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In his portrait of Dr Sassall, Berger is capable of profound insight and political analysis. However, he deliberately ignored the contributions of Sassall’s wife – although the doctor and Betty were a team. A footnote reads: “I do not attempt in this essay to discuss the role of Sassall’s wife or his children. My concern is his professional life.” Could Berger have imagined that Sassall’s 21st-century successor might be a woman? He wrote that “if his training were not so long and expensive, every mother would be happy for her son to become a doctor.” Now most GPs are daughters. If the title seems familiar to you, it is because it is inspired by the book A Fortunate Man. Written by John Berger this book blended text and photographs to tell the story of a country GP named John Sassall working in the same valley in the Forest of Dean in the 1960s. Long considered a medical classic, students and trainees have been encouraged to read it ever since and it is said to have inspired many doctors into General Practice, including the GP in A Fortunate Woman. Guilty confession: I didn’t like it. Sassall’s evolution in the book from a narrow-minded surgeon intolerant of minor complaints to holistic, patient-centred GP is revealing but I found the prose dense, the philosophical allusions opaque and Sassall as a character obsessive, dogmatic and at times unlikeable. This will have an impact on all of us at some point. But without more widespread recognition of the problem, we might not even notice what we are missing out on. A longitudinal study of continuity of primary care in England published in 2021 showed that not only were fewer patients able to see their preferred GP, but fewer even had a preferred GP in the first place. We have, it seems, forgotten to expect, or even to want, a doctor who knows our stories. That experience of a doctor-patient relationship that’s more than transactional is slipping from collective memory. And if it’s something you have never known, why on earth would you cherish it, or fight for it?
A Fortunate Woman: A Country Doctor’s Story - The Top Ten
This is a contemporary look at a rural practitioner, who serves the same Gloucestershire community as the Fortunate Man of Berger's classic, but so much more emotive and visceral. She, as her predecessor (bar one), embeds herself in the community she serves and shows rather than tells the huge benefits for both patient and clinician of this cross-pollination for their health.I hadn't read a Fortunate Man but this didn't in any way spoil my enjoyment of this book - it stands up well in its own right. Listening has become even more crucial. Ten-minute appointments are bad enough. Covid meant doing that behind a mask and face-visor, in scrubs made of old duvet covers. Now there is the telephone consultation. In the before-times, the doctor made a point of accompanying a patient from waiting room to consulting room, because it gave her a chance to assess their mobility and demeanour. Now there is the phone. The doctor has become adept at reading a voice, its hesitancies, emotions, evasions; 16 calls in a morning is the norm.
A Fortunate Woman: A Country Doctor’s Story Kindle Edition A Fortunate Woman: A Country Doctor’s Story Kindle Edition
Revisiting Berger’s story after half a century of seismic change, both in our society and in the ways in which medicine is practiced, A Fortunate Woman sheds light on what it means to be a doctor in today’s complex and challenging world. Interweaving the doctor’s story with those of her patients, reflecting on the relationship between landscape and community, and upon the wider role of medicine in society, a unique portrait of a twenty-first century family doctor emerges. One of the best books about medicine that I have read. The patients’ stories are vivid, moving, often unforgettable. Polly Morland has written with incredible sensitivity, appreciation and descriptive ability about the valley and the people who live there. Professor Roger Jones OBE I particularly enjoyed listening to the stories which I can relate to. There is a rallying call for the importance of continuity of care and the risk of losing this forever. When I chose general practice as a career it was this emphasis on continuity, families and community that appealed to me. A beautifully written book about a doctor working as a general practitioner in the Wye Valley. The book focuses on the relationship between the doctor, her community and the landscape.
If all that sounds despairing, Hodges then opens his doors, as he does every working morning, to offer the everyday hope of consultation. Aspen has moved to 15-minute appointments (from the NHS regular 10), because it accepts “that most people will come with a list and it makes sense to look at everything”. I sit quietly in the corner and, with consent, observe that still sacred confessional between GP and patient. Looking on, it is hard not to see almost every case as a brief essay on the state of the nation. All human life is here in this evocative portrayal of the challenges and joys of rural family doctoring in modern times. Enthralling and uplifting. James Le Fanu, author of The Rise & Fall of Modern Medicine Wendy Moore, TLS This book deepens our understanding of the life and thoughts of a modern doctor, and the modern NHS, and it expands movingly to chronicle a community and a landscape – “the valley” itself is a defining feature of people’s lives. The book maps on to Berger’s by likewise offering some case histories of the kind that might feature in a TV drama. Here too the doctor drives, walks, cycles to remote cottages, to scenes of sadness and dismay, fear, stoicism and horror accidents. (All cases have been “reimagined and reconfigured” so as to retain patient confidentiality.) There are also the day-to-day, in-person, ten-minute appointments – or there were, before the pandemic.
The big idea: why modern medicine can’t work without stories
A Fortunate Woman tells her compelling, true story, and how the tale of the old doctor has threaded through her own life in magical ways. Working within a community she loves, she is a rarity in contemporary medicine: a modern doctor who knows her patients inside out, the lives of this ancient, wild place entwined with her own. Part of this is the breakdown in secondary care. Christmas estimates that at least 20% of her workload is managing patients on interminable waiting lists. And it is a long time since she called an ambulance. “That’s not really functioning, so we usually have to drive patients to hospital.” Once there they are facing 12- and 14-hour waits in A&E. “Quite often at the moment,” she says, “I’ll turn up to work at half seven, and there’ll be a patient in the car park who has given up on the emergency department, and is waiting to bang on my door.” This biography is as much about person and place as it is about the transformation of family medicine from the human connections of a country doctor to a monolithic public service focused on efficiencies, fiscal accountability, and key performance indicators. It's a story that mirrors a similar transformation of society at large. As a member of the community she serves, the Fortunate Doctor knows her patients as more than just reporting data, but as human beings, and all the complexities and baggage that that involves—as did the doctor who served in this place before her. A remarkable, gripping and inspiring book that itself must surely become recommended reading for today’s trainee GPs… a gust of fresh, clear, contemporary air. Reading the Forest Polly Morland’s A Fortunate Woman, however, is a totally different and in my humble opinion a much better book and inspirational for all the right reasons. At a time of a barrage of negative publicity directed towards GPs, it is a book that reveals the positive impact that a caring GP has on the lives of their patients. The GP in A Fortunate Woman works hard, but she also understands the need for self-care. She has a supportive team behind her, both at work and home, she is reflective, in touch with nature and the landscape (beautifully depicted in the book, both in words and pictures) and through walking, she reaps the therapeutic benefits of exercise and fresh air. Work gives her meaning, but she has balance.That’s one of the reasons there are so few takers. When Hodges got his first salaried GP job there were 50 applicants. Today, all the local GPs I speak to insist that you could pretty much walk into any practice in the county and be hired on the spot. Not surprisingly, young doctors often prefer a few days a week as a contracted locum without the pressure of also being responsible – as here – for the management and livelihoods of 140 staff. The result is a kind of perfect storm of stress on the traditional partnership model – a recent Royal College of General Practitioners survey found that 42% of GPs in England were “likely or very likely to leave the profession in the next five years”, with nearly half of those suggesting burnout or stress as the prime reason. A Fortunate Woman’ is the best book I’ve read about general practice for a long time. Astonishingly perceptive, it shows how a committed GP can keep human values alive in an increasingly impersonal NHS – and why we urgently need more like her. Professor Roger Neighbour OBE, former President, Royal College of General Practitioners
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