Several years back my old family GP gave me a book on late Pre-Raphaelite art. He was an ‘old family GP’ in the sense that likely doesn’t exist much anymore. He had helped three generations of my family pretty much literally from cradle to grave. And in that other sense that also likely doesn’t exist anymore, he knew my family well enough to know that I was about to start a MA in History of Art and would be studying Victorian art. So he packed up this giant art book in a brown paper envelope and left it at the surgery reception for me to collect. When I thanked him and promised to return it (viewing the exchange as a loan) he insisted I keep it saying that, to be honest, he’d never really understood it anyway.
On some level I was quite shocked by his confession. At society’s dinner table we position a little card saying ‘seriously fucking clever’ next to the place setting of a GP or doctor. We expect them to know everything from how to diagnose breast cancer to the reception of Millais’ commercial paintings in 1863. Spelled out, that seems absurd: why should a GP know anything about art?
The reason is, as Viv Gordon’s Pre Scribed (a life written for me) demonstrates in alarmingly realistic detail, the type of student who goes off to study medicine at Queen Mary aged 18 has already been expected to know everything. The slow and steady march towards a sparkling UCAS application, for a certain type of person, starts way back in secondary school (if not before, depending on parentally sanctioned tuba and ballet lessons). It’s not enough to be good at human biology and a wiz at statistics. The conveyer-belt medical student is going horse riding on a Saturday morning, volunteering with St John’s ambulance on a Saturday afternoon, revising for extra-curricular French on a Sunday and considering early entry for a Classics A Level as, you know, a bit of fun to make them “well-rounded”. They need to know everything before they’ve even graduated or actually got on the university course in the first place.
And whilst some might still find it hard to muster up sympathy for a life that to those on the outside seems blessed with every middle class accoutrement, the sad truth is that not only is all this Not Very Fun, it’s about to get worse. Very much worse.
Gordon’s work is partly based on the statistic that out of the 65,000 registered GPs in the UK, one in five experience some form of anxiety or depression. The statement by the character in Pre Scribed that there is a huge amount of stigma attached to GPs admitting such problems also indirectly suggests that the number is much higher.
With a tone of voice that almost dares you not to describe the speaker as ‘capable’, ‘measured’ or ‘poised’, Gordon is all too believable as a General Practitioner. She wears soft-wash pink jeans which walk such a close line to ‘chinos’ that they share as much in common with 70s ‘shrink your Levis in the bath’ as Jeremy Hunt does with Florence Nightingale. You know that she buys them from White Stuff (but would have chosen Boden if she had a surgeon’s salary) and matches them with a darker pink printed top to show to the world that not only does she know how to make you feel better, she also knows how to appear inoffensively feminine yet never, ever, sexualised. For other examples of this mode of dressing see: teaching staff. She is perfectly self-contained to a level that, ironically, completely suppresses any sense of her as a human with a body that, well, functions.
In art history (see, I did read the book) the nude is discussed in relation to its edges and containment. Kenneth Clark famously discussed the beauty of the classical nude as relating to the meticulously controlled lines that effectively shrink-wrap it into a palatable object to be viewed by the connoisseur. Feminist scholars vehemently dispute Clark’s views on the nude, pointing out that this version of the female nude relies on containing and sanitising the female body so that it can be consumed by the outsider viewer as something entirely divorced from the messy, fleshy internal functioning of the real-life body and mind.
In her middle-class uniform, Gordon’s GP is contained in a similar way to the female nude. None of her inner thoughts or malfunctions are allowed to seep out her pin-tucked edges. And like the female nude, she needs to be like this mainly at the decree of other people. Her patients need her to be the mother that no longer exists to give them Calpol. Or they need her to be the one with scientific certainty in an uncertain, swirling world. They need her, on a occasion, to be the one who can quantify their depression via a handy points-based questionnaire to asses whether they are fit to return to their stressful job or not.
Yet Gordon’s GP (and all those she represents) needs more than a questionnaire and some Citalopram to make her life better. What she needs is to be working as part of a system that is not chronically failing both those that work within it and those that use its services. At one point in the show the character states that no politician wants to be the one to admit “the NHS isn’t working”. So instead they keep just about propping it up, like in those family photos from WWI where you don’t realise until too late that the man pictured in the uniform is actually already dead – and only then understand the real weight of the situation.
It sometimes feels like there’s a taboo against saying “I believe in and support the NHS, but also see that it is failing”. Instead you’re meant to say, “I believe in and support the NHS, and think that everything about it is great and they’re all SUCH ANGELS”. The second viewpoint is well-meaning, but also potentially counterproductive. Honestly admitting that the service is in a huge amount of trouble is not a sign of lacking support for the NHS; it can actually be the opposite. Supporting the professionals who work for it and ensuring good medical care for those who need it can only really happen if we’re willing to see the NHS as it really is and then have the necessary discussions about, you know, levels of tax and all those other things people and politicians would rather avoid.
The GP in Pre Scribed is not an angel. She’s a fallible human being who worked excessively hard to get where she is. And she, like the system, can only take so much before she really breaks.
Pre Scribed (a life written for me) is on as part of the Feel It festival, a series of events exploring breathlessness and pain organised by the University of Bristol. Click here for more details.