Adventures in Human Being
is a title chosen by Scottish travel writer and GP Gavin Francis for his book about the human body and our experience of being residents in it. He takes a different line on this from Bill Bryson, who in The Body: A Guide for Occupants
(Doubleday, 2019) aimed to describe and explain human physiology and pathology in as clear a way as possible for readers today. Gavin Francis highlights the various parts of the human body and its anatomy, but supplies a wealth of cultural and historical background as well and what it all means for a practising GP and his patients.
Adventures in Human Being
(Profile Books/Wellcome Collection, 2015) is one of a growing selection of popular 'medical' books on the market – on the experiences of hospital doctors and general practitioners, of surgeons and theatre nurses and care home staff. There is, too, a wealth of television output about hospitals, their patients and staff, medical and emotional outcomes both happy and sad, and each feeds off the other. Yet Gavin Francis manages to give an original twist to these many adventures in human being that makes his work well worth reading.
He says that it all started when he was young and got fascinated by maps and exploration. Then he discovered that the human body had an even more compelling geography of its own, and trained to be a doctor. His love of remote places, however, never left him, and later, as a qualified doctor, he went to Antarctica as team medic to the British Antarctic Survey. His love of geography and distant places never left him, as a recent book called Island Dreams
(Canongate, 2020), subtitled 'mapping an obsession', confirms.
In Island Dreams
, he examines the appeal islands have for and in the human imagination. For him, islands bring out the contrast between isolation and connection. They offer the chance to find 'an authentic self' for which most of us aspire. The experience, direct or through reading or television, may well then be therapeutic: it may open up new perspectives of self and of the external world, and it may also help the process of forgetting and of sorting things out in the mind and memory. 'Islands offer emptiness, time and space for contemplation… the opportunity for healing.' The dynamic between isolation and connection is one we all feel. He knows what it was like to be both far from people and surrounded by them, and know that this is a feeling everyone has at one time or another.
An early book, True North: Travels in Arctic Europe
(Polygon/Birlinn, 2008) is one in which he travels alone to Shetland and the Faroes, Iceland and Greenland, Svalbard and Lappland. He is often alone, open to encounters with wild characters and wilder places, impelled by his personal vision of the 'far North'. 'The northern fringes of Europe were once the edge of the world, a back-country of the imagination where reality and myth intertwined.' He ends up where he started, at Cape Wrath, feeling 'more grounded'. What in fact we would expect from a traveller's tale – after the excitement comes the reflection, both shared generously with the reader.
Yet Gavin Francis is also a doctor, one for whom medicine is not only a professional vocation but one blended and enriched by the cultural history surrounding medical knowledge. He is as much interested in medicine as such as in the social and cultural context within which it has developed and where it is applied. Being a travel writer and a doctor in a busy Edinburgh practice, he knows just what it's like to experience both isolation and connection. Living in a big city, he now regards his small family as a kind of urban island.
Human beings have always found islands very special – they are places of sanctuary and safety, of fear and loathing if we're imprisoned on them, places where dreams flourish and die. We all remember Robinson Crusoe (reframed by Diana Souhami's book of what it's really like), Easter Island with its mesmeric statues, Elba and Napoleon, Pitcairn where dreams of freedom turned to murder, and St Kilda with its lure of inaccessibility. Gavin Francis followed up True North
with a book about a different type of 'island' – living in a small group of people in the remotest place of all – Antarctica.
Empire Antarctica; Ice, Silence & Emperor Penguins
(Chatto & Windus, 2012) reveals a writer interested as much in the pragmatic science as in the explorative imagination. Many writers have gone there before, notably Sara Wheeler, but Gavin Francis again makes the experience special. He takes his responsibilities as team medic seriously as he must, knowing he might have to deal with everything from the common cold to a heart attack or appendicitis. He records the changes to his own body from the constant cold and the relentless darkness.
