Book Review: Enemies of the People

Are you happy with the way our current crop of politicians and their influencers are running the world? Do you believe Brexit will make Britain Great, that Trump is good for the USA? If so then this book may not be for you, unless you wish to gain a better understanding. It offers, in bite sized chunks, key facts about those who helped create the situation in which we find ourselves today.

Enemies of the People, by Sam Jordison, is divided into fifty short chapters dedicated to those who have worked tirelessly to further their personal agendas at such potentially devastating cost. These include the usual subjects – Vladimir Putin, Margaret Thatcher, Tony Blair, Nigel Farage, Ronald Reagan, Donald Trump – as well as the men and women who inspired their skewed ways of thinking. There are unexpected names – Pepe the Frog, Jesus Christ, Chris Martin, Mel Gibson, Simon Cowell, Your Granny. Although dealing with weighty subjects the content is not entirely sober and serious.

I was familiar with the majority of the names but not all of the information included. This is an important point to make. Although partisan in presentation the information has been verifiably sourced and makes for interesting reading, even for someone who tries to keep up with current affairs.

I learned that there is an inheritance of ideas, cherry picked and repolished but undoubtedly affecting decision making over decades. Country-wide catastrophe means little when personal power is at stake, when there are private fortunes to be made. Who says we learn nothing from history? These people have learned plenty from their predecessors and don’t care that their actions cause untold damage to those they purport to represent.

As well as politicians there are economists, religious leaders, writers, advisers and media figures. The common thread is the impact of their actions on the general population, and how most have got away with such behaviour. Methods of manipulating public thinking are among the most valued of skills. Wider suffering is shown to be of little interest to the perpetrators.

I bought this book for my seventeen year old son who is developing his own political views. The historical perspective, accessible language and concise structure will, I hope, offer him a wider perspective than he is picking up from popular web-sites, YouTube channels and the family influenced conversations of his peers. The book is witty without being bland, angry but on point. It does not attempt to offer answers but encourages readers to pay more attention, and not just to the dead cat on the table or Kim Kardashian West’s shoes.

Intended to provide a snapshot of our times rather than a roll call of evil the author states:

“I can’t pretend to be objective. In fact, I can’t pretend to be anything other than royally cheesed off. I’ve seen the world I love torn to shreds and I wish it hadn’t happened.”

If the enemies listed here can learn from history, so too can readers. This perfectly sized stocking filler offers as good a place as any to begin the conversation.

Enemies of the People is published by Harper Collins.

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Book Review: Fragile Lives

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“A successful cardiac surgeon is a man who, when asked to identify the three best surgeons in the world, has difficulty in naming the other two.”

Fragile Lives, by Professor Stephen Westaby, is a memoir that is both awe inspiring and heart-rending. It tells the story of the medical career of a man raised in working class Scunthorpe who became a world class, ground-breaking cardiac surgeon before watching his life saving profession being stymied by the NHS bureaucracy that we know today.

The first few chapters cover Westaby’s childhood, inspiration and medical training. Born in the post-war baby boom years he decided young that he wished to be a heart surgeon after watching a television programme, ‘Your Life in Their Hands’, in which American surgeons were able to close a hole in a patient’s heart thanks to the newly created heart-lung machine. Westaby gained entrance to a local grammar school and from there worked towards his dream of medical school. As a teenager he took menial jobs at a hospital, learning as much as he could through observation. His years of medical training at Charing Cross and the Royal Brompton in London brought him to his first surgeries, where he learned that a certain arrogance is necessary for a successful outcome. A surgeon must believe in their own abilities if they are to innovate and thereby save more lives. When a patient is cut open on an operating table the surgeons cannot know exactly what problems they will be required to deal with.

Subsequent chapters look at particular patients whose medical issues Westaby tackled in new ways. Not all of them survive, and those that do are changed.

“extra life is not ordinary life. There’s a price to pay and a second dying to come”

These cases are fascinating if poignant to read. There is an amount of medical detail included but the language used is accessible. Westaby’s confidence in his abilities and willingness to take risks not only saved many of the lives he held in his hands but also led others in his field to do the same. These world class doctors worked together, sharing techniques and outcomes for the good of their patients as well as furthering their own careers.

“For the unfortunate patient, any prospect  of survival depends upon having an experienced trauma surgeon at hand. Few are offered that privilege.”

Westaby worked all over the world and experienced many levels of both staff competence and facility provision. When dealing with a patient who will surely die without intervention, risks seem a price worth paying. This is the way, the only way, that new techniques and treatments can be developed.

A cardiac surgeon must retain a certain detachment as they are dealing every day with the dying who often harbour multiple health issues. Success rates matter. The monetary cost of surgery is high and those controlling the purse strings wish to invest only in proven drugs or equipment.

Pioneering surgery is now threatened by the blame culture. Even proven techniques are being rationed due to the focus on cost, whatever the benefit.

“When a surgeon remains focused on helping as many patients as his ability will allow, some will die. But we should no longer accept substandard facilities, teams or equipment. Otherwise patients will die needlessly.”

By the end of his career Westaby had become disillusioned with the NHS. He had watched too many of his patients die due to a lack of drugs and equipment simply because they are deemed too expensive by non medical decsion makers.

“What mattered was keeping down costs. Death comes cheap.”

Inevitably he looks back on his own younger years with a degree of pride and with more regard than he offers today’s trainees. Setting this aside there is a warning to be heeded. It is understandable that cardiac surgeons feel frustrated with the constraints placed on their ability to work effectively. What this means to the individual patients and their families is the difference between life and death.

Those who believe that the drama of medical TV shows is overplayed should read this book. It is a fascinating account of a career that observed and facilitated huge medical innovation. The effect this had on the patients whose cases are included had me in tears of both sorrow and joy. To anyone with an opinion on the value of national healthcare expenditure, this is a recommended read.

My copy of this book was provided gratis by the publisher, Harper Collins.