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Two must-read books on love and honour in the time of Covid

Book reviews: Intensive Care by Gavin Francis and Breathtaking by Rachel Clarke

In Intensive Care, Gavin Francis tells the story of his life as a GP in the NHS during the first wave of Covid. Photograph: The Irish Times

Estelle Birdy
Sun Jan 31 2021 - 06:00

Because it is not yet history, it was with some trepidation that I read two books written by British doctors about their experiences of the first wave of Covid-19.

Gavin Francis, author of Intensive Care, is a busy Edinburgh GP with a young family. He also sees patients at a clinic for homeless people, works in the Orkney Islands, previously worked as a surgeon and was medical officer for the British Antarctic Survey. He is widely published and has now written one of the most absorbing books – of any type – that I've had the pleasure to read. My feelings of inadequacy were only worsened by his sheer decency.

While we all know how the Covid-19 story unfolds, Intensive Care opens like a thriller with almost unbearable suspense and foreboding as news reaches the Scottish medical community of a novel coronavirus in Wuhan. The medical bulletin is read and dismissed. By Burns Night, January 25th, the doctor is with friends, discussing the virus and agreeing that it’s not going to be a big deal.

“But it was all in hand, it would be fixed, and the planet would go on twisting into the sun each morning and we’d keep our usual concerns: Brexit, politics, ageing, the changing climate.”

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Francis tells the story of his life as a GP in the NHS in the following months. The busyness of this “strange mingling of science and kindness” is startling. Morning clinics are spent dealing with a variety of illnesses, reading body language and checking for clues about living conditions or relationship issues that might be affecting his patients. Calls made, hospitals reports read, blood test results imparted, the good doctor is then off on his bike for home visits to high-rise blocks and comfy houses.

We hear details of his patients’ lives and concerns and how the growing problem of Covid-19 begins to affect the doctor and the world around him – the teenage anxiety sufferer, the homeless ex-prisoner and the older lady who asks only whether she’ll ever get to see her husband again as he is carried away barely able to breathe.

He writes of the challenges in evacuating the sick from outlying islands for medical treatment and the frustration of medics faced with government laxness and equipment shortages. Francis fears for his patients, not just because of the virus itself but because of the toll taken by the lockdown, isolation and lack of schooling for children.

All of this is interspersed with information on what a virus is, the origin of various medical terms, the history of vaccines and their uptake – there’s one particularly savoury passage about blowing smallpox scabs up children’s noses.

Although this is the story of a very dark time, it is full of warmth and decency. It is a book to be savoured. Beautiful things can emerge from desperate times; this book is one of those things.

There’s a change of pace and tone in Breathtaking: Life and Death in a Time of Contagion, Rachel Clarke’s heart-wrenching, infuriating and compelling account of life on the NHS front line during the pandemic.

“The pandemic is the first nationwide major incident in NHS history but instead of lasting 82 seconds, this is an incident with no end in sight,” Clarke writes, comparing the Covid-19 crisis to the major incident response to the Westminster Bridge terrorist attack.

Before beginning her medical studies, Clarke was a successful broadcast journalist – and it shows. A breathtaking deluge of stories from the eye of the storm gives us some idea of how individuals on the front line and the NHS as a whole were overwhelmed.

She tells of impossible choices and decisions, of ordinary people being the very best humans can be. The grand-daughter, permitted to visit her grandad as he nears death, who has to choose between leaving him to die alone and risking bringing Covid back to her husband who is receiving chemotherapy. The son who tells Clarke to keep safe from the horror that has just moments before taken his father. The bravery of Wuhan ophthalmologist Li Wenliang who alerted the world to this new virus, uploading a warning to social media even as he lay dying.

Clarke makes no hero of herself. At the start, her feelings regarding care of Covid patients echo those of years before, when treating a suspected Ebola patient. “My skin crawled in the semi-darkness. Images of bloodstained shrouds and bleeding eyeballs made me long to be anywhere but here. It felt shameful, a dirty secret, but my instinct to help was counterbalanced by another, equally potent – to flee.”

Clarke’s anger and frustration with politicians, officialdom and years of gutting the NHS is clear. “To allow for surges – bed occupancy should sit at 85 per cent but year-round the NHS is at about 100 per cent.” She shares her colleagues’ fury at Boris Johnson saying, “I shake hands continuously. I was at a hospital the other night where there were a few coronavirus patients and I shook hands with everybody, you will be pleased to know and I continue to shake hands.”

And beleaguered healthcare staff despair as Johnson is lauded in the press for his bravery in meeting the coronavirus head-on by attending a rugby match with his pregnant partner and 80,000 others.

Clarke sets out the omnishambles that was the Tory government’s handling of the crisis – the spin, the lies, the ignorance. Her detailing of the lack of PPE and the UK government’s shameful lying about it is astounding: “. . . it transpires that the government boosted its own numbers by counting the individual gloves in one pair as two separate items . . .”

Breathtaking is a visceral account of the pandemic on the front lines. It is about love, fear, honour and, above all, humanity. It is also a howl of anger at the lies, deceit and disregard for ordinary people by those at the top of society. I needed to take breaks while reading it – to cry, to think, to throw things in rage. Recommended.