Pat RichPicture of Pat Rich is an Ottawa based medical writer and editor.


Cometh the hour, cometh the man.

It would be the very height of pretentiousness to apply this phrase to Dr. Liam Farrell, an author and former family physician from Rostrevor, Co. Down, Ireland and I am sure he would be the last person to do so.

But at a time when family medicine seems to be at its lowest ebb, if not globally then very much here in Canada, there is much to be said for having a physician who can so eloquently write about both the rigors and the joys of general practice – and using erudite quotations and references to do so.

Picture of the book cover Are You The F**king Doctor? Tales from the Bleeding Edge of MedicineI would argue that Dr. Farrell does this in Are You The F**king Doctor? Tales from the Bleeding Edge of Medicine – a collection of his columns, blogs and short stories published over more than 20 years in publications such as the BMJ.

This is not necessarily an easy book to read, filled as it is with a juxtaposition of not just blood but all manner of unpleasant bodily fluids, and anecdotes which are usually brief – sometimes too brief to absorb either the story or the message contained therein. Dr. Farrell combines these descriptions with a degree of learning and knowledge that one takes for granted with a well-educated physician.

Take for instance this description of his office (aka ‘surgery’)

The surgery had the spiritual ambience of a monastery chapel, and if C.S. Lewis and J.R.R. Tolkien had walked in twittering gently on about morality and suspiciously androgynous fairies, I wouldn’t have been surprised.

All of this, mind you, in a short piece describing a woman bringing him a sample of one of her husband’s bowel movements.

If some of this book is not easy to read or comprehend, that challenge surely begins in the very first chapter where Dr. Farrell writes with grim realism about his own battle with morphine addiction. Once past this however, one finds oneself immersed in stories which are often very funny yet which deal with issues of life and death that family doctors must face every day.

Dr. Farrell talks about family medicine in a manner that would resonate with those Ontario family doctors currently tweeting in despair about the future of the profession:

… it is not a specialty, but rather a generality, with all the burdens and privileges that this role confers, demanding skills that reach across the divide, not just of a dissonant phalanx of fragmented medical specialties, but of that deep romantic chasm between science and art …


Real medicine is the process of making decisions among diverse influences. It involves discussion, calm deliberation and the capacity to balance valid but competing interests.

In this era of Choosing Wisely Dr. Farrell also writes from the trenches about patients who insistent on antibiotics to treat colds or x-rays for sprains.

Whether we are dealing with truth or Dr. Farrell’s feverish imagination is often hard to distinguish.

As he writes in a piece defending a much-maligned column involving trying to drive over a cat and instead hitting a young fox, Dr. Farrell states “I write by stream of consciousness; the caprice, the knights-move thought, the harsh imagery, something to grab the reader and want them to read on and assimilate the message.”

Picture of Pat Rich and Dr. Liam FarrellI have had the pleasure of meeting Dr. Farrell in person (the photo accompanying this article in no way reflects our interactions) and there are many others who know him as the gracious host of #Irishmed, one of the most successful regular tweet chats still dedicated to matters medical.

As a non-physician I can recommend this book to anyone who enjoys a good turn of phrase. But I would particularly recommend it to the family physicians who feel nobody understands them or the value of what they do – it’s not CME but the book may prompt more than a chuckle or two.

Note: this blog was previously published on Pat’s blog site