Gavin Francis's Reading List

"Because it’s a beautiful read and because it conveys in spare, unromanticised prose the lifelong love affair that Nicolson has with these islands in the Minch, between the Scottish mainland and the Isle of Lewis – which were given to him by his father. Nicolson’s father had bought them from a man who bought them from Compton Mackenzie of Whisky Galore fame. Along the way Nicolson digs down into the cultural origins of all that fascination we’ve been discussing, and he ranges over the history , geography, archaeology , biology , and politics of the tiny little archipelago itself. It opens with a discussion of the question, ‘who can say they really own the land?’ And then moves on into an examination of a question very close to my heart: what the word ‘remote’ really means in the context of islands, and what can we say of isolation, when an ‘isolated’ community in such a place has to be very close-knit in order to survive."

"Souhami does something very interesting with this book; first of all, she examines the story of Robinson Crusoe , which has somehow managed to hold onto its power and fascination through the centuries, and then she sets out to write a biography of Alexander Selkirk – whose story of being marooned in the early 1700s in the South Pacific largely inspired Defoe’s tale of Crusoe. Selkirk was a leatherworker’s son from Fife, just a few miles down the coast from where I grew up, and ran away to sea at a young age. Through a great deal of archival research Souhami reveals all sorts of details of Selkirk’s life, and what life was like in general for mariners and pirates in the south seas in the eighteenth century. It was a life consisting of almost unimaginable ordeals of discomfort, but there was also, through privateering against Spanish vessels, the opportunity to win great riches. Support Five Books Five Books interviews are expensive to produce. If you're enjoying this interview, please support us by donating a small amount . Souhami manages to tell Selkirk’s story with a focus being the island itself. In Defoe’s story, Crusoe lived on his island for something like 27 years, while Selkirk was on his just 4 years and 4 months. She talks about how he was almost captured by Spaniards two years into his experience, and there are very moving accounts of his rescue that she unearths from the (British) sailors who ultimately brought him home. Anyone interested in the background of Crusoe, and how they might survive on a desert island themselves, should definitely read this book! Defoe was prolific – he published sixteen other pieces of writing in 1718, the year Crusoe came out. And the appeal is I think at its heart because we love to imagine how we’d cope in his abandoned situation. It would be a terrifying one to be caught in, but it remains so appealing because it combines something quite frightening – being marooned – with something that many people also fantasise about – being left on a beautiful tropical island. What would it be like to cut yourself off from every single obligation in your life? How long would it take you to get bored? The tropical island is a stock image in our culture – it stands in for holidays, for rest and relaxation, for luxury, and reaching such a place is a shorthand symbol of success. Crusoe’s story also overlaps with other great myths – with the Garden of Eden, for example, or with the story of Odysseus marooned with Calypso. These undercurrents of other great stories run just under the surface with Crusoe, and to my mind they are a large part of why it continues to hold such power."

"When I was writing Island Dreams I wanted to look more closely at the kind of fairytale island fantasies that we’ve just been discussing with Crusoe , and in the book I describe a fair few islands that I’ve been to that really are like that – beautiful, tropical, with palm trees and beaches of yellow sand. But one of the principal themes of Island Dreams is the allure of isolation, and nowadays for that you’re likely going to have to set out for more temperate or circumpolar islands – not tropical ones. Ritter was a German woman living in a trapper’s hut with her husband on the north coast of Svalbard during the years when Germany was sliding towards fascism – you get the impression she was pleased to leave. Her book is still in print after almost 90 years because it’s so unusual to have a woman’s perspective on these landscapes – all travel writing of that era, but polar travel writing in particular, is so dominated by male perspectives. And Ritter writes with such eloquence about the beauty of polar isolation. She loves it there on the edge of Svalbard, the edge of Europe, looking out towards the north pole – and her husband spends much of his time away hunting so she’s alone. She revels in that solitude, and thanks to her beautiful book we’re able to experience it second-hand."

