In 1989, Iona Heath, an inner city GP in London, applied for study leave to spend three months reading novels. The Department of Postgraduate Education turned her down, but she took the three months off anyway and says it changed her life. The experiences of characters in fiction resonate with our own experiences, and those of our patients, and illuminate both.
There is fiction by doctors about doctors. AJ Cronin is not currently very fashionable, but there is more to him than Dr Findley. My favourite is probably more fact than fiction: Mikhail Bulgakov’s ‘The Country Doctor’s Notebook’. While few 21st century British doctors will experience the loneliness of making life or death clinical decisions in a remote Russian village in the middle of winter, many of us may see our own early experiences as doctors distilled in his stories.
There are doctors in fiction by non-doctors. Poor Dr Lydgate in Middlemarch is always quoted – ahead of his time (using a stethoscope!) but destroyed by an injudicious marriage. GPs tempted by sexual indiscretion might remember him with fellow feeling. Doctors in literature suffer other problems. Frank in Damon Galgut’s Booker-nominated ‘The Good Doctor’, or Eduardo Plarr in Graham Greene’s (to my mind) much better ‘The Honorary Consul’, both remind us that it is not just overwork which causes burnout.
But what excited Iona Heath was not empathy with fictional colleagues. It was the human experience which novels portray. The stresses and strains of infidelity – see ‘Anna Karenina’ in the nineteenth century or Sebastian Faulks’ ‘On Green Dolphin Street’ in the twentieth. The psychological effects of guilt – ‘Crime and Punishment’ and ‘Macbeth’. ‘La Bete Humaine’, Zola’s superb study of temptation and corruption, and his even more chilling novella about guilt, ‘Thérèse Raquin’. Mordecai Richler’s ‘Barney’s Version’ is an entertaining but telling study of the onset of Alzheimer’s disease. William Horwood’s ‘The Scallagrig’ gave me more insight into what it’s like to have cerebral palsy than any number of textbooks. In ‘The Way I saw Her’, Rose Tremain gets into the mind of an adolescent boy, and there are times in consultations when I think of Lewis and how he copes with the loss of innocence. For those who can read Spanish, I would recommend Rosa Montero’s ‘El Corazón del Tártaro’. It is the best novel I have read this year, but not yet available in English. My Spanish is not that good but I was hooked by the suspense, the language, and the vivid picture of family dysfunction, the degradation of drug culture, and the painful path to redemption.
John Salinsky, another north London GP, set out to tempt doctors into literature by outlining some of the pleasures awaiting those who dare to pick up the classics. He starts by analysing ‘A Midsummer Night’s Dream’. And you didn’t think it was relevant to general practice? How about conflict between children and parents (Hermia and her father), team building (the yokel players), child custody (Titania and Oberon), the devastating effects of unrequited feelings (the lovers), the risks of eye drops when used by someone other than the patient for whom they were prescribed …. Well, that may be a lesson too far, but it is entertaining to think about what works of literature can teach us. And not just the classics. How about ‘Bridget Jones’s Diary’?
Films and even works of art can have the same power to illuminate our own experience. Would readers like to share their own favourites?
First published in NASGP Newsletter 'The Sessional GP' October/November 2005
Judith Harvey was a research scientist, ran the VSO programme in Papua New Guinea and taught in a Liverpool comprehensive school before going to medical school. She has been a partner, a salaried GP and a locum, an LMC chair and a long-time supporter NASGP. Her charity, Cuba Medical Link, enables medical students to go to Cuba for their electives.
Judith has now published all her articles from the NASGP website as a new book Perspectives: A GP reflects on medical practice and, well, just about everything…