduation, I realised that I wanted to be a psychiatrist, owing to the influence and mentoring of Professor Sir Michael Bond. On his advice, I would visit the London's Maudsley Hospital whenever I could and beg to be given a rotation place. I was told that I was too young and needed to go and do something else first. I therefore decided to apply for Membership of the Royal College of Physicians by completing the MRCP examinations, a decision I have never regretted and I have used this knowledge every day in clinical practice. A medical rotation was a tough life and I was working 100–120 h a week. I did not enjoy the rotation and so was determined to gain the qualification as soon as possible. To that end I decided that, rather than spread my reading far and wide, I would focus on just one book to get me through Parts I and II within 18 months.

Davidson's Principles and Practice of Medicine by Ralston, Penman, Strachan & Hobson

Once again my copy is considerably older than the current (23rd) edition.^{Reference Ralston, Penman and Strachan4} Although comprehensive it gave you the main facts without too much diversion and debate. Many of my peers said that it would be insufficient reading for the MRCP and recommended the weightier American Harrison's Principles of Internal Medicine. To this day, I stick by my tried and tested Davidson's, which gives me the straight facts. Of course, my old copy nowadays needs to be backed up by online searches to keep up with medical science but the basics of diagnoses remain largely unchanged.

Once I started in psychiatry at the Bethlem and Maudsley Hospitals I was given The Orange Book and this became the book that I carried in my pocket at all times.

The Maudsley Handbook of Practical Psychiatry edited by Owen, Wessely and Murray

Invaluable to the trainee, The Maudsley Handbook of Practical Psychiatry (often referred to as The Orange Book) has gone through many iterations since that time and was published for a wider audience in 2014.^{Reference Owen, Wessely and Murray5} My original copy was small and fitted easily in my pocket. The section on Neuropsychiatry examinations was particularly invaluable and served as a reminder to me when I needed to present in the ward round to Dr Peter Fenwick and Professor W. Alwyn Lishman. I was, rightly, in awe of these men and this section meant I could present a full assessment and remember my Babcock sentence.

When I started at the Bethlem Hospital as a very junior doctor, I had been fortunate enough to work on the ward where Professor Isaac Marks had his patients. I had plenty of opportunities to work with the nurse behaviour therapists and patients with severe obsessive–compulsive disorder, and I could see that this was a potentially very serious and sometimes life-threatening condition often overlooked by general psychiatrists. The book I have been guided by the most in my career and have recommended the most to patients and colleagues alike is by Professor Marks. The debt I owe to Isaac is huge as he was my mentor as well as a positive role model of clear thinking and being guided by research.

Living with Fear: Understanding and Coping with Anxiety by Isaac M. Marks

This book was first published in 1978. The second edition^{Reference Marks6} expands on the number of conditions covered and the advice given. It is a self-help book for people with a variety of anxiety disorders, obsessive–compulsive disorder, sexual problems, morbid jealousy, trauma as well as morbid grief and other conditions. It approaches the task by first identifying the universality of most of these symptoms before defining when a problem is something that requires help. It then gives clear, step-by-step guidance on how to overcome the problem. Based on exposure therapy, it describes exactly how to set up a treatment programme. This book has rightly had an extensive worldwide audience and apparently has sold well in excess of 50 000 copies in the UK alone.

In addition, I avidly read Isaac Marks's book Cure and Care of Neurosis: Theory and Practice of Behavioral Psychotherapy, published in 1979. It is a ‘must read’ for everyone and I would have included it on my list were it not that his subsequent book, Fears, Phobias and Rituals, dramatically set me on my course of understanding of mental illness and psychiatry.

