Who would be a GP?
Over the festive period surgeries closed for a few days, which immediately provoked a crisis for numerous hospitals and their A&E departments, which were inundated with people in various stages of distress. Many, though, had no more need of urgent medical attention than someone with a runny nose.
But, ironically, even when surgeries are open many of us who make appointments at them can't be bothered to keep them. Meanwhile, faced increasingly with an aging and frail population, the NHS, which has received billions of pounds in recent years at the behest of politicians desperate to demonstrate their fealty to it, is on its knees and unable to cope. Tales of patients awaiting consultations lying on gurneys in hospital corridors, like planes in a queue to land, have become so commonplace they're barely worthy of remark.
How did we reach this pass? In the past anyone who needed to see a doctor either queued at the surgery or requested a house call. You were then diagnosed and treated on the spot or in a hospital.
Forty years ago I spent a couple of pleasurable weeks in Edinburgh's old Royal Infirmary, having had a cheekbone broken by a fellow with anger management problems. One day I went to see my doctor and a couple of days later I was operated on. After a short recuperation I was allowed home and that was that. There was no fuss, no need to call NHS 24, no sense that one was asking for more than one's just desserts. It was taken for granted that if you required treatment you would be able to get it as soon as possible.
The situation described in A Fortunate Man, a unique collaboration between the writer John Berger and the photographer Jean Mohr, is thus very familiar to me. In 1966, Berger spent three months as a fly-on-the-wall while the eponymous, Chekhovian rural doctor, John Sassall, went about his business in the Forest of Dean.
Sassall was the kind of doctor we would all like to have. He was intelligent, thoughtful, sympathetic, familiar, professional, confident. Above all, perhaps, he was part of a community, a cog without whom the wheel of civilization might find it difficult to turn.
Berger's account, first published in 1967, opens with a series of soberly related vignettes, which demonstrate Sassall's skills. In the first, which could have been written by Thomas Hardy, a woodman is trapped under a tree. In the next, he treats a young woman who is suffering from extreme emotional stress, the result, the doctor eventually discovers, of an affair she has had with the manager of the dairy where she works.
In another, Sassall's patient is an elderly woman who is near death. For a while, he sits with her husband who cannot understand how his wife, who seemed quite well the previous day, is now grievously ill. Sassall is not one to offer false hope. "The immediate danger is past," he tells the old man and his daughter, "another half hour and she might have died this morning, now she's got to pay the price of surviving the attack."
As a boy, Sassall was much influenced by the sea-faring novels of Joseph Conrad, which fed his imagination and helped alleviate the boredom of middle-class life. What makes him such a good doctor is his desire always to improve the service he gives. He is not motivated by money or glory. Rather he is driven by curiosity or, as Berger more precisely defines it, the need to know.
For Sassall, and others of his ilk, the patient is sacred. Every surgery, every visit, every telephone call is an opportunity to increase his knowledge and deepen his experience.
Moreover, reflects Berger, "Like any Faust without the aid of the devil, he is a man who suffers frequently from a sense of anti-climax. This is why he exaggerates when he tells stories about himself. In these stories he is nearly always in an absurd position: trying to take a film on deck when the waves breaks over him; getting lost in a city he doesn't know; letting the pneumatic drill run away with him."
Berger, whose novel G won the Booker Prize, is Sassall's silent witness, watching and listening while he offers succour. Part reportage, part philosophical treatise, part biography, A Fortunate Man is a joy to read and it ought to be prescribed reading, not least by those determined to practise medicine.
Integral to the narrative are Jean Mohr's photographs, which add pathos and mystery to Berger's pellucid prose. The last photograph shows Sassall with his back to the camera, striding towards yet another appointment, the nature of which neither he, nor we, can predict.
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