23 November 2015updated 26 Jul 2021 10:30am

Adventures in Human Being is an entrancing roadmap of the flesh

For Gavin Francis, medicine is “a skeleton key to open doors ordinarily closed”, and his latest book is as illuminating as it is enjoyable.

By John Burnside

What do victims of domestic violence and the heroes of Homer’s Iliad have in common? The answer is just one of an avalanche of thought-provoking, sometimes quite startling facts and observations to be found in Gavin Francis’s new book, in which he abandons his usual turf (his two previous books explored the cold regions of the planet and how we and other animals survive in them) for the geography of the human body.

Adventures in Human Being could be described as a road map to the flesh, written by a guide who is scrupulously attentive to the details of how we work and exquisitely aware of the glimpses of the soul behind the machinery. Francis is not only an experienced doctor but also steeped in both the classics and contemporary literature. His breadth is not just impressive but entirely convincing, as he moves easily from a 1977 essay by the military historian P B Adamson (“A Comparison of Ancient and Modern Weapons in the Effectiveness of Producing Battle Casualties”) to a close and illuminating reading of “The Halving”, Robin Robertson’s poem about heart disease.

Adventures in Human Being is a set of essays organised “from head to toe, like certain anatomy texts, though they can be read in any order” – which, at first sight, seems a risky approach. Surely, for most of us, the most interesting parts of the human body (with perhaps one exception) are located in the head and heart areas? It seems all too natural to assume that our abilities to reason, imagine and feel are more engaging than digestion or the processing of toxins. This, however, is to forget how far we have come in understanding the body as a whole, rather than the sum of its parts, and though Francis chooses “head to toe” as the most obvious way to navigate the terrain, his perspective is consistently holistic. So it is that his chapter on feet and toes turns out to be as engaging as anything he has written about the heart, or the senses, or the putative locus of the soul (which Descartes situates in the pineal body, a tiny gland, shaped like a pine cone, that regulates sleep and, so, by extension, our ability to dream).

Beyond the fine detail and the erudition of his medical investigations, what marks Francis out as a perfect guide to our physical selves is his sensitivity to metaphor, simile and analogy, his deftness with language. Here, he discusses a patient, named Claire, whose terrifying medical history has driven her into the operating theatre for dangerous brain surgery: “Her brain was structurally normal but functionally fragile, forever teetering on the edge of seizures. If normal cerebral activity – thought, speech, imagination, sensation – moves through the brain with the rhythms of music, seizures might be likened to a deafening blast of static. Claire had been so injured, frightened and handicapped by these seizures that she was prepared to risk her life with this surgery in order to be free of them.”

Describing a man named Edwards who has just emerged from profound depression after electroconvulsive therapy (ECT), Francis remarks: “After a while his facial expression, having previously been blank, would alter when I or one of the nurses went into his room to speak to him. He seemed startled by life, like a Lazarus unconvinced that he’d been done a favour.” Francis then proceeds seamlessly into a long passage in which the development of ECT and its uses is beautifully set out, in a combination of exact clinical terminology, humane observation and historical insight, from the ancient Greeks’ conception of seizures as a “sacred disease” to a period of “reckless experimentation with the brain” by Italian researchers under Mussolini.

That Adventures in Human Being is an astonishing, moving and enchanting book can be explained in part by Francis’s unique range of experience, his erudition and his enthusiasm; but his principal virtue might be the humility he brings to his task. We often think of medical professionals as arrogant, too remote from the people they treat. Francis gives the lie to that idea. Where we assume that most doctors see their work as something to be survived, emotionally and psychologically, by a calculated detachment, Francis sees his calling as a privilege. “My profession is like a passport or skeleton key to open doors ordinarily closed; to stand witness to private suffering and, where possible, ease it. Often even that modest goal is unreachable – for the most part it’s not about dramatically saving lives, but quietly, methodically, trying to postpone death.”

Gavin Francis will be in conversation with Suzanne O’Sullivan at the Cambridge Literary Festival on 29 November