Fears, Phobias and Rituals: Panic, Anxiety and their Disorders by Isaac M. Marks

Published in 1987, after I had become a consultant and was working with people with profound, refractory obsessive–compulsive disorder, this book delighted me.^{Reference Marks7} Suddenly many of the observations I had made and beliefs I had formed were set out with the evidence for them. This thorough and erudite book, written in Professor Marks's exquisite, precise English, draws together research not only from medicine and psychiatry but also from physiology, biochemistry, pharmacology, psychology and ethnology. Experiments show the universality of some physiological responses, such as those seen in anxiety and panic, within many species. The book also explained to me some of the hatred, xenophobia, racism and intolerance that blight our world by looking at these in evolutionary terms.

I was appointed as a consultant and senior lecturer at St George's Hospital Medical School in London at the age of 32. It was my dream job and one I remained in for 35 years. I started out naive and baffled by the complex power struggles that took place in the university and in the general hospital. Various professors and consultants took me under their wing and helped me through this time. Anthony Trollope became my greatest love. True to form, I devoured all his Barchester Chronicles and Palliser novels as well as his opera omnia. As I need to pick one, it is Phineas Finn, but I recommend anyone confused by the world of politics to read both series.

Phineas Finn by Anthony Trollope

This is the second novel of the Palliser series and tells the story of Phineas Finn, the son of an Irish doctor who is sent to London to study law.^{Reference Trollope8} He is a poor scholar but his wit, charm and good looks mean he is courted by the aristocracy and he finds himself in parliament. Along with complicated love stories this book (first published in 1869) covers religious prejudice, the limited powers of women in 19th-century Britain, xenophobia, anti-Semitism and the machinations of the political system. Decisions are made behind closed doors and in gentlemen's clubs. Phineas is frequently used by others to achieve their own aims. All in all, it is an indictment of the social class system. As the son of a doctor, Phineas is middle-class and therefore only suitable for limited roles in society. Much of this book is hard reading as, in many ways, we see similar prejudices operating today. Psychiatry may be ahead of the curve with a more diverse workforce than many other medical specialties. Nevertheless, we all need to be constantly vigilant for prejudices and the biases in ourselves and our systems.

My next book is another that caused me a moment of ‘Eureka’ when I first read it.

The Neuropsychology of Anxiety: An Enquiry into the Functions of the Septo-Hippocampal System by Jeffrey A. Gray

Jeffrey Gray's 1982 book^{Reference Gray9} (now in its second edition) demonstrates how psychology interacts with physiology. Looking at the role of anxiolytic drugs in particular, Gray demonstrates how the septo-hippocampal system may be instrumental in the development of phobic and obsessive–compulsive symptoms. He looks at a wide range of prenatal and psychopharmacological influences on our experiences, symptomatology and response to events. Many of his theories are controversial but this book's overarching message to me was that you can change a system using psychological means, which will alter the brain chemistry, or by pharmacological agents, which will alter behaviour and symptoms.

My final book choice I, again, first read as a teenager. However, it is a book I have returned to several times and I think its cautionary tales are as relevant today as they were when it was first published 1909.

Tono-Bungay by H.G. Wells

The protagonist of this novel is George Pondevero, who starts out as an earnest young man keen to promote good. He gets swept up in his uncle's production of a new quack cure, the ‘tonic’ Tono-Bungay. Although George believes this ‘medicine’ to be nothing more than snake oil he becomes a rich man. George leaves his uncle's employ to study aeronautics. As his uncle's business interests collapse, George arranges to steal a radioactive compound called Quap from an island off the coast of West Africa. This mission fails and he aids his uncle's escape in an experimental aircraft he has designed. His uncle dies and the end of the book leaves George in a new job designing destroyers for the highest bidder.

As well as Wells's obvious humour and sense of fun, irony and many puns, the book tackles multiple serious issues, including greed, corruption of money and power, the role of women in society as well as how talents can be used for positive or negative ends. Tono-Bungay is useless sugar-water but is hailed as the new panacea for curing all ills. Many believed in it because they wished to believe in it. To me it illustrates, once again, the need for properly conducted research trials and recognising many of the medical and psychiatric beliefs and rituals that we can easily adopt as ‘truths’.