Short Nonfiction: Breathtaking by Rachel Clarke

Little, Brown Book Group| 26 January 2021| 154 pages| 4*

Novellas in November is hosted by Cathy and Rebecca. This week the focus is on short nonfiction.

I’ve watched TV programmes about Covid-19, seeing what it was like in a number of hospitals as the virus took hold in the UK, so a lot of the information in Rachel Clarke’s book, Breathtaking: Inside the NHS in a Time of Pandemic wasn’t new to me. But, I wanted to read this book to get an inside perspective on what it was like working in the NHS during the pandemic.

There have been so many fears that the NHS would be overwhelmed and reports criticising the way the government has dealt with the situation – and this is still the case now as winter approaches and the number of daily confirmed cases of coronavirus is still high, whilst hospital waiting lists for non-Covid-19 treatment remain high. Add to this there are now reports that doctors are saying that casualty departments are on the ‘edge of a precipice’, leading to dangerous levels of handover delays with patients forced to wait in ambulances for up to 11 hours outside hospitals. On TV I’ve seen the enormous queues of ambulances outside hospitals waiting to admit patients!

Rachel Clarke is a palliative care doctor and her book recounts her experiences during the first four months of 2020, when she worked on the Covid-19 wards in the Oxford University Hospitals system. Taken from her diary that she kept at the time it has an immediacy as she records her insomnia, her fears for her family and also the tremendous resilience, courage and empathy that she and the rest of the hospital staff had.

She tells the now familiar story about the PPE shortages, the lack of funding they experienced and criticises the government for their failure to act quickly enough – which I echo. Although it is a grim account, as I expected, it is also uplifting to know the care they took of their patients and the attentiveness to their patients’ needs despite the fact that many of the staff were not trained in intensive care and had never dealt with anything like this before.The way they had to prioritise patients is shocking, but I suppose inevitable given the lack of resources and staff.

She found that being a pandemic doctor was revelatory:

The crisis has undeniably revealed sweeping truths about social and economic inequalities, class divisions, global interconnectedness and the fact that our society’s most vital key workers were, and remain, among the lowest paid and the least empowered. Historians will dissect the issues for years to come. My revelations were about people. I learned from ward to ward, from bedside to bedside, paying meticulous attention to one human being and then another. I discovered how to distinguish what we absolutely cannot do without from what is really in the end, superfluous. (page 18)

This book is a snapshot, written at the time:

It depicts life and death, hope, fear, medicine at its most impotent and also at its finest, the courage of patients in enormous adversity, the stress of being torn between helping those patients and endangering your spouse and children, the long, fretful nights ruminating over whether the PPE you wear fits the science or the size of the government stockpile. I needed, I think, to take a stand with my pen and simply say: I was there. I have seen it, from the inside. I know what it was like. Here, with all its flaws and its inherent subjectivity, is my testimony. Make of it what you will. (pages 18-19)

Breathtaking records the compassion and kindness of numerous people, and pays tribute to both NHS staff and volunteers in dealing with such a distressing and immensely horrific situation.

Failures of State by Jonathan Calvert and George Arbuthnott

The inside story of the UK’s response to the pandemic from the Insight investigations unit at The Sunday Times

Mudlark, Harper Collins| 18 March 2021| 422 pages| My own copy| 4*

I don’t read a lot of nonfiction, but this year I have been reading more than usual. This book caught my eye in August and although I’ve watched countless TV programmes and interviews and read numerous articles about the coronavirus pandemic I just had to read it.


Failures of State: The Inside Story of Britain’s Battle with Coronavirus recounts the extraordinary political decisions taken at the heart of Boris Johnson’s government during the global pandemic.

Meticulously researched and corroborated by hundreds of inside sources, politicians, emergency planners, scientists, doctors, paramedics and bereaved families, along with leaked data and documents, this is the insider’s account of how the government sleepwalked into disaster and tried to cover up its role in the tragedy – and it exposes one of the most scandalous failures of political leadership in British history.

In the eye of the storm was Boris Johnson, a Prime Minister who idolised Winston Churchill and had the chance to become a hero of his own making as the crisis engulfed the nation. Instead he was fixated on Brexit, his own political destiny and a myriad of personal issues, all while presiding over the UK government’s botched response to the global coronavirus pandemic. After missing key Cobra meetings, embracing and abandoning herd immunity and dithering over lockdown, Johnson left the NHS facing an unmanageable deluge of patients. His inaction resulted in the deaths of many thousands of British people and his own hospitalisation at the hands of the pandemic, yet further reckless decisions allowed a deadly second wave to sweep across the country in the autumn months with the economy on the brink of collapse.

