Book Review: Sick Notes - True Stories from the Front Lines of Medicine

Book Review: Sick Notes - True Stories from the Front Lines of Medicine

by Tony Copperfield. Monday Books; £8.99

Review by Jim Killgore, contributing editor

FEW MEDICAL writers offer a more bleak or subversively funny view of life as a GP in the NHS today than Dr Tony Copperfield. Many readers will be familiar with his columns and blogs in the Times or the medical tabloid Pulse. Now his self-described “cathartic moanings” can be read in paperback form.

In Sick Notes Copperfield welcomes us to fictional Bleak house medical practice, located in a “squat grey monstrosity” less health centre than “concrete cancer”. Here he faces a daily parade of humanity demanding antibiotics and Viagra (“The missus wants a bit more of the old how’s-your-father…”) or bearing long symptom lists (“more on the back”) in addition to the occasional genuine serious illness. This is healthcare as practised in the trenches, beyond the government spin of patient-centred care, managed referral and quality and outcome frameworks.

And what kind of thanks can be expected? “I’ve heard that you’re marginally less crap than the rest of them,” says one patient to Copperfield in explanation of why she resorted to seeing him. Another patient, grateful for the care provided her elderly mother, offers him thanks in the form of “something quite extraordinary: one loaf of sliced bread (white)”.

“We…I mean the whole family, really… we wanted to show our appreciation…”

No doubt (or at least one hopes) Copperfield’s observations and views on being a GP and the NHS in general are way over the top, as in all satire. But if you’re considering general practice as a career it might be wise to temper your enthusiasm with a read of this book. He suggests: “One way of training (to be a GP) would be to try and do the Times crossword on a high wire while one person shouts at you and another hits you with a plank.”

Saying all this – the book is not unrelentingly bleak. One does see the dedicated GP (actually two, Copperfield is the “pseudonymous creation” of a pair of GPs) shining through in places. His definition of health seems infinitely more humane and sympathetic than the high-handed one pushed by the World Health Organisation – “a state of physical, mental and social wellbeing and not merely the absence of disease”.

Copperfield offers: “I’d suggest that health is feeling ‘fit for a purpose’, no matter how tiny or grand that purpose might be.” Who can argue with that?