Ever read a book that you would like to like more than you do? I found Soulmedicine to be such a book.

The author, John Postley, a member of the faculty of Columbia University's College of Physicians and Surgeons, is described on the book's cover as "a family doctor in New York City for over twenty-five years." In his book he presents, in nontechnical language, a considered vision of how patients should seek (and, I guess, how physicians should provide) care in a world devoted to treatment. Many of the 13 chapters—including the opening chapter, which is about Postley's deep involvement in the final illness of his aged mother—deal with issues surrounding the end of life. Postley exhorts his readers to find a professional guide (read, "family doctor") who can help them with and sometimes protect them from technological measures that cannot stave off the inevitable ("Death is not defeat. Death is not unnatural. Death will come to us all.").

Postley outlines a kind of consumer decision-making process to help patients find the right kind of physician and to get them involved with that physician in choosing what to do about the ills that visit us all. Basically, I like what he says. His words have the ring of common-sense wisdom that comes from years of thoughtful practice. He sounds like my kind of physician. I think I would like him.

That having been said, why did I not like his book? Let me offer three reasons.

1. The title. I defy one to fathom what this book is about from its title. I found an answer on page 209: "Science alone, without the tempering influence of the soul, can distort the course of illness as surely as the application of concern without knowledge." But 200 pages is too many to go through before this illumination appears.

2. An unclear audience. Postley's vision can, I think, be summed up as "every patient is his own gatekeeper," and most of the book addresses the informed layperson who needs help navigating through the bewildering marketplace of medicine. It is confusing, however, that Postley seems at times to speak directly to physicians (or medical students) about how they should deliver care. He may be politically correct, but he misleads the reader, who has to ponder why he seems to be talking sometimes to "him," sometimes to "her," sometimes to "you," and sometimes to "me."

3. The writing. Postley's style would profit from an editor's hand. Time and again I had to pause, searching for an antecedent. For example, "The emotional strain of a serious diagnosis may result in a failure of judgment on the part of a patient. We hope that the fear of abandonment will have been at least partially relieved by your presence and interest, but there are other fears." I find no antecedent for "we" (does he mean physicians in general?) or for the you in "your" (does he mean you, the patient, in general?). And how the fear of abandonment relates to failure of judgment is beyond me. These frequent "traffic bumps" on the road to understanding slow the reader unnecessarily.

I do not know who should read this book. What it contains is worth knowing, but I think it will need more work before it finds its proper audience. I hope that it gets there.