"Schalansky is a designer to trade, and this book is an extraordinary testament to her skill – very plain, bold colours, printed in black, blue and orange ink, it takes the reader through a personal library of remote islands that really are remote – the likes of Bouvet island, where there was a nuclear bomb tested that almost went unnoticed, or even Juan Fernandez, where Selkirk was marooned. Each island gets a new map and has an accompanying text. To be honest, to my mind the accompanying texts are a little hit-and-miss in terms of their appeal, but the map images are so gorgeous that the pleasure of flicking through the book isn’t impacted at all. Yes of course! There’s a secret tribe of us cartophiles out there, flicking restlessly through atlases, admiring places that we’ll never actually manage to visit in real life, but which nonetheless hold us spellbound within the pages of the atlas. Lawrence has such a jaundiced eye; he once wrote from the French Îles d’Hyères I don’t care for islands, especially very small ones. That short story is a kind of warning, I think, about the egomania that can be implicit within the desire for solitude. Because Lawrence’s protagonist is a rich man who owns his own archipelago, and has the resources to buy ever more remote islands, there’s nothing to stop him sinking into a kind of misanthropic frenzy. I’ll just add below a little bit about the story that I wrote into one of the conclusions of Island Dreams : There’s an unwholesome puritanism about Lawrence’s island lover, the rich man seeking his protected domain with the kind of obsessive intolerance that turns loyalty to bigotry, love into hate. His love of islands leads him to abandon family and friends, to seek doom and oblivion. At the end he dies muttering: The elements! The elements! I think Lawrence’s protagonist becomes a kind of Kurtz-like figure, and like Conrad’s story about the Congo , it’s a cautionary story about the terrors that can be unleashed by the ego when it can pursue whatever it wants, unrestrained. Which brings me to another theme of Island Dreams , which is the idea from psychotherapy, and in particular the writings of Donald Winnicott, that we all need a measure of isolation in order to retain our psychological and emotional health. Too much isolation and we become insulated to the world (Winnicott’s distinction), but with recourse to isolation we have the opportunity to pause, reflect, recharge, and be better versions of ourselves."

"Whenever you start thinking about a subject, I’ve always found it a good principle to go back to the very beginning of what has been written about it. The Hippocratic writings were collected in the library in Alexandria around 300 to 200 BC, maybe even later. Essentially they are writings on medicine from across the Greek world that were deemed to have reached a certain standard. They are very varied, and from all sorts of different authors. I am no classical scholar, and I cannot make any comment on the translations, or even the cultures that they come from, but I really enjoy looking through them because you can see how intellectual curiosity was already working hard. Some of the Hippocratic writers are intensely trying to figure things out. One, for example, is confused about whether all the liquid you swallow goes down your oesophagus or whether some goes into your lungs. So he restricts a pig from water until it is very thirsty and then he gives it water with blue dye in it. And then he does something any butcher would be familiar with, but not many doctors: he slits its throat. He reports that if you follow what he has done, you will notice that some of the blue water goes down the trachea. And he has a whole theory as to why that is, what that tells us about the mechanism of swallowing. Yes he’s genuinely interested where that water goes and there is proper method. You can see constantly as you go through the Hippocratic writings how they’re reaching for answers. This is from a passage about the heart: In shape the heart is like a pyramid, in colour deep crimson. It is enveloped in a smooth membrane. In this membrane there is a smooth fluid rather like urine, giving the impression that the heart can move in a kind of bladder. The purpose of the fluid is to protect the pulsation of the heart, but there is just about sufficient of it to alleviate the heat as well. Amazing! it’s a completely perfect description of the pericardium, whose purpose is to lubricate the beating of the heart within its sac — though not to draw off heat. The writing can be extraordinarily poetic as well. Here, for example, the author has just opened up the ventricles of the heart and looked deeply into its chambers: These are the springs of Man’s existence. From them spread throughout his body those rivers with which his mortal habitation is irrigated, those rivers which bring life to man as well for if ever they dry up, the Man dies. Beautiful and completely straightforward! Not at all. That doesn’t come until 1628, although Galen was getting close to it. But there is an enormous amount in these writings about the effect of the environment on your health, and how the humours within the body are affected by the climate within which you live. It’s written, for example, that drought is more healthy than rain, and less likely to provoke fatal illness. The diseases usually peculiar to rainy periods are chronic fever, diarrhoea, gangrene. You can see they’re trying to reach out and put together some sensible ideas about malaria, diarrhoea in places without adequate sanitation and so on. Yes! The precepts, for example, recommend that you not overawe your patients with splendour of your dress. Be sombre and sober in your style. Use a cheap case, don’t wear a fancy hat. And then there’s a wonderful line: you must not force payment from a patient unable to pay, because your reputation will be higher for treating a patient who cannot pay you. Your dedication and devotion to the art is more important than whether you get paid. Beautiful! “Before there was even a profession such as medicine, there is writing with a scientific appreciation of the body and how to make it better” So right there at the beginning, before there was even a profession such as medicine, there is some writing with a scientific appreciation of the body and how to make it better. There’s no dogma here, because they’re constantly asking, try this for yourself, prove me wrong! And there is also the beginning of a professional ethic about a group of people who should hold each other to high moral and clinical standards. A few of the writings complain about quacks, who rip people off, and don’t pay attention to the high standards. There’s another ancient text I could have mentioned: Galen’s That the Best Physician is Also a Philosopher . It’s essentially a call to arms for doctors to concentrate on the perfection of their clinical skills and to give up on ideas of attempts to get rich through their art. It shows all the ways in which he doesn’t trust those doctors who use their talents for a gain other than the benefit of their patients. It is short and elegant."

