Book Review: Breaking and Mending

This review was written for and first published by Bookmunch.

“medicine is all about people, and people are made out of stories”

Why would anyone wish to become a doctor? It is a question most potential students applying to medical school will be asked. Perhaps they wish to save lives, to make a difference. Perhaps they come from a family of medics and it has always been expected of them. 

It costs around a quarter of a million pounds to train a doctor in the UK, a significant proportion of which must now be borne by the student, often in the form of debt. The course is one of the most demanding offered by universities. And yet for every place available, four people who expect to achieve the necessary exam results will apply. It is and remains a competitive career choice.

Joanna Cannon entered medical school in her thirties. She was accepted by the admissions panel as a wild card. Her motivation throughout the long years of training was to get into psychiatry. Breaking and Mending is the story of her experiences on hospital wards as a student and then Junior Doctor. It is a sobering indictment of how medical professionals – the people entrusted with individuals’ myriad and complex health issues – are treated by the NHS and certain of its senior employees.

“Stories bind us together, stories unite us, and we tell our stories in the hope that someone out there will listen, and we will be understood.”

Cannon’s story is told in snapshots that she describes as her Kodak moments. Each chapter details an encounter with a patient or colleague, the memory of which she carries with her. The burden of her emotional responses over time became a weight that she struggled to bear. The long and busy shifts a doctor is required to work took their toll and she found it ever more difficult to be the type of doctor she had worked so hard to become.

Written with grace and candour the descriptions and reflections are a balance between compassion, valuable learning and simmering anger. There is much for the reader to contemplate and absorb. Doctors work to ease suffering and delay death under exhausting conditions. Given the lack of care they themselves receive it is little wonder that too many of them face burn out.

Yet this is not a polemic. It is a very personal story that cuts to the heart of issues faced by a vital profession dealing daily with human suffering. Doctors must somehow find a way to inure themselves while showing others care and understanding. Their role goes beyond prescribing and administering appropriate clinical treatment. Good doctors learn to listen to the stories they are told by patients and to find the right words in response. They also benefit when colleagues notice and find time to listen to them.   

Any Cop?: Cannon is a skilled storyteller and this is a poignant and thought-provoking medical memoir. It highlights the importance of talking about topics that make many uncomfortable such as death and mental illness. It underscores the stigma doctors face if they admit they are struggling to cope with the conditions under which they are required to work.

 

Jackie Law 

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Book Review: Three Things About Elsie

Three Things About Elsie, by Joanna Cannon, is:

• a tale of a friendship;
• a murder mystery;
• a sympathetic study of ageing.

Its protagonist is Florence, an octogenarian living in Cherry Tree Home for the Elderly. When the story opens she is lying on the floor of her sheltered accommodation having suffered a fall. As she waits to be found she considers events from the previous month during which a figure from her past returned, triggering memories that she struggled to make sense of.

Memories are a problem for Florence but she receives help from her best friend, Elsie. Florence and Elsie met on a bus when they were children. Later they worked in the same factory and would go dancing together on a Saturday night. This is where they were, sixty years ago, the night Ronnie Butler drowned. Now Ronnie has reappeared, he is Cherry Tree Home’s newest resident. He is introduced by staff as Gabriel Price.

Florence is on probation at the home. Her muddled recollections, shouting and frequent agitation have led the manager, Miss Ambrose, to suggest she may be better off at Greenbank. Florence knows all about Greenbank, that it is a place old people go to fade into themselves and then die. She wants to stay where she is but Miss Ambrose tells her she has lost the ability to judge what is for the best. Florence is frustrated as she struggles to find the right words when she needs them. Her jagged attempts to voice her concerns are routinely dismissed.

Elsie listens to Florence. She helps her friend to sort through her memories when they become jumbled. They tell their friend Jack all about Ronnie and try to piece together how he can possibly be at Cherry Tree when he was buried all those years ago.

Florence has noticed that items in her flat are being moved but the uniformed staff tasked with taking care of residents are familiar with her habit of misplacing things. She becomes scared that Ronnie has gained access to her private rooms and, after all this time, wishes her harm. He knows that she knows what he did to Elsie’s sister before he drowned.

With Elsie’s help Florence gradually retrieves the jigsaw pieces of her past and puts them together. Jack suggests they talk to others who knew Ronnie back in the day. These elderly mystery solvers go in search of triggers that will unlock the final answers still somewhere inside Florence’s head.

A holiday in Whitby, a walk along the beach and a missing person all come together as Florence gradually remembers. Yet even when the picture is finally clear in her mind she must somehow find words to explain, words that Miss Ambrose will hear.

The writing is rich in imagery with the reader experiencing the difficulties of being taken seriously when senescence affects daily behaviour. The point of view switches between Florence and various staff members enabling the reasons residents are treated as they are to be understood.

There are poignant snapshots throughout the tale such as a skip filled with the contents of a vacated room at Cherry Tree, valued photographs and mementoes now carelessly cast away. Florence reflects on her life and wonders if she did anything at all that made a difference or will be remembered. Her predicament is heart-rending but the depiction of senility along with its moments of lucidity are tenderly conveyed, as is Florence’s care of and need for Elsie.

I found the sadness and frustrations vexing to read in places, the richness of certain expressions capturing the essence at times Battenberg sweet. What comes across clearly is the speed at which life passes, and the many facets of even an ordinary life lived.

