"A few years ago I found myself in A&E. I was mentally and physically broken... but I knew I had to carry on. Because I wasn't the patient. I was the doctor." This first work of non-fiction by the author of The Trouble With Goats and Sheep and Three Things About Elsie is a memoir of her time as a medic, in which she powerfully articulates the need for better care for those we rely on to care for us. Cannon includes case studies of some of the patients who provided her with what she calls her "Kodak moments".
Since 2014, graduate doctors in Scotland have been given a poetry book, Tools of the Trade, to “help navigate the stress of their vocation”. Narrative non-fiction such as Cannon’s offers more than stress relief: it has as much to teach new doctors as anatomy and physiology and pharmacology textbooks. Perhaps even more.
Only occasionally does the book veer into politics. Although Cannon’s points – that NHS clinics are crowded and waiting lists are full – are relevant, sadly they came as no news at all. Where it sings is when it focuses less on facts and instead searches for truth. And it really sings. Cannon has written a study of a philosophical study what it means to be human.
Cannon’s unusual journey through the system — she didn’t attend medical school until later in life — has all the makings of a highly charged novel, complete with unsavoury characters: the registrar who abandons the newly qualified Cannon mid-shift to go on holiday, the consultant who shouts and spits on her during a meeting. And there is plenty of tragedy, as she writes frankly about how difficult she found it to maintain professional distance from her most heartbreaking cases.
Before Cannon's debut novel, The Trouble With Goats And Sheep, she wrote a blog I read avidly, which detailed her life as a junior doctor. This raw and emotional memoir of those times is full of depth and insight, and made me so grateful to all those who work in healthcare.
There’s an admirable ballsiness to Cannon. She whistleblows. She wears her heart on her sleeve. Plainly, she wants to nurture mental health in others and seeks to expose the stress, ridiculous workload and lack of pastoral care she experienced in medicine. She highlights common student fears of letting down their family, those proud spectators on the sidelines who had cheered them on for years. Along with fellow medics, who she quotes anonymously, she was overwhelmed to the point that she considered taking an overdose. Like them, she often felt too tired to drive home, but did so anyway.
Breaking and Mending is a brilliant observation of hospital life. Like a small town, there are shops, a bank, cafés, a hairdresser, and also local code words and customs to learn. When a porter is called to collect a ‘package for Rose Cottage’, it’s a body for the mortuary. ‘The hospital at night is a different country,’ writes Cannon; a muffled peace comes over the corridors, but this is ‘just a smokescreen, and buried somewhere in that silence there is a never-ending sound of small tragedies’...The determining predictor of burnout, however, is clearly neither compassion nor the lack of it. It’s a much less poetic cluster of systemic variables that shape a junior doctor’s day, many of which Cannon’s book includes: whether or not there’s time for a vending machine lunch; quite how bad the rota’s gaping holes are; if working in yet another hospital means living far from partners and families; having seniors who insist on stoking a culture of bullying and humiliation.
In the past few years, there has been a plethora of medical memoirs. What sets Cannon’s book apart is not just its humanity and wisdom but the novelist’s keen observational eye. Cannon is a chronicler both of the human condition and the quotidian details – the clothes, the tics, the sights, sounds, smells and ephemera – which speak to who we are.
While the medical profession’s loss may be publishing’s gain, one cannot help but wish that the NHS might be filled in future with doctors just like Cannon.
This short and devastating book tells the story of how Cannon entered medical school with a heart full of gratitude and admirable intentions to “make a difference”. She was a “wild card” candidate in her 30s, who had left school at 15 with one O-level and had already formed a clear image of the kind of doctor she wanted to be. But “compassion will eat away at your sanity”, she discovers, as a cruel consultant screams in her face, her head swims from lack of sleep and food, her registrar disappears to Amsterdam, leaving her to cover a horrific nightshift – her third nightshift as a qualified doctor – and patients she cares for die in pain. “The doctor you wanted to become would not be able to survive,” she confesses.
Before she became a novelist, Cannon worked as a doctor. Here, she recalls her days on the wards in the most moving ways.