Annie Farrell is a GP partner in Liverpool and clinical lead for the psychosexual service at Axess Sexual Health, Liverpool.
I haven’t written a book review since I was at school, never mind a review of a collection of poetry. Like lots of things, spending time immersing myself in poetry isn’t something I would ever give myself permission to do, so it was wonderful to attend the launch of Nicky Carter’s first pamphlet of poetry, The Ghosts of A and E, in Liverpool a few weeks ago.
Hearing them read by the author was a real privilege and took us all to those places captured in the poetry. For those medics among us there were some knowing, understanding nods and glances. We had been there too in one way or another. As far as I know, I was the only psychosexual doctor in the audience and so was able to enjoy a certain smugness of knowing. The poem ‘First Appointment’ particularly resonated:
‘have I got the right notes
referral letters
this place is grim and it doesn’t smell right
but this rooms ok
I’ve got to get something for tea tonight
first patient
new patient
the letter doesn’t tell me much
but she’s so young
I wonder if she’ll turn up’
For me, this captures exactly how I feel before seeing a new patient. And the clinic is grim, and the room still doesn’t smell right!
This pamphlet is a haunting telling of a professional and personal life — with both a glinting clinical eye (sometimes the medical terminology will be challenging for the non-medical reader) but also a raw personal emotional release that seems necessary, as part of recovery and restoration. It is a collection of poems, some of which appear to have a more traditional poetic structure, and some that are more passages of prose telling a story. Like our Institute of Psychosexual Medicine work, these poems often take you to being there with the author — the feelings real and palpable, ‘senses crackle and hiss’ (‘Diagnosis’, line 16) to the point where you feel like an intruder with no business being there at all.
This is about a working life: from early life as a nurse in the locked wards; to the haunting of accident and emergency; to much more personal accounts of her own trauma, pregnancy, and the picture of a loved one coming home from a shift on a COVID ward trying to keep their family safe, and the anger that comes with this towards those who have no understanding of this sacrifice.
“The titular poem … is almost an unbearable read. The subject of nightmares that still haunt 20 years on.”
‘They Gave Us Keys’ is a snapshot into the life of a young mental health nurse on a locked ward. The keys symbolising the heavy burden of responsibility weighing down young and what should be irresponsible shoulders at that time in life. Maybe even then Carter had that seeing and listening skill that made the situation especially challenging, and the responsibility sit especially heavy.
The titular poem, ‘The Ghosts of A and E’, is almost an unbearable read. The subject of nightmares that still haunt 20 years on. The picture of young doctors thrown from one catastrophic situation to another, sharing the terrible load together without any grown-ups to hold them and tell them it’s going to be alright:
‘At some point when the shaking stops, I need to eat. Knee deep in ghosts, I wade to the vending machines, find them empty. I sit among the crowds and cry. By now, there are so many ghosts in A and E, there’s no room left for the living.’
As a GP, the privilege to be allowed to share in the lives of patients, the poem entitled ‘I’ve Never Told Anyone This Before’ mirrored my work as a female listening GP and psychosexual doctor. These women are everywhere in our communities — indeed I still get told about domestic abuse that has been undisclosed and undetected for years. The violence has ceased with frailty but the words are still violent. Women stick it out, in this duty of caring, as described in ‘I See You’:
‘And all those ageing ladies who change the nets and curtains just because its Christmas … carry on with bodily care; tea, beer, Sunday lunch, clean sheets, toileting needs … another time, a better opportunity, might have seen them leading governments, CEOs of overseas charities, engineers, explorers, sculptors carving filigree from stone. Instead they knit the bones of community, sew sinew binding generations’
“I would recommend this pamphelt to anyone, clinicians and non-clinicians alike.”
These are stories that should be shouted from the rooftops but have forever been kept locked away. What would our world look like if these women really were in charge?
Grown into a psychosexual doctor, Carter is in control, a mother figure to young patients confused and carrying their burdens of trauma and humiliation. In ‘Phallus’, the dichotomy of the penis representing domination and ridicule is perfectly captured:
‘How can this tragicomic phallus, symbol of strength, used both to pleasure and demean, be so readily at the mercy of the gods unseen?’
The description in ‘It Still Messes with My Head’ of that patient carrying that trauma to such an extent that:
‘just the thought
of penetration
feels like injury
any touch
a button to fast
forward no
way back’
It is as if Carter has had all these experiences bubbling away and they must now be carved into the page to ensure they don’t continue to carve into the brain. We are instead invited to notice, live these experiences too, and carry them away with us.
The pamphlet does have a hopeful end in the poem ’30 Years a Sponge’. Now retired, Carter has the opportunity to:
‘work on a new self-portrait;
a different set of words and song,
and lots and lots of colour.’
I would recommend this pamphlet to anyone, clinicians and non-clinicians alike. Carter’s intellect and warmth are inspirational, and transport you into these (not always comfortable) situations like a live stream. It is a brave thing to put these experiences out to scrutiny for anyone who cares to look. Illustrating these experiences in such a sharp, concise, but beautiful way is really a talent. Certainly, for me, many of the poems resonated so much, I felt heard, and I hope Carter feels the same.
Featured book: Nicky Carter, The Ghosts of A and E, Yaffle’s Nest, 2024, PB, 34pp, £10.00, 978-1913122546
Featured photo by Annie Spratt on Unsplash.
