Paul Main is a retired GP, Honorary Senior Clinical Lecturer, School of Social and Community Medicine, University of Bristol, Emeritus Deputy Director & Associate Postgraduate Dean, Severn School of Primary Care, Health Education South West.
Over the past decade there has been an increasing awareness of the toll that medicine takes upon the mental health of NHS staff. This is particularly true of general practitioners. The author was a GP in Tewkesbury for twenty five years, and this was his first novel, much of it based upon his own experience of depression.
This is a reflective book that works on several levels. The historical and artistic thread of Van Gogh’s last days is woven with the life of a small French village and its doctor Paul Gachet, in the nineteenth century, with a descriptive sensitivity that makes you feel you’re there. The sense of place is acutely observed and described, with a slow pace that has time for the detail that makes the environment rich, as a backdrop for the short time frame over which the events occur.
There has been an increasing awareness of the toll that medicine takes upon the mental health of NHS staff.
The psychological journeys of Van Gogh and his country doctor are empathetically told. Van Gogh’s severe and deteriorating bipolar disorder and the ability it gave him to intuit deeper levels of the psyches of his contacts, illustrates one of the book’s themes of the wounded healer. This is woven into the parallel narrative of a general practitioner suffering a developing and disabling depression in the twenty first century, for whom the outcome is different – because of love. Symbolism sensitively links the two narratives, and the story is woven with poetic imagery.
The character development is a result of acute, compassionate and – at times – humorous observation – the village folk and the events of their lives – the story told with an economy of words, used for maximum effect. Pictures of people we feel we know are painted with an astute and deceptive simplicity, both in the French village and the general practitioner’s practice.
The story is a teaching tale – empathetic description of mental illness from the inside.
The story is a teaching tale – empathetic description of mental illness from the inside, a thread of the difference made to life by love, of the place of the wounded healer and the transformative effect of ‘I-Thou’, subject-subject relationships as a healing process; the importance, in the work of the healer, of that which cannot be measured.
I was left reflecting on the teaching elements of the story long after the book was finished – the interweaving of characters and events, linking across time, was unforgettable.
Beyond the Silence. Andrew Chapman. Pilrig Publishing, 2010, PB, 320pp, £7.99, 978-0-9564421-0-9