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Every reader will meditate on their own encounters with GPs. Of her doctor, Morland writes: “Her life’s work is not simply about the application of a body of knowledge to an assortment of human objects… it is a pursuit meaningful in and of itself.” The word “relationship” is often used. The doctor says that hers is the only branch of medicine founded on relationships. 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 a compelling, thoughtful and insightful look at the life and work of a country doctor. Funny, moving and not afraid of the dark, it will speak to readers everywhere. 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 Fortunate Woman by Polly Morland | Book review | The TLS A Fortunate Woman by Polly Morland | Book review | The TLS
As A Fortunate Woman ends, ‘after the longest of winters, comes spring’ and with her patients vaccinated, a return to face-to-face consulting, new staff and a trainee our Fortunate Woman is beginning to feel hopeful again: ‘She crouches down next to her bike to peer into a hole in the wall where a stone came loose a few weeks ago. Inside, there is now a nest. New life, she thinks.’
In the snow-bound January of 1947, a new GP arrived in “the valley”. He had served as a navy surgeon in the war, but now he was a country doctor, there to stay. Eighteen months later, each of his patients received a terse letter: “You are now part of the National Health Service, so you don’t need to pay me any more, thank you very much.” He remained for 35 years. For me, this story is so much better than John Bergers’s book about a single handed doctor working in the same practice forty years ago.
A Fortunate Woman - Polly Morland
Rachel Rutter near her practice in Stroud. ‘For a long time now, we have in essence been firefighting the daily triage list.’ Photograph: Gareth Iwan Jones/The Observer This book was inspired by the discovery of a long-lost book in the bookcase of the author’s mother—John Berger’s A Fortunate Man—which was itself the story of a country doctor published in the 1960s. In a series of coincidences, unbeknown to her, author Polly Morland found that she was living in the same remote valley that was the setting for A Fortunate Man. In turn she spoke to the current doctor of the valley who said that Berger’s book had been a big influence on her own choices to become a doctor. Author and doctor began to meet and talk, and the idea for a parallel book, set in modern times, came about. In this rare rural setting the doctor knows her patients well and provides a system of continual care in their community. 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. A New Statesman Book of the Year 2022 As author Polly Morland was cleaning her mother's library she came across a misplaced book. It was, "A Fortunate Man" (1967) by John Berger, which was about a country doctor who practiced in her own community some five decades before. The book is about the doctor who replaced the Fortunate Man, who herself was inspired to pursue family medicine by the same book when she was a medical student two decades earlier. It was, even so, very hard to take the decision to give up the practice and the patients to which she has devoted her working life – she plans to work fewer hours as a locum. One factor, she recalls, was reading about the Surrey GP Gail Milligan, who took her own life in July aged 47. Milligan’s husband, Chris, described to the medical press how his wife had become overwhelmed by the 24-hour demands of her job. “Her mind was constantly on work. And she felt guilty for stepping away. She became a shadowy figure in our lives. She was at work for 12 to 14 hours, and when she got home she was working again.” Rutter is the mother of two teenage children. “When I read that,” she says, “It really hit me: I’m working those hours too.”
Revisiting Berger’s story after half a century of seismic change, both in our society and in the ways in which medicine is practised, 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. 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 This was “Dr John Sassall”. How capable he was, how eccentric, how dedicated and how unlikely, nowadays, was revealed in John Berger’s classic 1967 book A Fortunate Man. Sassall was a friend and Berger shadowed him for some months, along with the Swiss photographer Jean Mohr. The subtitle of their collaboration is The Story of a Country Doctor. It is not a story as such; it proceeds through a series of vignettes, psychological explorations, case studies and in-depth enquiries into the relationship between one man and his calling, his patients and his environment.
A Fortunate Woman by Polly Morland - Pan Macmillan A Fortunate Woman by Polly Morland - Pan Macmillan
It’s worth reading A Fortunate Man as half of a diptych, followed by this new book, A Fortunate Woman, immediately afterwards. The latter came about through a perfect alignment of coincidences. The author, Polly Morland, is a journalist and film-maker with a kindly, dramatic writing style and a feel for the human story. In 2020 she was clearing her mother’s house, after her mother, suffering from Alzheimer’s, had been moved into a care home. It followed, she writes, a “frightening and chaotic” year of “doctors and paramedics, nurses and social workers”. They had all been “well meaning and professional”, but none had known her mother “before all this started, nor stayed long enough to get to know her now”. It was not that she was out of the ordinary’writes Polly Morland near the start of her compelling and beautifully written book A Fortunate Woman, ‘ Put simply, she is a doctor who knows her patients. She is the keeper of their stories, over years and across generations, witness to the infinite variety of their lives. These stories, she says, are what her job is all about. They are what sustain her, even in days as hard as these.’ In May, the Commons Health and Social Care Committee held an evidence session on continuity of care. They heard from Dr Jacob Lee about what it’s like to see someone in a practice that doesn’t have personal lists. “You are trying to read their notes and get a feeling for what has been happening in the past. It makes the consultation really challenging when you are looking at blood test results and letters for patients you do not know because they are split between the different GPs who are in that day. It is so inefficient and difficult to try to do a good job for that individual.” 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?
If you want to read a book that moves you both at the level of sentence and the quality of language and with the emotional depth of its subject matter, then A Fortunate Woman is definitely the book you should be reading’ - Samanth Subramanian, Baillie Gifford judge I was consoled and compelled by this book’s steady gaze on healing and caring. The writing is beautiful' - Sarah Moss, author of Summerwater and Ghost Wall This was exactly my cup of tea. A beautifully written portrait of a rural GP whose tender care for her patients elicits such trust, admiration and even friendship that it seems almost alien in our transactional medical system. Beautiful and fascinating … it combines the structural elements of storytelling with the skill of real-life reporting, clustering them in the brilliance of a cloisonné-finish. Dundee University Review of the Arts
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