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This slim volume presents a GP-psychoanalyst's-eye view of a small number of general practice patients, seen over a longish period of time. It is unusual and well worth reading. It would be of particular interest to general practitioners with psychological or Balint interests, and other professionals working with, or alongside, general practitioners in the community.
Kenneth Sanders worked for almost thirty years as a general practitioner in North London, and at the same time developed an interest in psychoanalysis, later training to become an analyst. In this volume, and in his earlier book, A Matter of Interest, he calls on the primal experience of infancy and psychoanalytic theory, to help him understand and describe the patients seen in his surgery. He uses Bion's idea of a ‘proto-mental system’, in which the psyche and soma are inseparable, to illuminate many of the psychosomatic symptoms that form so much of a GP's work. His prose reflects this essential psychosomatic unity, easily moving from psychological to somatic imagery.
The heart of the book is the description of the Nine Lives of the title. Each one is an absorbing account of a small group of intertwining lives, observed over time (in some cases over twenty years) by their family doctor. The description of the doctor's interactions with his patients is set against a background of the changing social character of the North London suburbs between the 1950s and the 1980s. It is the Sanders's quality of human observation that makes the book special. He follows the strands of these patients’ lives in an unusually painstaking way, and with a great ear and eye for significant detail. The author seldom gives up his