With access to key figures at the top of government during the most tumultuous year of modern British history, Failures of State is an exhaustive and thrillingly told story – and one of the most essential pieces of investigative reporting for a generation.

My thoughts:

The book covers the period from 24 January 2020 – 23 January 2021, with a Prologue covering the period from 24 April 2012 – 23 January 2020. Since it was written time has moved on and further information has become available, but this book is a reminder of how it started and described what subsequently happened. So, much of it was what I already knew, especially about the steps that were taken in the UK to cope with the situation.

In considering the two phrases ‘we were following the science’ and ‘we have taken the right steps at the right time’ they ask was this in fact what happened? They used many sources as described in the blurb and their research gave them the answer ‘no’.

In particular, they question why the government failed to act more swiftly, what the scientists told ministers, whether Britain was equipped to fight a pandemic and what were the consequences. I’m a cautious person and I remember being anxious that not enough was being done at the time and thought that we should have locked down earlier than we did. Reading this book makes me think that I wasn’t being over-cautious. I am also a bit cynical about what I read in the papers and what I hear and see being reported, so I viewed this book with caution too. Many of the sources are named in the book, but many are not.

I am appalled at what this book reveals. I am appalled by the corruption, outright lies, obfuscations, misinformation and incompetence they report – worse than I had thought at the time.

But most of all I am utterly appalled by what is revealed about the NHS and the restrictions that were imposed on reporting what was taking place in hospitals. The NHS had limited capacity to deal with the pandemic and the public were not made aware of the selection process that was used in deciding who could be given intensive care. If it had been reported there would have been widespread panic, terror and outrage. It is appalling that so many people were not given intensive care, and that so many had died who could otherwise have survived.

It is a shocking account of a terrible year – words fail me.

Library Loot

It’s been a while since I wrote a post about my library books. I’m lucky as the mobile library van visits here once a fortnight, stopping nearly outside our house. So, I regularly borrow books both from the van and from the branch library. These are my recent library loans.

First three non fiction books:

Non Fic Lib Bks May 2018

  • Do No Harm by Henry Marsh one of the UK’s foremost neurosurgeons. I first read about this book on BookerTalk’s blog. She wrote: In Do No Harm he offers insight into the joy and despair of a career dedicated to one of the most complex systems in the body. This is a candid account of how it feels to drill into someone’s skull, navigate through a myriad of nerves that control memory, reason, speech and imagination and suck out abnormal growths. I thought it looks interesting, so I reserved the book to read it for myself.
  • And then I saw Reaching Down the Rabbit Hole by Allan H Ropper and B D Burrell sitting on the shelves. I admit that I was drawn to this book by its title on the spine, not realising until I took it off the shelf that this is also a book by a neurosurgeon, Dr Ropper, an American professor at Harvard Medical School. This is a glimpse into the ways our brains can go wrong, how a damaged brain can radically alter our lives.
  • Learn to Sleep Well by Chris Idzikowski. After reading Why We Sleep by Matthew Walker I thought it would be a good idea to read a book about getting better sleep as I don’t get the average of eight hours of sleep Professor Walker recommends. It’s sub-titled ‘get to sleep and stay asleep overcome sleep problems revitalize body and mind.’

And now the fiction:

Fic Lib Bks May 2018

  • A Perfectly Good Man by Patrick Gale. It is set in Cornwall, about a parish priest Barnaby Johnson. Earlier this year I read Gale’s Notes from an Exhibition and found although this book is not a sequel it has some of the same characters and I want to know more about them.
  • Deadline by Barbara Nadel. I haven’t read any of her other books – this is an Inspector Ikmen Mystery set in Istanbul. I liked the blurb on the back cover – Ikmen is invited to a murder mystery evening at Istanbul’s famous Pera Palas Hotel where he finds himself embroiled in a deadly game of life imitating art. Halfway through the evening, one of the actors is found dead in the room where Agatha Christie used to stay when she was in Istanbul.
  • Sisters by Patricia MacDonald, another new-to-me author, (one of the reasons I like to borrow books is to check out new-to-me authors). This is described on the back cover as a ‘fast-paced novel of psychological suspense‘. Alex Woods is shocked to find out after her parents’ death that she has a sister that her mother had kept a secret from her. She decides to search for her.
  • How Green Was My Valley by Richard Llewellyn. I’d reserved this one, a book I’ve been thinking of reading for a while. It’s a story of life in a mining community in rural South Wales as Huw Morgan is preparing to leave the valley where he had grown up. He tells of life before the First World War.
  • Rubbernecker by Belinda Bauer – see my Friday post for details of the novel and the opening sentences.  I’ve already started reading it. It’s about  Patrick Fort, a medical student with Asperger’s Syndrome, studying anatomy and trying to identify the cause of death of a body he is dissecting. I borrowed this book as I loved her first book, Blacklands.