"I think it’s a really important piece of writing just because it’s so beautifully executed. That said, it does lose its way about half way through, and Woolf goes off in pursuit of some enthusiasms that I don’t share. Maybe that’s because I’m not living in 1920s Bloomsbury. I respect Hilary Mantel’s point of view: her essay is about being really very ill whereas Virginia Woolf’s essay is about having a touch of the ‘flu, and they’re two very different things. But Woolf asks a profound question: why don’t we have a greater literature of illness? Exactly! She writes Novels, one would have thought, would have been devoted to influenza; epic poems to typhoid, odes to pneumonia; lyrics to toothache. But no; with a few exceptions — De Quincey attempted something of the sort in The Confessions of an English Opium Eater ; there must be a volume or two about disease scattered through the pages of Proust — literature does its best to maintain that its concern is with the mind, that the body is a sheet of plain glass through which the soul looks straight and clear, and, save for one or two passions such as desire and greed, is null, and negligible and non-existent…People write of the doings of the mind; the thoughts that come to it; its noble plans; how the mind has civilised the universe. They show it ignoring the body in the philosopher’s turret; or kicking the body, like an old leather football, across leagues of snow and desert in the pursuit of conquest or discovery… I think she’s put her finger on a real issue that, in 1922, literature needed to more closely address the transitions in experience that being ill can effect. And maybe the problem is because there are so many different ways of being ill. It’s as Susan Sontag wrote: “Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.” And when you are given a diagnosis it can be liberating, because your illness has a name, and it becomes something outside you that others have suffered before. But it can also feel as if you’ve been handed your passport for the kingdom of the sick. You move amongst all the people who are well, but you no longer feel you are any part of them. John Donne also wrote very well about illness 400 years ago. “Disease hath established a kingdom, an empire in me, and will have certain arcana imperii , secrets of state, by which it will proceed and not be bound to declare them.” It’s like an evil empire is slowly colonising his body but he doesn’t understand the rules by which it’s operating. A deeply disturbing aspect of illness that we consider our bodies to be ourselves, but then you get a diagnosis like a tumour…and suddenly you think, my body is no longer myself. I’m up here, above the neck perhaps, and it’s down there, the body is in mutiny and I need to surpress it. Illness can disassemble us, split what we consider ourselves."

