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In this bumper book review I have reviewed the following 10 books: Helman C, ed. Doctors and Patients: an Anthology. Abingdon, Oxon: Radcliffe Press, 2003:1 85775 993 1; Coulehan J. Chekhov’s Doctors: a Collection of Chekhov’s Medical Tales. Kent State: Kent State University Press, 2003: 0873387805; Glaister L. As Far As You Can Go. London: Bloomsbury, 2004: 07475 7095 7; Rogers J. The Voyage Home. London: Little, Brown, 2004: 0 316 72671 0; Salway S. Something Beginning With. London: Bloomsbury, 2004: 0 7475 6992 3; Murray J. A Few Short Notes on Tropical Butterflies. London: Penguin Viking, 2003: 0 670 91348 0; Lewis G. Sunbathing in the Rain. London: Harper Collins, 2002: 0 00 712062 1; Forbes p, ed. We Have Come Through: 100 poems Celebrating Courage in Overcoming Depression and Trauma. Newcastle: Bloodaxe Books, 2003:185224 619 7; Elfick H, Head D. Attending to the Fact: Staying with Dying. London: Jessica Kingsley Publishers, 2004: 1 84310 247 1; Lewis G. Keeping Mum. Newcastle: Bloodaxe Books, 2003: 1 85224 583 2.
Literature pays attention to the smallest, most significant details of how people are, can be, and have been: in the ways they relate to each other, individually, socially, and to our world. It forms a channel between the reader, and the closely observed. Since literary authors include some of our best and deepest thinkers, literature can also be a gripping and memorable way to communicate what they have deduced and how they have interpreted this raw observational data, using the full panoply of literary devices such as narrative, metaphor, plot, and characterisation. Their skill lies partly in making a process of deep learning thoroughly enjoyable: we learn best when enjoying the process.
These books are all written with skill and experience. Not all these authors work in medicine or health care. Since, however, practitioners need to observe closely and to understand the role of metaphor, narrative, and character in people’s lives and bodies, this is immaterial. Health issues abound in literature because the three constants in life are that we will be born, get ill or get critically injured, and die. And of course we not only suffer or delight in these ourselves, but in our nearest and dearest as well. Health fascinates any reader, not just the clinician.
Cecil Helman has gathered together literary wealth. Clinician readers with little time can be certain of encountering writings focused toward their interests and needs here. The collection includes stories about and by doctors, clinical encounters, and personal patient accounts such as Rachel Clark’s description of her cancer—so harrowing in so young a girl. Arthur Conan Doyle and Sacks are included, as is Kafka’s complex and clever story about a country doctor. This collection, with Helman’s insightful introduction and notes, will be invaluable to anyone running a medicine and literature course, as well as fascinating for any clinician or student.
Coulehan’s Chekhov’s Doctors presents an extraordinary kaleidoscope of doctors in medical and social contexts. I read it straight through, but the stories would also repay being read separately. Chekhov’s observation of detail, both of character and place, is precise, building up vivid pictures and portrayals, immersing the reader in nineteenth century Russia: a different world from ours. They mostly are not really stories, but studies of character and situation, raising as many questions as they answer. The introduction and Coulehan’s commentaries are succinctly useful. A book to read and mull over, and a place to learn about what adversity can do to human clinicians and their patients. Another doctor/writer says: “My early answers to the question ‘what is healing’ came from these stories. I still have a piece of an envelope on which I copied part of a letter Chekhov wrote to an editor who had criticised his story, Ward Number Six, [included in Coulehan’s collection]: ‘The best of writers are realistic and describe life as it is, but because each line is saturated with the consciousness of its goal, you feel life as it should be in addition to life as it is, and you are captivated by it”. Life as it should be in addition to life as it is.1
Those who read little fiction really do need guidance and support when choosing contemporary texts, they are so varied in quality. Jane Rogers and Lesley Glaister are reliably worth reading, as much as anything for their observation of how people relate to each other, and the effects those relationships have. Glaister’s novels are not horror as the book jacket asserts; her skill is in depicting psychological oddities and aberrations. This book is as deliciously bizarre as her other eight, offering deep insight into a psychopath, and the way people can become willing victims.
Jane Rogers’s books are deep psychological studies. The Independent reviewer asserted: “she writes better than almost anyone of her generation”, and went on to say that her books were so carefully plotted and the characters so believable in spite of strange happenings. The Voyage Home involves the child of a missionary trying to make sense of her past, her parents, and her own sexuality. If you want to understand people better (as anyone in medicine and health care must), read Jane Rogers.
Something Beginning With is a stunning first novel. Salway’s academic work studies the way families interact and impact on individuals. Her novel has an innovative form. Beneath an ingenious deceptively light surface lurks great insight into the way women relate to each other in close friendships, and the way parents can have an impact on their children’s adult sexuality.
I was not sure about Murray’s A Few Short Notes on Tropical Butterflies; many concern doctors or medicine in different ways. They are clever, set in mainly exotic locations, and rely on extremely dramatic events. I am afraid I found them unsubtle; but other reviewers have raved.
Gwyneth Lewis’s Sunbathing in the Rain takes the reader on a psychological journey into and through her acute depression. I would hardly call it cheerful, but it certainly turns depression to excellent account: a must for anyone who has suffered this terrible disorder, and for their carers.
Poetry last but not least. We Have Come Through celebrates courage in overcoming depression and trauma, and is published in collaboration with Survivors Poetry. This dynamic organisation, run by and for survivors of mental illness, coordinates self help writing groups, and publishes a supportive magazine. This collection, including Rimbaud, Shakespeare, Stevie Smith, Andrew Motion, and six Survivors members, gives great insight into depression and trauma. Many individual poems could be photocopied and given to patients to offer hope and understanding. Several of them turned me round from a dark moment, moving me to tears.
Attending to the Fact—Staying with Dying, a poetry collection by a hospice trustee and hospice chaplain, is deeply moving and accessible. Offering insight into the dying process, as well as the difficulties and problems of working with the dying, it should be on the desk of everyone who works with dying people in any capacity.
Keeping Mum is a psychiatric detective story, or requiem in poetry, for the dying language, Welsh. Gwyneth Lewis, who writes in both Welsh and English, eloquently mourns her language, as only a writer with acute psychological sensitivity can.
These books will help you through the long dark evenings ahead (odd to write: my fingers melting on the keyboard in July heat). A further help might be to belong to a reading group. Responses and reactions can be shared: all equally valid whoever you are, and however varied they are. Bonnebaker, reporting a hospital based reading and discussion programme in America, says: “As one physician noted: ‘I’m amazed by how differently we read these books. It makes me wonder how differently we hear our patient’s stories. And how our patients perceive us.’”2 Indeed.