Stories are what medicine and novel writing share, says Joanna Cannon, bestselling author of The Trouble With Goats and Sheep and Three Things About Elsie. “We tell our stories in the hope that someone out there will listen, and we will be understood.” Breaking and Mending is an account of what nearly broke her when she was a junior NHS doctor. It also, with great respect and care, tells the stories of those she tried to mend – Paul, a 38-year-old father of two with pancreatic cancer; Joan, a blind, cantankerous and “wonderful” 79-year-old; Alex, a junior doctor who hanged himself two days after being discharged from the psychiatric ward – and I read most of them through tears.
This short and devastating book tells the story of how Cannon entered medical school with a heart full of gratitude and admirable intentions to “make a difference”. She was a “wild card” candidate in her 30s, who had left school at 15 with one O-level and had already formed a clear image of the kind of doctor she wanted to be. But “compassion will eat away at your sanity”, she discovers, as a cruel consultant screams in her face, her head swims from lack of sleep and food, her registrar disappears to Amsterdam, leaving her to cover a horrific nightshift – her third nightshift as a qualified doctor – and patients she cares for die in pain. “The doctor you wanted to become would not be able to survive,” she confesses.
Cannon details “the handkerchief quiet of palliative care”, “the rush of an outpatient clinic” and the competence of the crash team, “a sharp, blinding algorithm of efficiency”, with obvious admiration for her NHS colleagues. She writes fascinatingly about care, patience and the right and wrong types of kindness, and mentions just in passing that “I have been assaulted several times in A&E”. But it is clear the NHS she loves is broken. And “of all the underfunding in the NHS, it is most noticeable by far in mental health services”. One patient has stopped taking her medication because “it took away the voices she heard, and they were the only ones keeping her company”.
After nearly giving up on medicine, Cannon finds her true home in psychiatry, where finally she is not just allowed but encouraged to engage with her patients. You get the impression that she’s a damn good doctor, and she also has some sound advice about how we could all be better humans. The story of the struggling NHS has been told in several excellent books recently, and this is among the best. We need to listen.
• Breaking & Mending: A Junior Doctor’s Stories of Compassion and Burnout is published by Wellcome (£12.99). To order a copy go to guardianbookshop.com or call 0330 333 6846. Free UK p&p over £15, online orders only. Phone orders min p&p of £1.99.