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What I’ve been reading this month

Sylvia Plath’s Mary Ventura and the Ninth Kingdom packed far more food for thought into 40 pages than many writers manage in 400. The plot involved a young-ish girl sent on an ominous train journey by her parents. It was spine-tinglingly creepy, and the discomfort was only heightened by the clear allegory to the path our up-bringing bringing sets for each of us. I actually read this twice, as I couldn’t help myself from flicking back to the start almost as soon as I’d reached the end.

“It is worse, much worse, than you think” was the opening to David Wallace-Wells’s The Uninhabitable Earth: and the next 310 pages proved his point. This book explained the current position of the world with respect to global warming, and how much worse the situation is going to get as a result of damage that has already been done. I found this text both arresting and illuminating. It was one of those rare books that completely changed my understanding and frame of reference on a topic. And yet, it was also a reasonably easy read by virtue of the engaging style of writing.

Lorrie Moore’s Terrific Mother was a short novella in which a 30-something women was caught up in a simple accident which resulted in the death of her friend’s baby. This caused her to spiral into a deep depression, at the nadir of which she decided to marry an academic. She was whisked off to Italy as a spouse on a academic retreat, and fell for her American masseuse. Despite the heavy subject matter, especially at the start, this was written with an oddly true-to-life lightness and a certain sense of wit. It was 76 small-ish widely spaced pages long, very easily read in a single sitting, and that felt like exactly the right length for the story.

Amateur, Thomas Page McBee’s short autobiographical account of training for, and taking part in, a charity boxing match as a transgender man, was thoughtful and reflective. McBee’s exploration of boxing was fascinating: it’s a sport I’ve never engaged with in any meaningful way, yet one on which that I held a passively negative view. McBee’s exploration of boxing and the reasons men fight educated me and allowed me to see more of the nuance behind the sport. The discussion of masculinity was interesting too, particularly given the particular perspective McBee can bring as a transgender man.

A River in Egypt by David Means was a 34-page story covering a father’s thoughts during and after taking his infant son for a sweat test to diagnose Cystic Fibrosis. I thought Means did a great job of capturing the broad tumult of thoughts that people experience in situations like this: the complexity and frequent tangents felt true to life.

In How to Think Like a Roman Emperor, Donald J Robertson gave some historical context to Marcus Aurelius’s writings, and also drew some interesting and insightful comparisons between the practices advocated by the Stoic philosophers and techniques of modern psychotherapy. I appreciated that Robertson discussed differences as well as similarities and that the analysis went beyond superficial description of the longevity of the ideas. I thought that some of the more imaginative parts of the book didn’t quite work, but I enjoyed it nevertheless.

I was a bit disappointed by Ian McEwan’s Machines Like Me. It was a story about a the experience of a young couple who buy a human-like robot. I felt that there were too many ideas stuffed into the novel: resurrecting Alan Turing, a counter-factual social history of the 1980s, and technologically advanced and life-like robots. There were lots of interesting ideas hinted at, but none of them particularly well explored. The characterisation was very thin by McEwan’s usual standards – I didn’t really feel that I understood the motivations of the central human characters. It all just came across as bitty and confused to me.

I struggled to the end of Merve Emre’s What’s Your Type? this month, a book which promised to be a history of the cultish Myers-Briggs personality test, but turned out to be an interminably dull biography of Myers and Briggs. I don’t think I took anything useful away from this.

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Reflecting on my first ten years as a doctor

Ten years ago today (eleven by the time this is published), I learned that I had passed my medical school finals and became a doctor. It doesn’t feel like it was a decade ago.

At work, I recently happened to have a meeting with someone I worked with as an F1 doctor but haven’t seen since. It felt like we worked together a month ago rather than a decade. I still occasionally say “hi” in the street to the porter who used to comment on my “Bird’s Custard” colour tie as an F1. And yes, somehow my F1 year was long enough ago that ties weren’t yet banned in hospitals.


I think the Simon of ten years ago would be amazed to find that I’m now working in public health. I didn’t enjoy the occasional public health bits at medical school, and I wasn’t even really aware that it was it’s own specialty until I came to pick a career path. Public health always struck me as worthy, dull, and far removed from anything that actually had any measurable impact on patients.

It was only after a serendipitous run of F1 hospital rotations that I started to see the point. My first job was in upper gastrointestinal surgery, a subspecialty involving seriously brutal surgical interventions to treat cancers with very poor prognoses. My second job was in stroke medicine. My third was in gastrointestinal medicine, a speciality in which a large proportion of the patients had end-stage liver disease as a result of alcoholism.

I think it’s impossible to go through that sequence and not feel slightly despairing: hospital medicine comes too late for most of these patients. Their lives very often cannot be pieced back together: as one particularly insensitive consultant used to regularly say, for those patients “the party’s over”.

The most effective treatment for these patients would be to rewind time and tackle their problems before they were ill. This initially pushed me towards General Practice, until I realised (late) that this was the point of Public Health. My realisation of this came so late that I didn’t really know what public health doctors did all day, but stuck in an application to the specialty anyway… as well as general practice.


After long essay-style application forms, written exams and half-day intensive interviews known as “selection centres”, it somehow came to pass that I was offered places on both the GP and public health training schemes. I had 48 hours to decide between a familiar career path and one which sounded fascinating but that I barely understood. In truth, I hedged: I went with public health because general practice always under-recruits, and I was pretty confident that a re-application to GP would be successful in 12 month’s time if public health turned out to be awful.

