Max Pemberton (2)

Set in a different country and in a different century (!) from my own experience but so much of this was familiar, and conjured up memories that were occasionally so strong they were accompanied by distinctly remembered emotions. The medical and hospital systems in the UK and Australia are very similar and not a lot has changed.

This type of writing has the problem of needing to hit the right tone or it just doesn't work, and Pemberton gets it right most of the time. At the start I thought show more 'oh oh, this is going to be too flippant in his search for humour, and too self-pitying, but he reigned it in very quickly.

The book is structured as a diary of the working year of a Junior House Officer (six months surgery and six months medicine) in the NHS in Britain. It is a fictionalised account of events that a HO would encounter, but Pemberton does say that everything that happens in the book is based on something that did happen in real life. It is also based on a regular column that Pemberton wrote for the Daily Telegraph newspaper. It's easy to see that he's taken the columns and turned them into a coherent 'story' by adding sections describing incidents and characters from both the hospital and his (almost nonexistent) personal life. In the longer column sections he uses a patient's problem or a specific situation as the basis for a discussion of some of the social, moral and ethical issues involved in medicine and medical care. And also some NHS administrative and 'political' issues. They are a collection of thoughtful and insightful (though obviously somewhat superficial) opinions on the issues. The shorter in between bits show very accurately and honestly what it's like during the first year on the job: frustrating, terrifying, emotionally and physically draining, and quite often also disillusioning. And not just what happens, but how he really feels, both physically and emotionally. That crushing feeling of constant tiredness is one not easily forgotten.

Overall this is a very worthwhile book, both for those with and without any medical background. It's a far cry from the "House of God" type of approach, and while occasionally I felt that the diary entries and the patients and incidents were too obviously concocted just as the framework for the 'lesson', the lessons themselves are worth it. It's also well written, with an underlying humanity and tenderness that shines through. And it is, after all, totally based in reality. show less

Max is back for another adventure as a not-so-junior doctor. This year, he’s back at the same hospital he spent his first year at. Only this time, he’s got a rotation closer to his final specialty (geriatrics, with some psychogeriatrics and some general medicine). There is still plenty of room for odd presentations to the ED (one for example, involves a circular device being used a little too long, nudge nudge wink wink) and funny things that patients say and do. Max’s experiences are show more also tinged with sadness at times- at the end of life care for older people as well as the state of the NHS (National Health Service, that’s the public health service in the UK. You can easily apply the issues anywhere though).

The great thing about Max’s writing is that he has a fantastic ability to explain things, whether it be disease, treatment or bureaucracy, in easily understood terms. Even though I’m not in the UK, I was able to understand the cost-saving measures put in place for the building of hospitals and services offered. Max also wrote the clearest explanation of what a prion is and its effects on the human brain – not an easy task. This ability to put into plain words limitations of today’s healthcare (such as chemical sedation for demented patients, locking of ward pantries to restrict food after hours, shutting emergency departments) strengthens his argument – what about the patient? Isn’t the aim of healthcare profession to do what’s best for them?

Please don’t let the above paragraph detract you into thinking the book has a preaching tone. It doesn’t. There are laughs, sadness and frustration aplenty. We also see the return of Flora, Ruby and Lewis, who each have stronger storylines in this book. There is also the return of the Three Marys (secretaries) and Trudy, supplier of cakes and knowledge, along with some new characters. Max and his friends also get time off to go on holiday and attend a wedding, even if everything doesn’t turn out as planned…

I’ll be interested to see what Max does next. He is an excellent writer who always makes reading about medicine a fascinating subject. If only he could rewrite some of my textbooks!

http://samstillreading.wordpress.com show less

I can’t remember where I first saw this book, but I was immediately interested. A real junior doctor, writing about his experiences in the first year after medical school? From my experiences, I thought it would be funny, sad and interesting- and I got exactly what I expected. Max is a brilliant writer and sounds like a fine doctor too. He has got the trials and tribulations of junior doctors across the globe down pat- it’s not about saving lives and surgery, but filling in a million show more forms, charting boring meds and writing while trying to listen, learn and walk while your pager bleeps endlessly.

Perhaps I’m biased because I work in the medical field myself, but Max explains things so brilliantly and poignantly- from seeing the first dead body, to continually working until you drop, forging bonds with patients and knowing that no matter what you do, you can’t save everyone. It also realistically captures the grind of constant overtime and the doubt that follows after graduation. It’s not all sweetness and light, but that’s life in the hospital.

There are some great characters in this book too- from housemate Ruby (who snares the McDreamy of the hospital- with Grey’s Anatomy-like results) to Max’s sister who invites him out when she has a medical issue.

I was actually happy when I missed my train so I had more of an opportunity to read this- something that rarely happens.

Well done Max, I look forward to reading your next book! show less

I don't read The Daily Telegraph, so I'd never heard of Max Pemberton until I started to hear the gentle murmurings about this book. I picked it up on a whim when it arrived in a box of books at our shop, and it turned out to be well worth a read.

It's a kind of diary of Pemberton's first year as a junior doctor, fresh out of medical school, terrified, and absolutely clueless as to the day to day running of a hospital ward. Along with his friends Ruby, Supriya and Lewis, he has to negotiate show more the egos of his consultants, befriend the nurses and secretaries who will help him adjust, learn to book scans and prescribe medication, cope with his mistakes and develop a confident bedside manner. Along the way there is death and despair, hope and uncertainty, joy and laughter.

I learned a lot about the way a ward operates, and developed a whole new respect for the doctors and nurses who fight every day to alleviate suffering, sometimes against the most horrific odds. There are also some pertinent points made about the way the NHS has been politicised by the government and the changes that are being made against all common sense. It's nice to here a doctor's view of these issues rather than just the political spin placed on it for the media. All in all, this is a great little read; amusing, informative, eye-opening and full of heart. show less