Towards the end of his time there, he feels 'the itch to leave', get back among people again, and reflects on the sacrifices of isolation: 'giving up all the richness of life in community' and 'abandoning diversity for the sake of something simpler and purer'. The recurring theme of isolation and connection.
He is medical scientist enough, however, to concentrate on his job, on the most effective role he can take to help the team, and how it is that the Emperor Penguin manages to survive and flourish in such a harsh climate. Like Cherry-Garrard back in the days of Shackleton and Scott, he is drawn to these penguins, and writes about them, and the seas and ice-fields around them, as a true naturalist. It is not by accident that he sees Antarctica today through the imaginative lens of those great explorers. The dreams of a boy seem to have been realised as a man.
Back in Scotland after all these adventures, but still clearly planning more in the future, Gavin Francis is now a busy Edinburgh GP. Understandably, the focus of his writing has turned to medical matters. These enable him to explore that theme of isolation and connection from a different vantage point – that of what it is to be a human being (existentially one in which we veer between aloneness and loneliness), knowing we are ultimately alone at death and, for many of us, feeling vulnerably isolated when we're ill. A human being with a physical body where things can go wrong and often do.
Adventures in Human Being
is a book about this, about his experience as a hospital and family doctor, and about the cultural landscape we employ to better understand as creatures the healthcare system treats. 'I'm reminded each day of the frailties and strengths in each of us; the disappointments we carry as well as the celebrations. Beginning a clinic can be like setting out on a journey through the landscape of other people's lives as well as their bodies.' He regards his job as a 'passport or skeleton key to open doors ordinarily closed; to stand witness to private suffering and, where possible, ease it'.
Then came Shapeshifters: on Medicine & Human Change
(Profile Books/Wellcome Collection, 2018), a series of reflections and insights on and into why human beings want 'to transform themselves and how they do it', and the consequences for them. From cosmetic surgery and muscle-building to anorexia and the use of prosthetics, Gavin Francis takes the reader through a series of examples, many in case-study form. He has seen many of them as a doctor. Many may have harmful effects – trying to stay 'forever young', tattoos and body art, the alteration of sleep patterns, bulimia, and transitioning.
He wants to know what motivates us to do this, what medical history tells us about what they thought about it long ago, and how doctors then and now try to deal with the consequences. This topic theme has been approached by other disciplines like social anthropology and consumer research, as in Heather Widdows' Perfect Me: Beauty as an Ethical Ideal
(Princeton University Press, 2018).
Most topical of all Gavin Francis' books is one set in the era of the Covid virus, Intensive Care: a GP, a Community, and Covid-19
(Profile Books/Wellcome Collection, 2021). This describes a year (2020) in the life of a doctor and his patients. Most revealing are the ways in which he, like so many in healthcare as well as in the community, had no idea of how fast and wide the virus would spread.
Again Gavin Francis examines the medical evidence: how the virus affects not just the lungs but the circulation of the blood, the challenges of triage in hospitals and medical practices, the shortages of equipment and the confusion of the policy-makers. An irony emerges that, at the start, we knew very little about the virus, and yet disparage the medical knowledge of earlier practitioners like Vesalius, Galen and Sir Thomas Browne.
For him it is a tale of 'triumph and tragedy', one at the time of writing the book an unfinished story, one in which only if everyone has 'a shared purpose', policy-makers and healthcare workers and the community, in making it work. This is, then, a landscape of the community as well as one of the human body, a narrative about the challenges confronting us all when we live in the bodies we have, and where healthcare cannot fix everything. A deep modesty and accurate self-knowledge informs this book, transient as it must be as the trajectory of the virus moves on.
This is the grounding in authenticity Gavin Francis himself speaks about in his other books, a knowledge of self and others that comes from travelling and reflecting, being alone and being together. Writing books for him is clearly not over, and it's clear that the adventure has many laps still to run. His work is one where landscapes of many kinds merge: anatomical, topographical, anthropological, cultural. His adventure in human being is one all his readers share with him.
Dr Stuart Hannabuss is a writer and reviewer based in Scotland