‘This pain, of all pains, cannot be palliated’: a doctor cares for her dying father

Dear Life arrives at a time when the public appetite for the personal accounts of medical insiders shows no sign of abating, with scores of such books having been published in recent years. Their enduring popularity is often — and, arguably, best — characterised as a kind of literary fallout from a decade of austerity and the very public ire this has drawn from health professionals.

Rachel Clarke’s 2017 debut, Your Life in My Hands: A Junior Doctor’s Story, was written partly as a response to the 2015 dispute between NHS junior doctors and the then health secretary Jeremy Hunt, as well as the general impact of austerity measures on the NHS. Dear Life offers shades of the same criticism (‘I wish I could drag a government minister by the scruff of their neck… to see for themselves the reality of a health service pared to the bone’), but here the focus is on broader issues. Clarke writes of the desensitising effect of medical training (‘empathy… was under assault from day one of medical school. With biochemistry and anatomy filling our days, one way or another, people were reduced — either to chemical interactions or to corpses on slabs’) and the impact this can ultimately have on patients.

Conversely, palliative medicine ‘places patient, not disease, centre stage’ — a principle Clarke espouses convincingly in this book: ‘Why do you only ever earn a truly patient-centred hospital environment either by being a child, on a children’s ward, where surroundings are taken seriously, or by being on the brink of death?’

Her reflections on the health service and her career take on a different hue when she learns of her father’s cancer diagnosis. ‘My patients are now the face of Dad’s future.