Swimming against the tide

In medicine we are generally encouraged to 'not put our heads above the parapet'. There is even a medico-legal principle based on it. The Bolam principle states that 'the doctor is not liable for his diagnosis or treatment if he follows a responsible body of medical opinion'.

Perhaps it is the desire to act differently when out of the clinical environment, or maybe a tendency not to accept what I am told without challenge (also drilled in since medical school) that made me want to like JK Rowling's 'The Casual Vacancy'. Some of the reviews had been far from kind. Niceties of highbrow literature aside, this lady knows how to tell a good tale and I was unashamedly gripped until all 503 pages were done.

But UK GPs beware, if you expect escapism in your literature, you will be disappointed. I imagine the majority of my colleagues will be quite familiar with most of the 'dramatis personae'. Howard is a bon viveur who runs the local delicatessen. He has already had a coronary event, has uncontrolled hypertension and other sequelae of obesity. Colin is a deputy headmaster with OCD who tortures himself daily with things he may, or may not have done. Sukhvinder is the underperforming sibling in a high-achieving family. She is bullied via Facebook and self-harms in her bedroom, once her family have gone to sleep.

Samantha is the neglected wife, a fading beauty who finds some solace in the bottom of a bottle. Terri is a formerly abused addict, who can't say no. With the threat of her methadone clinic closing, she struggles to hang on to her children. Robbie is her son. He is three years old, developmentally delayed and a little neglected, with some inappropriate sexual behaviours thrown in for good measure.

In the closing chapters, I felt a little like an unwilling spectator trapped on a roadside, as a car crash unfolded spectacularly in front of me. In true Potter fashion, all the elements were brought together to a breathless finish. Being a fully signed up member of Pedant UK, there were two medical points I had trouble with; the type 2 diabetic on insulin and granny dying, possibly as a result of her theophylline being overdosed. Otherwise I didn't spot any howlers - please let me know if you did.

In the last month we have updated the following articles on issues that are touched on in the novel:

Anti-hyperglycaemic agents in type 2 diabetes

Peripheral arterial disease

Drug misuse and dependence

Alcohol-related problems

Heart valve disease - (various) includes: https://patient.info/doctor/mitral-stenosis and https://patient.info/doctor/mitral-regurgitation

Safeguarding children - currently authoring, out next month