Book Review by Nick Goldie
Dear Life, Karen Hitchcock, Black Inc 2016
Readers of The Monthly will be familiar with the medical column written by Doctor Karen Hitchcock: wry, spare, hard-hitting.
Her new book Dear Life is all of these and more. Dr Hitchcock has firm opinions about most things medical, and backs them with clinical evidence and personal anecdote. This book examines the process of aging, the nature of hospitals, the problems of modern medical practice, and the prospect of death itself.
“It’s difficult,” she writes, “for us to think about our own death, except as a kind of puppet show, with ourselves watching as a spectator.” This is a mostly cheerful book, with stories of people and patients she has known.
To start with, Hitchcock addresses the problem of futility. Is it futile to lavish care on an unresponsive patient, perhaps a close relative, who has only a short time to live? No, she says emphatically. Care is a two-way street, and all parties are the richer for it.
She is equally emphatic about euthanasia, and scathing about celebrities (especially Andrew Denton) who claim to be expert in the subject. Doctors, she says, do not have and should not have the right to kill their patients. She uses the word “kill” with intent.
Euthanasia in Hitchcock’s view is always for the benefit of the survivors, the medicos, the relatives. She hopes for a society with the values and resources to say to the patient: “Don’t be scared. We will attend to you, ease your pain, witness your anguish. No, we will not kill you.”
Note the need for adequate resources, as this is another of Hitchcock’s major themes. She is deeply concerned about the future of health care in Australia, and our increasing acceptance of the consumerist model. Vividly, she refers to the American health system turning “into a dragon raking gold into its cave” and pours scorn on “coin-operated doctors”.
We meet some memorable characters: Fred, 84, sick and miserable because his dog has just died – there’s a happy ending involving a replacement dog; forgetful David, depressed George, Irena (who could stand up to Stalin, but not the nursing-home regime) – and above all tipsy Min.
Min, at 92, was a great character. Until the late 1990s she ran a boarding house in Melbourne, went to the market, had a beer or two in the pub, and was known to all the locals. ABC broadcaster and historian Michael Cathcart was one of Min’s tenants, and found himself increasingly in the role of carer.
She became unsteady: the pub started serving her sarsaparilla rather than beer; “the stallholders at the market understood what she wanted and gave her the right change. She was propped up by a close-knit community.”
This, to Hitchcock, is a model of how things might be. New drugs are not the answer. “We wait for the dementia cure (the obesity cure, the diabetes cure) rather than changing our society to decrease incidence and severity … to reduce non-communicable disease, the actions we need to take are societal; make it easier for people to move more and eat well, strengthen education, promote community participation and meaningful work.”
Mostly cheerful, sometimes moving, this is an important essay by a fine writer.