Book choice: Breaking & Mending

By Joanna Cannon

Wellcome Collection, hardback, £12.99, 2019

Review by Dr Greg Dollman, medical adviser, MDDUS

WHILE the style of Joanna Cannon’s latest book makes for easy reading, its content is far from easy. Breaking & Mending: A junior doctor’s stories of compassion & burnout explores the troubling reality of doctors putting aside their own wellbeing in the quest to help their patients.

More and more we hear and read about the culture of presenteeism, the burdens on NHS staff and burnout. Thankfully it is more accepted now that doctors too become ill and that our vocation should not equate with “sacrifice and the surrender of the self”.

Breaking & Mending will remind you of the many highs and lows of being a junior doctor. Cannon tells of her grave doubts as a trainee about her choice of profession. She describes the difficulty of moving from one specialty to another, always trying to fit in, wanting to be the best but knowing this cannot always be the case. Happily she concludes that, having found her place in medicine (as a psychiatrist), she could not imagine doing anything else. She writes about the incredible privilege of being a doctor.

Cannon started her medical studies in her thirties: the "wild card" of her year. She describes her journey from optimistic student to depleted junior doctor, days away from leaving the profession.

Breaking & Mending explores the concept of ‘hope’, what she calls "the most important ingredient" to mend a damaged life.

Cannon explains that it was only later in her medical training that she came to an understanding that “returning a life to someone very often has nothing to do with restoring a heartbeat” and that a life can be saved by a conversation or just listening.

For Cannon, words are most important. She tells of being criticised by her colleagues for talking to patients "too much", and not being listened to when her physical and mental health declined into "a deep well of despair". She did not recognise this decline. "I'm fine. I’m absolutely fine", she would reply when asked. How true her observation that burnout is too often "quiet and unseen".

Towards the end of the book, Cannon writes "let’s remember to check in with colleagues that they are okay – because this is what communities do". Perhaps we all need to ask our colleagues a second time: "truly, how are you?"