“We have disappointed each other, the ministry and me, watching each other grow from the breezy optimism of youth into crabbed middle age.”

Curiosity about the state of hospital services in countries other than the US, UK, and Australia is what prompted me to read The Ministry of Bodies by retired doctor Seamus O’Mahony, who writes of his final year of his career at what what he semi-affectionately calls the ministry, more formally known as Cork University Hospital.

“The management narrative – a cynically clever one – was that the ‘trolley’ [bed] crisis was due to ‘low number of discharges over the weekend’, not an inadequate number of beds.”

It’s depressing, though not surprising, to discover that Ireland is no more immune to the woes that affect modern hospitals the world over. The record of O’Mahony’s last year exposes yet another under-resourced hospital system, where the need for services is greater than bureaucracy provides.

“A round could not last longer than three hours....Assuming thirty patients over three hours (I had very often seen more than fifty), that gave an average of six minutes per patient.”

O’Mahony operates as a gastroenterologist consultant, practicing his specialty in his out-patient hospital clinic, and has a regular surgical list, but he spends much of his time in the hospital as a physician on the general medicine service. On the wards he sees patients whom other services refuse to claim, -alcoholics, the elderly, and somatic syndrome sufferers among them, documenting a daily litany of fear, frustration, courage, and crisis.

“I retired on 7 February 2020, the day before my sixtieth birthday.”

While there is some humour here in the absurdities, overall I found The Ministry of Bodies to be a disheartening read. At fifty-nine, O’Mahony finds he is tired of the expectation that he is to do more with less, by long hours, by management double-speak, and petty professional turf-wars, and really, who could blame him?

‘To practise medicine is to have a permanent feeling that you’ve forgotten something.’

Dr Seamus O’Mahony, now retired, writes of what life is really like for a medical professional, a consultant gastroenterologist, in a large teaching hospital in Cork, in Ireland. He writes of an impossible caseload, of departmental boundaries, of life and death. He writes about everything that is good or bad, and sometimes just plain ugly, in the health industry where expectations far outstrip resources.

‘Is there anything more useless than good intentions?’

And, like most bureaucracies, where demand for services outstrip supply, complex rules have been developed which often make it even more difficult to obtain (or to provide) treatment. It is made more difficult by the complexity of humans: those reluctant to seek treatment, those unable to comply with treatment and those unable to obtain treatment. There were so many instances of people whose illnesses are a consequence of lifestyle choices, and of those stoic people who suffer in silence for far too long.

Dedicated doctors and nurses burn out: unable to reconcile ideals with reality, unable to back up from endless shifts with insufficient resources. And then the COVID-19 pandemic hit.

‘I retired on 7 February 2020, the day before my sixtieth birthday.’

Read this book and weep. Weep for the professionals sacrificed, for their suffering patients and the lives lost. How can we improve? I doubt that the answer is simply more resources, it will be more complex than that.

Note: My thanks to NetGalley and Head of Zeus for providing me with a free electronic copy of this book for review purposes.

Jennifer Cameron-Smith