If I Betray These Words

Moral Injury in Medicine and Why It's So Hard for Clinicians to Put Patients First

By: Wendy Dean, Simon Talbot

Narrated by: Wendy Dean

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 LLC

Critic reviews

"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

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.

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.

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.

Richly insightful and thought provoking

As a neurology resident, I recommend to anyone wanting to understand modern healthcare challenges

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.