Why We Sleep by Matthew Walker

Penguin Books|4 January 2018|368 p|e-book |Review copy|4*

I have read several books and watched TV programmes on sleeping, but Why We Sleep: the New Science of Sleep and Dreams is one of the most in depth and thorough books on the subject that I’ve come across. It is fascinating and disturbing in equal measures.

It emphasises how important sleep is to our health. Eight hours sleep each night will improve your immune system, help prevent infection, regulate your appetite, lower blood pressure, maintain your heart in fine condition, improve your ability to learn, memorise and make logical decisions.

But be warned if you don’t get eight hours sleep you run the risk of doubling your risk of cancer, of increasing your risk of developing Alzheimer’s disease, diabetes, cardiovascular disease, strokes, and heart attacks, and insufficient sleep contributes to all major psychiatric conditions, including depression, anxiety and suicidal tendencies. It is a terrifying scenario as every major disease in the developed world has very strong causal links to deficient sleep.

Matthew Walker is professor of neuroscience and psychology at the University of California, Berkeley, where he is director of the Center for Human Sleep Science. He goes into great detail examining every aspect of the subject looking at what sleep is, how we sleep, as well as why we should sleep and the external factors that cause poor sleep. There are sections on sleep deprivation, sleeping pills, insomnia and other sleep disorders and on dreams – creativity and dream control. He also considers the sleep requirements of babies, children, teenagers and the elderly.

There are a number of things I highlighted as I read the book, including:

  • sleep is the foundation of good health
  • every major system, tissue and organ of your body suffers if your sleep is short
  • the shorter your sleep, the shorter your life
  • the less you sleep you’re more likely to put on weight
  • sleeping six hours or less increases your risk of developing cancer by 40%
  • routinely sleeping less than six or seven hours a night demolishes your immune system, more than doubling your risk of cancer

He cites the World Health Organization’s and the National Sleep Foundation’s stipulation of an average of eight hours of sleep for adults. So, what can you do to improve your sleep if you don’t get eight hours? I really want to know. Walker refers to behavioural methods for improving sleep, such as cognitive behavioural therapy intended to break bad sleep habits, obvious methods such as reducing caffeine and alcohol intake, removing LED devices from the bedroom and having a cool bedroom. Other things to establish – having a regular bedtime, only going to bed when sleepy, avoid sleeping in the early/mid evenings and daytime napping etc, etc – nothing I haven’t come across before.

Why We Sleep is full of fascinating facts, but at times it is repetitive with lots of detail about sleep experiments that made me worried about the effects on those people who undertook them. Matthew Walker is most certainly on a mission to educate people about the importance of sleep, even if there is nothing new he has to offer about how to improve sleep times.

Saturday Snapshot

This scene has become very familiar to me over the last four weeks:

Edinburgh Cancer Centre view of Edinburgh skyline2

It’s the Edinburgh skyline I can see from the Edinburgh Western General Hospital. The tall spire towards the left of the photo is the Scott Monument in Princes Street Gardens. Moving to the right of that is the fortress that is Edinburgh Castle and below that the green dome is the copper-clad dome of West Register House, one of the buildings of the National Archive of Scotland, in Charlotte Square.

And this is why – it’s the view from the Edinburgh Cancer Centre, where I’ve been going for the last four weeks. (Last week I wrote about being diagnosed with a breast cancer – see this post.)

It’s not as grim inside as it looks outside – it’s quite nice actually. I’ve got two more sessions of radiotherapy next week and then that is the end of my treatment, apart from follow-up appointments and a bone density scan. I’ll be glad to get back to ‘normal’. Maybe then I’ll get back to writing about books – I’ve got quite a pile lined up to review.

See more Saturday Snapshots on Alyce’s blog At Home With Books.

