Shadows in Wonderland: A Hospital Odyssey

23 Apr 08

This is his account of cancer, of hospitals, and of what it feels like to lose confidence in your health.

It is a book that you can either dip into or read from cover to cover and it has been well received in critical circles as an expose of the NHS and metaphor of the state of the Nation.

At one level, it certainly does deliver these two objectives, though not in an especially coherent way. At another level, it is an effective and emotional account of one man’s journey.

At a third, it is a mish-mash of banal memories and borrowed ideas. Sometimes, all three come together, as in his account of what it felt like to have his car clamped whilst trying to deliver his wife (who also had cancer) at the appointed hour for an MRI scan: ‘Now, however, confronted by a clamp on my car, a fine I can ill afford to pay and an aggressively unpleasant security guard, I am suddenly struck by the feeling that life really is unfair and that the whole world is against me.’

Ludlow’s experience of the NHS is largely that of good people doing their best within an organisation that overwhelms all good intentions with obscure and unfathomable rules, that no one individual (not even the consultants) can defy.

His literary hero is Kafka and he argues convincingly that hospitals are no longer places of healing, recuperation or rest but ‘non-places’ through which patients pass to receive interventions or procedures.

Starved of the basic comforts of life – natural light, food and touch - the patient becomes dehumanised and the institution takes over.

Hospice or super-hospital? Super-specialist or holistic practitioner? Treatment of the disease or care of the individual?

Quoting Voltaire and Solzhenitsyn, Ludlow argues strongly that we need generalists to treat the whole organism and ‘avoid patients being passed from specialist to specialist like a basketball’ and to integrate care in the interests of the patient, not the institution – quoting here ‘the bridling insistence of the Royal Free’ that he should have a further barium meal, rather than obtaining and accepting the results he had at the Middlesex Hospital.

Odysseus took ten years to reach Ithaca.

This hospital odyssey has no obvious destination, but his journey and that which he charts for the hospital that ultimately saved his life, is thought provoking and honest.

Dr James Heathcote

Rating: 4/5