Florence lying on the floor of her room is confident she will be found and treated with kindness, a kindness she has shown to others throughout her long life. Those who read this book will likely come away more willing to grant even the difficult Florence’s of this world such simple respect. For that, and the slice of a life captured between the pages, this is a story worth reading.

My copy of this book was provided gratis by the publisher, Borough Press.

Gig Review: An Evening with Joanna Cannon

Last month my husband and I spent a weekend in Salisbury to celebrate his birthday. As I do when I visit anywhere new, I searched out the bookshops and found this window display at Waterstones.

“Why don’t you go?” my husband asked. I smiled. The city is an hours drive from our home, along narrow, windy roads, and I do not enjoy driving in places I am unfamiliar with. I don’t go out much because I am nervous in company. I could find many reasons why I would not go.

Fast forward a few weeks. My daughter is home from uni and Joanna Cannon is in the news for her latest book deal. As a medical student and writer my daughter was interested in this author’s story. She offered to accompany me and drive us to the event.

Thus, last night, we set out on a road trip. We arrived at Waterstones early and took our seats in the front row. You can see the backs of out heads on the left in this picture (posted on Twitter by PostConsumerBookClub (@PoCoBooC) ).

An impressive following of bloggers had congregated on the right but I was much too shy to introduce myself as they chatted happily together beforehand and then again at the end. Perhaps the evening will be written up on their sites too.

The event was hosted by Tom Bromley who knows Joanna from her time at the Faber Academy where he teaches. They talked of her initial application, what she hoped to achieve on the course, and she mentioned how she went on to attend the York Festival of Writing in 2014 where she won their Friday Night Live competition (she wrote about this experience here.)

‘The Trouble with Goats and Sheep’ has now been sold in many countries around the world and Joanna talked of the edits that certain territories requested. A glossary of British confectionery from the 1970s has been included in some translations. Most wished to retain the Englishness which is at the heart of the story.

We were treated to a reading and I was reminded of the humour of the book. Its appeal is the gentleness with which it is written yet it has scope and depth. Joanna told us that her aim was to write a book which gave a voice to those who struggle to fit into society. As a psychiatrist she understands these issues through her dealings with patients.

Audience questions were invited and Joanna talked of trying to fit in time to write her second book alongside the publicity required for her debut. She described her writing process (very early starts to each day and editing as she goes along) and of how what she says is not always reported as she meant (if you are reading this Joanna then I hope I have managed a degree of accuracy).

The topics discussed flowed and it seemed that no time at all had passed before Tom drew proceedings to a close and audience members were invited to have their books signed. The couple sitting behind me unpacked at least seven copies – authors must love such readers!

I introduced myself and was happy to be recognised. I am delighted with the inscription in my proof.

            

‘The Trouble with Goats and Sheep’ is published by Borough Press and is available to buy now. To read my review, click on the image below.

 

Book Review: The Trouble with Goats and Sheep

The Trouble with Goats and Sheep, by Joanna Cannon, is a captivating tale set in a typical English housing estate during the long, hot summer of 1976. The narrator is ten year old Grace, who is trying to find God in the hope that He will look after her friends and neighbours, one of whom has recently disappeared. Grace and her friend Tilly visit each of the houses in The Avenue, where Grace lives, questioning the residents as they check to see if God is in their house. What they discover instead is a Pandora’s Box.

This is a joyous book to read, packed full as it is with apparently throwaway comments which provide insights into the fragile binds that hold a community together. Many of the residents of The Avenue have a long, shared history and plenty that they would prefer to remain unspoken, preferably forgotten. They care about being seen to belong.

One of the neighbours, Mr Bishop, is regarded as different. When things have gone wrong in the past he has been blamed, gaining a reputation as dangerous. The accepted consensus is that he should move away; steps have been taken to try to drive him out. As far as is possible he is shunned by all, and has been for many years.

By all except the woman who has disappeared, Mrs Creasy. Prior to her leaving she had been a valued friend to almost everyone individually. The fear is that she now knows too many of their secrets. Some even hope that she may be dead.

Grace and Tilly are fabulous characters with their childish naivete and perceptiveness. They do not pick up on the adult guile, although they observe the damaging results. Many of the nuances of social etiquette are lost on them. When they feel a shift in atmosphere between adults they search out the reasons.

When the police arrive to investigate Mrs Creasy’s disappearance guilty consciences bubble to the surface. Behind every closed door in this ordinary street lurks a fear of unbelonging.

Attitudes to women, to people of colour, and to any kind of difference in the 1970s are painful to remember. It is not so much that these have changed after forty years of so called progress but they are now displayed with less forthrightness.

Grace and Tilly are curious but not yet prejudiced. The questions they ask of the adults demonstrate the rampant hypocrisy, presented here with wit and humour. Alongside, my heart ached at the childish hurt inflicted on Tilly when Grace sought out ways to be accepted by their peers.

The heat of the summer beats down on the parched street as the girls go house to house in their quest. The weeks pass and Mrs Creasey remains vanished while her neighbours’ secrets slowly unravel them.

The denouement brought to an end the heatwave and the summer, a satisfying finish that offered the obvious yet oft ignored remedy to the cancer of rejection so prevalent throughout societies.

This is not an easy book to pigeon hole. It is a compelling whodunnit, a fascinating social history and a nuanced exploration of the human psyche. It is also a deftly told tale populated by recognisable characters written with a lightness that belies the depth of the observations.

Recommended to all seeking a readable and entertaining story, this is glorious nourishment for the heart and soul.

My copy of this book was provided gratis by the publisher, Borough Press.