Books: Histories

Delicious is not a word that normally springs to mind when describing a book but consultant oncologist Sam Guglani’s debut novel is just that: delicious. Despite wanting to devour each chapter I deliberately slowed down to savour every word, every morsel, of this poetic, poignant, and charged novel.

Histories is — as the title states — a collection of stories set within one hospital over 1 week with each chapter offering a different perspective, and many of the substories interlinking. We are privy to the inner thoughts of the experienced, weathered, alone but not lonely consultant physician Dr Bhatia — or ‘Bat-yer’, the new but not-so-new consultant oncologist Dr Emily Carroll still orienting herself to this new role, wondering why after reaching the highest rung on the ladder she feels: ‘less steady, more easily knocked about … as though all her other patients, all their shouldered but invisible histories, weigh upon and unbalance her’.

Then there is Josh Webster, the hospital porter with his own profoundly enlightening opinion on how to really take a history, and many more.

Although Histories is a novel that can be enjoyed universally, there are so many parts that the clinician reader will not just empathise with but also cry out in solidarity and recognition — how it is often not a catastrophic event but more often that one final straw that can break us. As one doctor speculates: ‘… maybe this is how doctors and nurses finally burn out. Past their failures, their hours, all their inhaled sadnesses. Perhaps finally it really is broken printers and the like, the accrued weight of so many tiny things.’

There is the absurdity of debating drug rationing due to cost restraints when the NHS increasingly cannot afford enough doctors and nurses. How true and continually surprising it is: ‘… how quickly consultations are shaped. In seconds really, set in motion like clockwork or else broken and thrown off course. The wrong word or inflection, even the wrong posture … like the notional butterfly at sea, its tiny wingbeats troubling the air, which is magnified then into storms at the coast.’

How much we as doctors — and, dare I say, GPs — pride ourselves on how well we communicate with our patients, how compassionate we are, how adept we are is thrown into sharp focus by Guglani’s subtle but scathing depiction of some of the doctors depicted in the book. The hospital domestic’s impression when she is confronted on Sunday mornings with the task of cleaning the doctors’ mess: ‘… smeared plates everywhere, half empty bowls tipped up and left out, clothes and stethoscopes … they scribble messages on the board: Someone fucking clean up.’

We hear one consultant — a pinstriped old boy from the old guard, now sick and a patient himself — ruefully reflect with a colleague on how he was asked by a junior doctor about CPR: ‘He wanted to know if I’d like — how did he say it? If I’d like to have CPR … Like it was a jar of sweets up on a shelf.’

The only criticism of this otherwise flawless novel is in the dialogue between Tom Patrick, the hospital chaplain, and Nathan Munro, the consultant oncologist. This conversation feels stilted, forced, and slightly unrealistic, serving only to labour a point about whether a competent doctor devoid of compassion is still a good doctor.

Holden Caulfield shared with us in The Catcher in the Rye that: ‘What really knocks me out is a book that, when you’re all done reading it, you wish the author that wrote it was a terrific friend of yours and you could call him up on the phone whenever you felt like it.’

After reading Histories you will be left feeling the same way about Guglani.

• © British Journal of General Practice 2018