"It takes courage to love the things of this world when all of them, without fail, are fleeting, fading, no more than a spark against the darkness of deep time." The author grew up riveted by her father's stories of practising medicine, and eventually she fulfilled her deep-seated desire to become a doctor herself, and a specialist in palliative care. Then when her beloved father received a terminal diagnosis, she had to relive all her training in the most personal way possible.
There is much to admire in this honest account from the front line of death, though I rather itched to take a scalpel to some of the early chapters and found myself skipping over anything unrelated to the core story of life at the hospice and Clarke’s relationship with her father, who had practised in the Swinging Sixties and used to buzz around the streets in his scarlet MG and drink his post night-shift pints with the meat men from Smithfield Market.
Drawn to patients with “life-limiting” illness, she decides to specialise in palliative medicine and goes to work in a hospice, a place “steeped in fear and taboo”, where she spends her days not just as doctor, but as priest, hand holder and confidante. As much as it’s about knowing when to up the dose of morphine, the job is also, crucially, about listening to stories and fulfilling final wishes. One patient, a Star Wars fan, tells Clarke he had imagined the hospice to be the Death Star and she replies that she’ll try to be more Princess Leia than Darth Vader.
Clarke repeatedly describes her own fallibility: the mistakes she makes, the fear and recoil she feels, the cases that go wrong. She lets us see her as a doctor, but also as a daughter, a wife, a mother. The compartments are not neat: she works as a scientist, but also as a counsellor, a teacher, a priest, a fellow human being. Her heart is in her job. There are many thrilling doctor-as-hero accounts, and they are often by men; there are fewer doctor-as-healer ones, and those I know of share the kind, unironic and emotionally invested quality of Dear Life.
The book should also be essential reading for anyone who cares about our beleaguered health system. Clarke powerfully conveys the battering the NHS has endured over the past decade of austerity, neglect that has resulted in overcrowded hospitals and the rise of “Corridor Medicine”.
In his poem, Carver says that “a sweetness” in life prevails at intervals given a chance. Dear Life is a painful read at times, because it forces you to reflect on some of the worst situations anybody ever has to face. However, the book is also a compassionate gem, full of its own episodes of sweetness. I won’t spoil the story, but Clarke’s true anecdote about the “magic string” that helps children facing radiotherapy is heartbreaking and inspiring.