Not so long ago, first-person accounts of what goes on in the operating theatre or the emergency ward – and in the hearts and minds of those who work there – were hard to find. Author William Boyd said recently that when writing his novel about a surgeon, The Blue Afternoon, some years ago, he failed to unearth any descriptions of surgery by surgeons at all. But no more. The medical memoir has become a publishing phenomenon.
Atul Gawande’s Being Mortal; Do No Harm by neurosurgeon Henry Marsh; Paul Kalanithi’s When Breath Becomes Air; Fragile Lives by heart surgeon Stephen Westaby (whose next book, The Knife’s Edge is just out); This Is Going to Hurt by Adam Kay; The Language of Kindness by nurse Christie Watson; War Doctor by the humanitarian surgeon David Nott – the list goes on. It is as if the medical profession has all of a sudden found its voice. Many of these memoirs have won prizes and several were bestsellers: Kay’s has been in the top 10 for 19 months.
Molly Case joins their ranks next week with a powerful account of her life as a cardiac nurse, How to Treat People. She has a theory about why there is such an appetite for dispatches from the operating theatre and the intensive care unit, where matters of life and death are part of the daily round. “Modern life is so frantic and everybody is so busy clicking things online and rushing around that there’s this collective need for introspection. People want to look inward at their bodies and minds. They want to unpick how society works and find out what makes the people looking after them tick,” she says.
Case first caught the public eye six years ago as a student nurse, aged 24, when she performed her poem Nursing the Nation in front of a packed auditorium at the Royal College of Nursing’s annual congress. Her electrifying recital, with its battle cry “Hear us goddamn roar”, received a standing ovation and has been viewed almost half a million times on YouTube. Case went on to perform her poetry at the Glastonbury festival and across Britain and Europe. Her debut collection, Underneath the Roses Where I Remembered Everything, was published in 2015.
What got her up on her feet that day at the RCN congress? “I was frightened and demoralised, going into my second year of training for a profession in which I saw people who really couldn’t work any harder being relentlessly criticised in the media. I felt it was time we stood up and told people just how wonderful we are,” she says. Her memoir has quite a different feel. Rather than an angry call to arms, it is an eloquent homage to the NHS and all those who work for it; a hymn to the art and science of nursing itself. “I wanted to celebrate this incredible career I feel so joyous to have and the amazing community of people I work with,” she says. The book is a personal story, too, which tells the tales of patients she has known. And threaded through it is a love letter to her father, the veteran music journalist Brian Case, whose failing health brought him into Case’s own cardiothoracic ward for a heart bypass last year.
Case no longer feels the need to defend her profession; the detractors who disparaged NHS workers a few years ago have melted away. “It’s a different time,” she says. “The popular press view us as the good guys now. I think that is partly and unfortunately due to terrorist attacks all over the country and horrendous events such as the Grenfell fire. These atrocities have revealed the worth of public sector workers – nurses, doctors, paramedics, firefighters – who seem to have their heads screwed on, while the people who are supposed to be leading us are in meltdown.”
How to Treat People is not overtly political but implicit in the stories Case tells is just how difficult her job has been made by 10 years of austerity. “Staffing levels are frightening,” she says. “Too often there are too few staff not only to do the job you’re there to do but to do anything above and beyond. My job is really incredibly simple. It sounds corny but I’m there to help people, to care for them and make them feel better. It’s not rocket science. Not be able to do that is frustrating to say the least. The job is busy, your bottom doesn’t touch the chair, you’re on your feet for 12 hours, which is fine. I enjoy that way of working but if you have too many patients you can’t provide anything extra. You can’t even offer them a wash in the morning, one of the most basic fundamentals of care.” Even worse is when what she is doing feels unsafe: “You catch eyes with your colleague on a short-staffed shift and you both know that you are flying by the seat of your pants and you are lucky that nothing has gone wrong. It’s so depressing and this is why nurses are leaving.”
I ask her if she ever thinks of giving up. “God, no. It’s such a privilege to do this job. It’s the opposite of selfless for me because of the enjoyment I get doing it. I get a huge buzz from people trusting me and allowing me to make them feel better. There’s nothing like it. And it’s great as a writer because you get so many ideas.”
It’s no great surprise to learn that this accomplished writer has a first-class degree in English and creative writing, from Bath Spa University. She only decided to train as a nurse halfway through her studies, after taking a part-time job in a care home for elderly people. “I’d only ever worked in coffee shops before; I’d never had experience of looking after people and I found I loved it. It was so formative. I adored talking to them, being with them, hearing their stories, helping them to go to sleep, tucking them in,” she says. Eight years on, she has just become a nurse specialist in inherited cardiac conditions. It is tough, not just on an emotional and physical level. “You use your brain all the time. People don’t realise how intellectually challenging it is. You’re making difficult decisions all the time.”
Do writing and making poetry help her to process the psychological demands of the job? “It’s more positive than that and more exciting,” she says. “Poetry for me is what I assume drug-taking must be like. It is a buzz, it is a hit. If I have a new poem or an idea for one in my head I don’t want to eat, I don’t want to sit still, I don’t want to sleep. Having an idea marinating in my head is absolute joy. I’m so grateful that I have writing in my life.”
Case’s literary influences seem surprising – until you listen closely to the recurring rhymes and rhythms of her verse and the penny drops. “I grew up on a smorgasbord of hip-hop and rappers,” she says. “I used to think, come on, I’m a white middle-class girl from Bromley, this isn’t supposed to be my music, it’s not been made for me, it’s not my story to tell. But still, I was hugely drawn to the literary devices and poetic techniques of these artists and the seductive quality of the way they rhyme and I still very much am.” Favourites include Eminem, NWA, Common and Kate Tempest. And How to Treat People was partly inspired by listening to the same album over and over again: Colouring Book by Chicago artist Chance the Rapper. “It’s very spiritual. It really is absolute poetry, and when he performs it is often very stripped back, like spoken word. His music has brought me so much peace and joy and excitement and inspiration.”
Nursing, however, provides the most inspiration of all. “It was my big challenge to myself when I started training – could I be both a poet and a nurse? And my answer is yes. On the wards, I see poetry in the everyday, day after day.”
