A better world

You don’t have to be ill to benefit from the wisdom in this book on medical recovery written by a GP.

Recovery: The Lost Art Of Convalescence by Gavin Francis

I was taken gravely ill a year ago; so unwell that I only later learned that my family had been told that without surgery I would not have lived to Christmas. I am grateful each day to the medical staff that I even have a next day.

It was an experience I characterise as “interesting in retrospect”, since it was the first time I was in intensive care and hospitalised. But that is only the beginning of the story.

Gavin Francis has written excellent books on the specifics of the human body – Adventures In Human Being, for example – and recently on the pandemic with Intensive Care .Thisnew book could not be more timely, as it deals with the other side of illness. It is brief, useful and written with his customary blend of case study and literary precedent. As he states at the outset: “The medicine I was trained in often assumes that once a crisis has passed, the body and mind find ways to heal themselves – there’s almost nothing more to be said on the matter. But after nearly 20 years as a GP I’ve often found that the reverse is true: guidance and encouragement can be indispensable. Odd as it seems, my patients often need to be granted permission to take the time to recover that they need”.

I can certainly affirm this. When I was discharged I was very solemnly told that I would take at least eight weeks to recuperate and I said “alright” and thought “I’ll be dandy in a fortnight”. It seems the experts were correct.

My sarcasm had a serious point. As Francis shows here, there is no definite boundary between being sick and being healthy. Often, a clear diagnosis – such as “that leg is broken” – does not map neatly onto recuperation, with loss of musculature, depression and frankly, a sense of having let everyone down concomitant once the cast is cast off. There is also a deep psychological returning: in a strange way I missed hospital because there I was being cared for, although my family say it was actually that I was loving being the centre of attention. Afterwards, every normal tic of the body, from a burp to a stubbed toe, is read as a sign of recurrence.

So how do we recover? In some ways this book is a statement of the obvious. “Space, light, cleanliness, greenery, quiet”, as he writes, is a good start. Indeed, there is good scientific evidence that hospitals where you can see a patient can see a tree need fewer analgesics or pain relief. Manage expectations. If you feel the need to, change a routine; but balance deciding that you will do 5k a day with your body’s insistence otherwise. All of this is good, practical advice. Where the book really shines is on the nature of being in medicine or care, and the sense that it is, in a nice simile, more akin to gardening than to being a mechanic. Sometimes different