"John Berger was an astonishingly skilled and observant witness of anything he turned his gaze onto. He started out writing on art for the New Statesman in the 1950s and his essays there are extraordinary. They were so original, so new, they made people look at old paintings in a completely novel way. When he turns that genius onto the doctor-patient consultation he picks out some of the many levels of non-verbal interaction that go on in an everyday medical consultation. They’re revealed in all their subtlety. And it’s a portrait of a man he loved, the doctor John Sassall. A Fortunate Man opens with six observations of Sassall working among his patients in the Forest of Dean in 1966. Berger describes beautifully how the doctor himself has to constantly change what kind of person he is depending on what patient he’s dealing with, and what that patient expects. Sassall allows himself to be a chameleon, to become the doctor that he thinks that patient most needs. And I think that is one of the hallmarks of a really effective practitioner. Does the patient need a warm, friendly, arm on a shoulder, or something more informal and jokey, or more of a patriarch, or do they need a scientist to lay out the statistics? People at different phases of illness need different kinds of doctors. I think Berger captures that. The book becomes an extended meditation on the practice of medicine, which is an attempt to engage a deep sense of fraternity. Berger keeps coming back to this word: the doctor is like an elder brother — not a father figure — and we want the doctor to witness our suffering. There’s a beautiful meditation on the idea that in times of extremes, of dying, the value of the doctor is not just the morphine they prescribe, but that they have seen many others die before. He explicitly says that this is a benefit the clergy once provided by the death bed – not absolution, but witness and having witnessed others die. This is, in a way, so obvious: when you practice medicine you realise that this is what a lot of people need from you. But it’s rare to have it articulated so well, so concisely. Mohr and Berger lived with Sassall for six weeks, and were with him for every patient visit during that time, even on night calls. And Berger said of Jean Mohr he’s the perfect photographer for that, because he’s completely invisible — like a lamp stand! Patients wouldn’t even notice him taking pictures of them. The two men went back to Geneva and worked independently for a month on the project, and John was dissatisfied with the results. He thought they’d both tried to tell the story on their own, and realised they had to go back to the drawing board and make the words and the pictures into a conversation. And they succeed brilliantly. As you read the book, your appetite is whetted by a bit of text and then it’s satisfied by a photograph, which raises other questions, which the text goes on to explore. It’s very beautifully done. I never met Sassall – he shot himself in 1982. I was contacted by his son Simon, and we met. He was very open about the fact that his father was a troubled man who suffered extreme swings of mood. Sassall’s wife had always helped him through those periods and she died in the late 1970s. The reason Berger calls him a ‘fortunate’ man is because he gets to do exactly what he wants, which is to pursue his dream of the universal — of what is it to attempt to become a kind of renaissance man or woman in the twentieth century. This is, of course, not possible in the way it was in the fifteenth century: there are simply too many areas of knowledge to cover. But it’s still possible to pursue a passion for trying to understand as many different human perspectives as you can. Sassal wanted to be with and to help as many different kinds of people as he could in a particular restricted community. I don’t want to comment or theorise about Sassall’s suicide. But I don’t think the fact of it detracts from Berger’s position — that Sassall was pursuing exactly what he wanted to pursue. And that’s the point that Berger makes in his epilogue – he respects Sassall’s decision, and admires that he held on ‘for as long as he could.’ A lot of people who have lost a loved one to suicide will take exception to Berger’s conclusion: he transforms the act from one in which those of us left behind agonise over what we could have done differently, to one in which we feel gratitude that he or she stayed with us as long as they could. Support Five Books Five Books interviews are expensive to produce. If you're enjoying this interview, please support us by donating a small amount . Berger writes “John Sassall, the man I loved, has killed himself and yes his death has transformed the story of his life. It has made it more mysterious, not darker. I see as much light there as before.” How do you take something positive out of a suicide ? But Berger manages it, by asking: what if we look at it like this? What if we’re just grateful for the years that we had? And yes maybe it means I didn’t understand him as well as I thought I did. I loved that man, but I didn’t know him as I thought I did. “The book becomes an extended meditation on the practice of medicine” It reminds me a little bit of a wonderful paper, published in The Lancet in 1917/18 by W. H. R. Rivers, the psychiatrist who treated Siegfried Sassoon and Wilfred Owen. He talks about how he developed a technique at Craiglockhart, which at the time was very new, of trying to find a redeeming feature of the horror that the men had experienced in the trenches. He gives the example of a man wracked with panic attacks and flashbacks of a going out onto the battlefield and finding his friend blown apart by a shell and trying to gather the bits of his friend together and his personal effects for his widow. And he’s tortured by this memory. Rivers says, well we can’t suppress the memory but we can perhaps find some aspect of that awful experience that’s positive. Many people in the trenches died slowly, and in great pain, but this man obviously didn’t, he was killed instantly. Rivers reports that when he put it like this the man’s expression changed straight away, and from that night onwards his nightmares stopped. When dreams of the event came back, they didn’t have that same horror. The man found he was even able to talk with his friend in dreams. Rivers insists that it’s possible to take something very dark, and find in it some aspect which is tolerable, or redemptive, and switch your perspective on it."