I was also put off by the obsession with portfolios in General Practice. My experience of clinical portfolios was that doctors were judged too much on their ability to write and present evidence rather than on their practice of medicine. I was, even if I say so myself, great at presenting portfolios of glowing assessments as a Foundation Doctor, but this felt a bit flat. It seemed to me that people in public health were known by results and reputation, and I liked that idea. I’m not so sure that was an accurate assessment of either speciality, but it certainly played a part in my decision-making at the time.

Leaping into public health felt brave at the time, even if it seems like hedging in retrospect: no end of people were telling me that I’d be “wasted” in public health and that my skills with patients meant that I’d be a fantastic GP. Some of this was subfusc whispers in my ear, some was formal written feedback, some was mildly paternalistic advice. Only a minority were enthusiastic. Luckily, once I set my mind on something, I’m pretty strong-willed.


Public health wasn’t awful. I mean, it had its moments: within weeks of me accepting a place, the coalition Government announced an intention to move public health outside of the NHS. This may have been the right decision, but it was terrifying for me as an NHS doctor to know that my NHS career path had been cut off just as it was beginning.

As I progressed through my training, I came to really enjoy health protection, the part of public health which deals with outbreaks and other biological, chemical and radiological threats to the population. I liked the combination of clinical-style short-term pressure, thoughtful balancing of risks, and the close association with clinical colleagues (and occasionally patients). I wrangled the system to spend almost half of my training in health protection placements, and since 2016 I’ve been a consultant in health protection. It is—by far—the most enjoyable and rewarding job I’ve ever done, in which I’m surrounded by a brilliant team who never give anything less than their best.


So, in career terms, I could not be further from where I thought I’d be ten years ago. But I also couldn’t be happier with the choices I’ve made. I don’t really know that there’s a lesson in that.

Someone once told me that the most important thing in career planning is to do what you enjoy and collect certificates along the way. Delayed gratification is rarely worth it in career terms: the gratification might never come. But its hard to ever regret doing something you enjoy, and collecting certificates provides tools to make a “leap” to something else when the first thing stops being fun.

I don’t know whether that’s good advice or not, but it roughly correlates with my experience over the last ten years. Let’s hope that I’m still enjoying things as much ten years hence – whatever I’m doing then!


The picture at the top is obviously my own. It was from my graduation which was, of course, a little later than the day I found out I’d passed.

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What I’ve been reading this month

Long-time readers will know that I think Will Storr is one of my favourite writers. His latest book, The Science of Storytelling, was really aimed at other writers: it gave advice backed by psychology on the creation of works of fiction. I found myself completely absorbed in Storr’s discussion of storytelling theory. I really enjoyed the way that he connected science and art (as he always does), and I was very much taken with the examples he chose to present throughout his book, some of which were among my own favourite books. Because I’m not the target audience, some of the content was of less interest – for example, the appendix on story frameworks – but I devoured and enjoyed the whole book nevertheless.

A Monk’s Guide to a Clean House and Mind by Shoukei Matsumoto, a Buddhist monk, was a short book reflecting on the psychological benefits of cleaning. The passion of the argument was more than sufficient to carry the length of this short book, and so I really enjoyed it. It was neither particularly deep and philosophical nor a great source of practical cleaning tips; it’s just an enjoyable, well-written and concise explanation of a passionately held point of view.

Emily Maitlis’s much-lauded Airhead, a series of anecdotes about conducting television interviews, left me a little disappointed. Many of the anecdotes were about things that have gone wrong and Maitlis had enough wit to make these genuinely funny. Some were more thoughtful – Maitlis reflects interestingly on the shift from volunteering on the morning following the Grenfell fire to presenting an edition of Newsnight the same evening. But there wasn’t much more to this book than a series of anecdotes: no reflections on the changing media landscape, nothing about Maitlis’s personal development over time, and no grand argument which she was trying to prove. I enjoyed this book, but left it thinking: “So what?”

Another wildly popular book that did little for me: Normal People by Sally Rooney. This was a book about two people – Marianne and Connell – who grew up together and remain friends into adulthood. Their level of closeness varied over time. The two main characters have been widely praised for being very lifelike, but didn’t seem that way to me. This was partly, I think, because the dialogue between them was rather oddly stilted and formal considering their closeness, and partly because the other characters were so lightly described as to be hardly there, which made their world feel thin. I didn’t quite understand what the fuss was about: but this was on the Booker Prize long-list, so the problem is more likely to be me than the book!

Fay Weldon’s The Life and Loves of a She Devil, first published in 1995, was a much-lauded darkly comic novel of a woman scorned and going to extreme lengths to reinvent herself and exact revenge. There were some great lines, but the whole thing felt pretty dated to me, especially in terms of gender politics/ stereotypes. The comedy felt a bit thin to me: revenge can be entertaining, but revenge seemed to be the only note this book was willing to play.

I often complain that I don’t really like short stories: but in truth, I wonder if I’ve just always picked bad ones. So I’ve decided to challenge myself to read the twenty short stories picked by Faber for their 90th anniversary ‘Faber Stories’ collection over the next… well, I haven’t set myself a deadline.

The first of these I picked up was Julia O’Faolain’s Daughters of Passion, a short story in which an increasingly delusional IRA hunger-striker reflects on the childhood friendship which led to her involvement with the IRA. I enjoyed this: O’Foalain played with language in creative ways to reflect different mental states, and drew subtle connectiosn between delusion, misunderstanding and terrorism. All in 49 pages.

The second was A Good Man is Hard to Find by Flannery O’Connor. I found this a bit pedestrian. The story concerned an American family crossing paths with a criminal while on a road trip. Most of the character development is focused on the grandmother. There are a lot of themes hinted at – most prominently the nature of moral good (or perhaps moral evil) in the context of modern American Christianity, but none of the themes were really developed into anything… perhaps because the story was so short.

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