Intensive Care: A GP, a Community & COVID-19, by Gavin Francis
Richard Davenport-hines
RICHARD DAVENPORT-HINES
Intensive Care: A GP, a Community & COVID-19 By Gavin Francis Profile Books £16.99
Alas 2020, such a pretty and satisfying numeral to look at, was the year of COVID-19.
Reported to the World Health Organisation by the Chinese authorities on 31st December 2019, this opaque and capricious virus and the regulations introduced to limit its transmission have transformed societies across the world.
At the time of writing, well over one and a half million people have died.
Hundreds of millions have mourned, lost their jobs or homes, gone bankrupt or abandoned hope. The confusion has been made worse by the avalanche of conflicting information and dodgy opinions. Every pub bore, forbidden to visit the pub, has become an expert epidemiologist.
Gavin Francis is not a bore, nor is his expertise bogus. He is an Edinburgh general practitioner, who has previously worked as a surgeon and emergency physician in several continents.
He was once the medical officer to the British Antarctic Survey, and his beautifully-written, thoughtful books, Empire Antarctica: Ice, Silence & Emperor Penguins and True North: Travels in Arctic Europe, can’t be recommended enough. His interest in geography is clear in his bestselling exploration of bodily parts, Adventures in Human Being: A Grand Tour from the Cranium to the Calcaneum.
Unlike many physicians who also write like angels (Somerset Maugham, Celan and The Oldie’s Theodore Dalrymple), Francis is never embittered or misanthropic. He describes his new book, Intensive Care, as a work of contemporary history, ‘an eyewitness account of the most intense months I have known in my twenty-year career, a hot take on the pandemic which speaks of the tragic consequences of measures taken against the virus as much as it tells stories of the virus itself’.
He is too modest to say that it is rich in compassion, patience and humanity.
Early in the global pandemic, Francis read two books with plague themes, Boccaccio’s Decameron and Defoe’s A Journal of the Plague Year. His own effort matches them.
He writes of his medical work in the Orkneys, and in Lowlands conurbations. Babies, nursing mothers, geriatrics, homeless people, ex-prisoners, the terminally ill, the obese, the smokers, the witless, the worried well and the mortally sick all feature in Francis’s reportage.
He never cheapens his accounts with sentimentality or sensationalism. Reading his tales of misery and occasional hope is never a chore.
COVID-19, as Francis writes, spreads through speech and touch. It attacks the basic elements of our humanity – ‘how we connect, empathise and show love’. It turns all people, good, bad and indifferent, into ‘potential assassins’.
He is perhaps most interesting of all when he mentions the psychodynamics of the pandemic. An agoraphobic patient, who contracted COVID-19 at a funeral, stopped taking her pills to control anxiety because she felt so much better when no one else was allowed out.
Many of Francis’s patients present with problems that are essentially related to mental health: people cooped up together in immiserating marriages, single parents, people going broke or indebted to moneylenders, parents of delinquents, or people who self-harm, have panic attacks or have recurrent alcohol-related injuries.
Schizophrenics and others with chronic mental illness were discharged from long-term care in the belief that they would be safer outside institutions.
I thought I knew the course of the pandemic pretty well. In fact, on Francis’s showing, I had misremembered events and jumbled their sequence to an extent that startled me.
Intensive Care is attentive to the human geography of the pandemic. Francis recalls the body bags in mass graves in Iran, and the German finance minister who killed himself.
He celebrates the partial recalibration of job prestige. Shelf-stackers in supermarkets have provided a vital public service, although they are paid indecently low and precarious wages in accordance with the scales of social and economic justice that have made Jacob Rees-mogg stinking rich.
This is a short book, written in terse sentences with strong and immediate impact. It is intended to raise the human spirit as well as our understanding of health workers, shelf-stackers and the rest of us.
It made me think of the sentence with which George Eliot closed Middlemarch: ‘For the growing good of the world is partly dependent on unhistoric acts; and that things are not so ill with you and me as they might have been, is half owing to the number who lived faithfully a hidden life, and rest in unvisited tombs.’