As someone whose bread and butter is in the reporting of health data and statistics, I can affirm the Covid-19 pandemic has led to a veritable tsunami of both. Occasionally, we are reminded, however, to consider names and not numbers.
Seamus O’Mahony, a retired professor of gastroenterology, does exactly that in his glorious account of his almost 20 years in a large teaching hospital in Cork (you have one guess), the titular “ministry”.
The author, a veteran of the NHS as well as the HSE, casts a frequently acerbic eye on proceedings at the ministry over the course of two decades and via a litany of often-amusing and frequently startling vignettes, we get to know many of the patients he treated during that time.
O’Mahony is both droll and self-deprecating as he recalls life at the ministry, his disdain largely reserved for, but not limited to, pharmaceutical reps, hospital management and the nebulous concept of food intolerances. His sharp and pithy observations, and easy way of explaining complex medical conditions, serve to give the reader the impression they are an eager intern at his elbow, seeing these patients with their own eyes. From the benign (halitosis) to the lethal (liver disease and lung cancer), a host of recurring characters with often myriad health problems illustrate just how difficult it is to be a doctor these days.
Indeed, this book provides an insight into the realities of healthcare that no journalist could hope to capture. As the professor explains, “the ministry was an oasis of kindness and comfort. It was also a place of chaos and conflict, of institutional cruelty.”
Titbits and casual asides are many, and can be gruesome: “Free access to the balconies lasted for a few short years only; I witnessed in 1984 the grisly fall to earth of a man with delirium tremens who had flung himself from a top-floor balcony.”
Or, on caring for patients with chronic liver disease “only 30, she was so jaundiced her skin colour had progressed from yellow to green” or “I have often been struck by the sheer hairiness of men with liver cirrhosis: you hardly ever see a bald one”.
The “medical memoir” has been something of a literary craze in recent years, most notably former doctor and comic Adam Kay’s This is Going to Hurt, which was a number one bestseller. O’Mahony’s belongs in that genre, although this particular brand of wit and rancour — especially when dealing with disease and dying — is not easily replicated.
However, I am happy to report he has it in spades, as more pages than not caused me to laugh out loud. I lost count of the zingers but that’s not to say they are too many in number — rather it keeps the book zipping along and I wager that you’ll read it in almost one go. “In one generation, the Irish had gone from pious lickspittles to aggressive secularists. I almost missed the nuns,” he muses at one point.
His brutal honesty is as refreshing as it is unprecedented, such as when he discusses the foibles of his colleagues. “Middle-aged male doctors love to be the subject of such rumours and urban myths; they stiffen with pride when suspected of being a salty old dog.” Reader — I gasped. At one point he suggests that “icians” are low status and “ologists” are high status. Admitting that he is, more by accident than design, a so-called “ician”, his disillusionment is clear: “Bullied by managers and clinical directors, they rarely cure anyone.”
The good doctor freely admits his limitations as he grows older, explaining the evidence behind the old cliché of “young doctors and old lawyers”. “I cannot recall one doctor who quit at their peak, who left before the juniors started to snigger on the rounds, before the nurses started covering for them.”
The book covers the run-up to his retirement; having written two similarly caustic books, his “medical apostasy” as he calls it, was making his position untenable.
O’Mahony retired just last year, as the coronavirus crisis was making itself known. As he explains in the epilogue, he volunteered to return to clinical work just weeks later — he was never called. Medicine’s loss is non-fiction’s gain.
Lockdown means you can’t go for a pint with Professor Seamus O’Mahony. But you can read his book, and that’s the next best thing.
Memoir: The Ministry of Bodies by Seamus O’Mahony
Apollo, 320 pages, hardcover €21; e-book £6.49