"Anatole Broyard was editor of The New York Times book review – a highly literate man, linguistically brilliant and a wonderful prose stylist. He was diagnosed with prostate cancer fairly young. This book is a collection of essays he published in the The New York Times about his illness. He has a gentle irreverence about the medical process which is comforting after you’ve read a lot of medical memoirs. He says things like: “My first urologist, who was quite famous, wanted to cut off my testicles but I thought this was admitting defeat right at the outset.” And then he describes all the terrible things he had to go through to get his prostate cancer treated. He says, I would like a doctor who is not only a talented physician but a bit of a metaphysician too, someone who can treat me body and soul. “To get to my body my doctor has to get to my character. He has to go through my soul. He doesn’t only have to go through my anus.” Oh yes. He writes a penetrating account of what it’s like to have a bone scan, looking for metastases of your cancer. He writes about what’s going through his mind as he lay under a huge machine that scans all your bones looking for ‘evidence of treason’. “There’s a horror movie appeal to this machine. Beneath it, you become the Frankenstein monster exposed to the electric storm.” I appreciate this book for its irreverence, the elegance of its prose and because the essays in it are succinct, punchy, with the tyrannical discipline that newspaper journalism has to have. And I like the idea. Yes, he writes I want doctor who is a good reader of illness. I cling to my belief in criticism, which is the chief discipline of my own life. I secretly believe that criticism can wither cancer….When you die your body dies with you so I want a metaphysical man to keep you company. I want a doctor with a sensibility, and that seems almost like a contradiction in terms. Many books on illness tell the reader about the waking life of the cancer patient but not about daydreams or fantasies, or how illness transfigures you. Broyard writes: You wouldn’t know that inside every ill person there’s a Kafka character, a Han Castrop trying to get out, But there are books about illness that are too eloquent, full of chanting and dying falls that piously sound as if they were written on tiptoe. To be ill is to be an odd mixture of pathos and bathos, comedy and terror with intervals of surprise, and to treat it too respectfully is to fall into the familiar traps of Romantic agony. That idea of the pathos and the bathos is a lovely one, and it’s very close to my own experience. Sometimes medical consultations can be really humorous, funny, and I find myself laughing with my patients about the absurdity of the human situation. That you can have all these best laid plans about how your life is going to go and then — wham — 55, and you’ve got metastatic prostate cancer. And of course that’s a terrible terrible thing, but it’s a natural human thing to turn situations of high tension into comedy, because that’s how we cope. And that’s what I love about Broyard. He does it with such panache."

"This book is about the poet Kathleen Jamie’s diagnosis, treatment and recovery from breast cancer. She describes in the introductory essay how she had a mastectomy and was a tired of the medical gaze as experienced in all her clinical consultations, and wanted to have a contrasting kind of gaze. For friend of hers, the artist Brigid Collins, she sat for a series of portraits of her mastectomy scar. And in the eyes of the artist the scar becomes all sorts of things. It becomes a horizon. It becomes a rose stem. It becomes the line of the seashore. And it was during this process they began to feel there was an imbalance there. Jamie needed to write some poems too to accompany the painting and sculptures. And so she begins to write short prose poems, mostly about the process of healing and the transformation that comes about in her own sense of herself during a protracted period of convalescence. Jamie accomplishes what Virginia Woolf was lamenting that we don’t have. Get the weekly Five Books newsletter She writes about her summer of convalescence where nobody asked anything of her for the first time in her life. Nobody expected anything except that she walk and read and heal. And how that time to heal is such a great gift. So it’s a book which is utterly original and gets at something very real and valuable about convalescence. Sometimes I find myself recommending it to patients. Of course I recommend books with titles like How To Manage Your Anxiety . But I have had conversations with women who have mastectomies about Jamie’s book, for example. I’ve had conversations with men who’ve had prostate cancer about Broyard. There’s an amazing essay written in the 1970s by Ursula Le Guin about menopause called The Space Crone . She urges women to claim menopause as a valuable transition in life, a liberating transformation, something like an opportunity to be grasped, and I’ve recommended it to women going through menopause. I’ve known people suffering PTSD after military deployment in Afghanistan, and have recommended they read Redeployment by Phil Clay. Generally no. Medicine is a very different world to publishing. There’s something about medical training that is so taxing in the early years that often other interests get pushed out. I don’t know. I think writing and reading is a source of solace and it fuels my enthusiasms, and always has. At high school they gave me prizes for English and for Biology , and it always felt as if they were two things I could combine. Chekhov famously said literature was his mistress, and medicine his lawful wife. But that seems an odd way to put it. For me they are complementary. They support and nourish one another, and the relation they bear is not one of rivals, but more like the left and the right foot of a steady gait."