A doctor’s journey to healing
Alastair McAlpine’s autobiography tracks how he came to work with terminally ill children
If you were to meet a group of university students, one of whom was studying medicine, how would you be able to tell which one? Don’t worry, they’ll tell you!
That hoary old chestnut from my student days has been resurrected as a convenient entry point for the topic of this week’s book — the art of healing and those who practise it.
It is such a very human quality to spend literally every second of our lives gallivanting around in as wondrous a vessel as the human body and yet know basically nothing about how it operates.
Our bodies are complicated machines sculpted out of a complex mishmash of organic and inorganic molecules, powered by electricity and piloted by … Well, we’re not exactly sure what, even though we ourselves are the pilots.
We spend quite every moment of our existence on this plane in them, yet 98.3% of people are gleefully unaware of most of their inner workings, let alone how to repair them if they malfunction or are damaged.
The remaining 1.7% of people have decided that this lack of knowledge about the only body we ever get issued is unacceptable and they become physicians.
And, since the dawn of their profession, they have been respected and revered — students of Apollo, those who know things about us that we do not even know about ourselves.
They are looked upon with the sort of reverence usually reserved for spiritual leaders. And this reverence is hardly misplaced.
To become a doctor is a daunting task. From an academic point of view, not only is one required to commit to memory vast amounts of complicated information, usually drowned in incomprehensible jargon, but one is also expected to be able to apply this information to unusual situations. As most doctors will tell you, diseases don’t read textbooks.
Then there is the emotional side of what they do. Doctors who work across the vast majority of medical specialities have to deal with tragedies that most of the rest of us cannot picture.
What for most people is a once-in-a-lifetime horrific event — a car crash, a cancer diagnosis, a childhood adventure gone wrong — is a daily occurrence for our medical professionals and this takes its toll.
Most, in fact, learn to partially or completely suppress their emotions and become impassive deliverers of knowledge, expertise and service.
No one wants to see a doctor who is as freaked out about a situation as they are, and so on top of their vast anatomical and physiological knowledge, medical professionals must learn the art of becoming who we need them to be.
But who is that, exactly?
That is the central question that drives Alastair McAlpine’s emotional debut, Prescription: Ice Cream. Throughout this memoir, McAlpine takes us on the journey of self-realisation that ultimately leads to a professional reinvention.
Dr McAlpine is a palliative paediatrician, meaning that his medical speciality is making terminally ill children comfortable in their last days. This is an interesting career, to be sure, and the path he took to get there is equally interesting.
The book is split into three acts and told out of chronological order. Each section walks us through a pivotal stretch of McAlpine’s life. And, in the process, we bear witness to the author’s slow and stubborn awakening to the fact that he doesn’t have all the answers — but also that he doesn’t need to.
The first section talks to McAlpine’s two-year internship at Chris Hani Baragwanath hospital in Soweto. Bara, as it is known, was a hospital that, as McAlpine puts it, “was regarded as the Navy Seals of internship” and this comes through strongly in the text.
McAlpine does well to illustrate the utter chaos that exists in South Africa’s busiest hospital and the seemingly impossible task of attending to the throng of patients who are cared for there.
We are given a glimpse behind the curtain of public healthcare in South Africa and, as such things usually are, it is equal parts fascinating and horrifying.
Adjacent to this, we are shown the humanity of the staff who work there and how they find, and cling to, oases of joy and respite in the wastelands of morbidity and mortality.
The second section takes us back in time and gives us the story of McAlpine’s descent into alcoholism as a young medical student and his tortuous climb back out of it.
In the first part of the book, he deals with his potential fallibility as a medical professional. The second part hits harder, because he is now dealing with his potential fallibility as a human being.
In confronting his addiction, McAlpine is forced to deal with the fact that he often hid behind his considerable intelligence and charm and now had to face that from which he was hiding.
The third section jumps ahead in time to when McAlpine is completing his paediatrics specialisation. We meet the children and hear the stories that, ultimately, lead to him choosing palliative paediatrics.
In a way, this is three books in one — a mile-a-minute joyride through being a trainee doctor in a busy hospital; a quiet, introspective peek into a man’s battle with his own demons and a heartstring-pulling tale of how a doctor can make a difference.
Overall, the journey is an interesting one. Though the story is relayed non-chronologically, it makes perfect sense in the telling.
The detour into McAlpine’s stint in rehab is necessary to bridge the gap between him thinking doctors should be efficient and emotionless professionals and realising total care of a patient, including emotional support, is the way in which medical professionals can truly change and enhance lives.
In rediscovering his own humanity, he is able to so successfully tend to that of others. These are complicated vessels, yes, but they are inhabited by people, after all.
Prescription: Ice Cream is a memoir of an interesting life led by an interesting person and is at once thought-provoking and emotionally stirring. A worthwhile read.
Prescription: Ice Cream is published by Pan Macmillan.