Why I haven’t been writing many book reviews

I’ve not been writing many book posts these last few weeks, I’ve now read four books and not written about them, although I have nearly finished a post about Hilary Mantel’s A Place of Greater Safety.

Here’s the reason.

This is something I’ve been thinking about writing about for a while now, but now seems the right time. Last August I was diagnosed with a breast cancer. I couldn’t feel a lump, but my breast didn’t look right and I thought it might be a cancer. My GP couldn’t feel a lump either but thought it best to check it out at the local hospital’s breast clinic. It was still a shock to have it confirmed- even more so when the consultant said he thought I needed a mastectomy and he could do it very soon. But when they examined the biopsy it turned out that the type of cancer I had was oestrogen receptive and it was possible it would shrink by taking hormone therapy tablets. I was amazed to say the least. Apparently if you have to have a breast cancer, this type is the best one to have!!!

And so, from August to February I faithfully took the tablets, with practically no side effects – and they worked, shrinking the cancer by about a third. Still, I did need an operation, but a wide local excision, or lumpectomy in everyday language, and not a mastectomy. I had the operation at the beginning of March. It was just day surgery and went well. It was a strange experience, having surgery to correct something that wasn’t causing me any pain or discomfort and coming round from the operation with scars and discomfort – and that was all it was discomfort, soreness, massive bruising and swelling.

But all the cancer has been removed, the bruising has disappeared. It’s still tender and I get darting pains every now and then. Currently I’m having 20 sessions of radiotherapy as a precautionary measure. It’s every weekday, but the sessions are only 10 minutes long, with the actual radiation only taking about two/three minutes. There was a planning appointment where they pinpointed the area to target, and I mean pinpoint as I have at least four (I lost count) minute tattoos that outline the area. For someone who hates the idea of having tattoos, this was quite daunting, but they are such small dots I can hardly see them and it didn’t hurt (much) when they did them.

So far, I’ve had 8 treatments and it has all been painless. I’m told that tiredness kicks in after about a fortnight’s treatment and by the end of the sessions my skin may get red and sore, as though I’d got sunburn. I hope that is as bad as it gets. The most difficult thing so far has been the travelling to Edinburgh for the treatment. It takes 1 hour 20 minutes each way, which is tiring enough on its own. D is driving me and we’re listening to Blue Lightning by Ann Cleeves, the fourth in her Shetland series with Detective Jimmy Perez investigating murders on Fair Isle, which is keeping us both guessing who the murderer could be.

I’ve always had a dread of cancer, made more personal when my mother had a mastectomy, when I was in my twenties. She died five years later, after it had spread. My father died of bronchial cancer, after smoking since he was ten years old and four years ago this August my sister died of lung cancer – she’d smoked since she was 15. But, I have to say, that so far it’s not been too bad. I’m a terrible wimp regarding needles and injections and that has been the worst thing for me – the most painful was the injection before the doctor took the ultrasound core biopsies, but it wasn’t much worse than injections I’ve had at the dentist. It’s the fear of the unknown that has been more terrible than the treatment itself.

I am so grateful for the NHS – speedy appointments, kind and caring medical staff, and practically pain free treatment (I won’t mention the nurse who had great difficulty taking blood from me). I’ve had so many tests and scans and thankfully the cancer hadn’t spread anywhere else. Even so, the surgeon took a biopsy of my lymph nodes when he did the lumpectomy just to make sure, which confirmed the cancer hasn’t spread .

I like to know as much as possible about what’s happening to me and I asked the breast care nurse if there was anything I could read about breast cancer. She warned me off reading statistics online as these are often out of date and gave me a pack produced by Breast Cancer Care, which is an excellent introduction. What I have found most helpful are the Macmillan Cancer support publications, particularly Understanding Breast Cancer and Understanding Radiotherapy. Books on cancer are rather more problematic, as so many are out of date, or are aimed at the medical profession. There are some written by patients, but I’m a bit wary about them as symptoms and treatments differ from person to person. Treatment in the future looks promising as I’ve seen on the news about progress that’s being made in diagnosing cancers and less invasive ways of treating them.

This may have slowed me down, writing about the books I’ve read, but it certainly hasn’t slowed down my reading. It has brought home to me just how many books there are and that it really is true – ‘so many books, so little time‘. It’s not just books, of course, because no matter how young or old you are, how well or ill you are, life is unpredictable and we should make the most of it whilst we can.

I am optimistic, because as my breast care nurse said ‘the cancer’s away and the prognosis is good.’