Sometimes, it takes a lifetime to become an overnight success
Last Friday, I took part in a (virtual) session at the Science Foundation Ireland Summit on writing, and publishing, books on scientific subjects. It was a jolly event, and even included some discussion on strong language, Fergus Shanahan taking issue with Luke O’Neill over the title of his new book – and pointing out that there was a well-known north Dublin variant of the word “b#llocks” that he should have used instead. It was a nice moment. You probably had to be there.
One of the things I liked about the session (particularly the pre-event chit-chat*) was the talk of rock and roll. I’m more used to literary-type events (rather than science-type ones), and I don’t think music, of any kind, has ever featured – at least not that I can remember. Perhaps I’ve been hanging out with the wrong people all this time. In fact, I’m reminded of the words of one of my heroes, the doctor-poet William Carlos Williams, giving advice to younger poets on looking for readers among what we would now call the science community, “From among whom some of your best readers will come, if you have any sense.”
I digress. The panellists said many interesting things, and of the several memorable things Fergus said, one has stuck in my head. When he was asked by the host, Claire O’Connell (herself co-author of a fine book, just published, on, and with, the Nobel laureate William C. Campbell**), about his writing process, Fergus responded: “I’ve basically been writing this book for the last forty years.” Obviously not literally, but you get the point: he has distilled his professional, and personal, experiences, into a couple of hundred pages of text. This might make the book sound dry and uninteresting. It is not. It is warm, readable, and above all, deeply human, and humane. Unlike with many books, you feel as though you’re being addressed by a real, live human being, not an expert, pontificating from on high. And how refreshing that is, in the age of the algorithm. In short, it’s a remarkable piece of work; I defy anyone not to find something of value in it.
In fact, I would go further, and say that, based on the couple of hundred books I’ve published, and the hundreds more I’ve edited, The Language of Illness is something approaching a masterpiece. You needn’t take my word for it. (Nor should you: I have a vested interest in the book succeeding; skin in the game, as they say in poker circles.) Muiris Houston called the book “wonderful”; Deirdre McGrath, “a must-read”; John F. Deane, “a treasure”; Deirdre Bennett, “a tour de force”; and Desmond O’Neill, “a classic”. And that’s just a handful of them – and very shortened versions, at that. (You can blame Twitter’s character-limit.)
Annie Proulx’s novel The Shipping News was published when she was fifty-eight. For my money, she is the finest living writer of English (as opposed to “English writer”). But she didn’t exactly rush into it, did she? I don’t know how old Fergus is, but it would be fair to say that he isn’t a blushing ingénue. And The Language of Illness is not his first book. He’s the author of around 750 publications and articles. I’m not familiar with them. As I said, I’ve obviously been hanging out with the wrong people. Come to think of it, he’s about as far from being a “celebrity author” as you could hope to find. He may have to get used to dealing with a little more attention in the future.
Publishing history is littered with could be described as glorious failures: books which, for whatever reason, were virtually forgotten soon after seeing the light of day. Well, it’s not happening this time. Not on my watch.
Seán O’Keeffe is the Publisher at Liberties Press
Prof John Crown’s review of The Language of Illness is in today’s Irish Times. Don’t leave it too long to order your copy (of the book, that is). There were only 1000 copies of Ulysses printed in the first run. It would be nice to have one now. In the words of the inimitable Harvey Norman: once they’re gone, they’re gone.
* Chitchat features in The Language of Illness – on page 66, as you ask.
** If you asked a person on the street to name as many of Ireland’s Nobel laureates as they could, a fair few would be able to reel off one or all of the “awesome foursome” (to quote, of all people, the British PM) of Heaney, Yeats, Beckett and Shaw. (The fact that you know who they are based on their surnames alone, tells its own story.) One or two might even give you Seán MacBride. I’d hazard that not many would say William C. Campbell. And Ernest Walton – another scientist – is not exactly a household name either. Another situation that needs changing.
"Fergus Shanahan draws from many wells for this fascinating and beautifully written book. It is peppered with references to literary and artistic works as well as examples from his own experience. He explores the changing nature of the doctor-patient conversation, which has been shrinking in time and is often accompanied by the computer screen; the trust that language can build or destroy; and the value of 'chit chat' that can uncover details important for clinical diagnosis, for the patient’s quality of life, or both. In a timely chapter on the language of plagues and pandemics, Shanahan reflects on the new 'corona-speak' such as 'social distancing' and 'flattening the curve'. . . . He borrows from the singer Madonna to state that we live in a microbial world (as well as a material one)."
–Dr Claire O'Connell, Irish Times, "Science Books to Peruse This Pandemic Winter"
“A fascinating and sensitive exploration of the difference between the ‘illness language’ characteristic of a patient’s subjective awareness of their illness, suffering and fear, and the medical practitioner’s objective consideration of their disease. I recommend it strongly, not just to front-line medical personnel, but also to the rest of us who are, or will, sooner or later, be ill.”
––Patrick Masterson, Emeritus Professor, University College Dublin
“There could be no better time to publish a book exploring how we talk about disease and illness. . . . In a thought-provoking and engaging book, pitched at ‘anyone who cares about caring’, Shanahan has drawn on his experience as a physician and father to a seriously ill son. He combines a rich selection of literature . . . to reflect on how the language we use shapes doctor-patient interactions [and] patient and carer experiences. . . . a sweeping tour de force.”
––Dr Deirdre Bennett is Head of the Medical Education Unit in University College Cork
"A scholarly yet accessible dissection of the toxic influence of language on medical care, this book should be mandatory reading for all healthcare professionals, and also for all patients and future patients."
––Liam Farrell, medical journalist, former GP and author of Are You the F**king Doctor?
“a ‘must read’ for all medical students and doctors in training, and for medical educators. Professor Shanahan discusses, in a warm, insightful and humorous manner, the particularly challenging topic of how and why doctors, health-service managers and policymakers continue to communicate poorly with patients [and] offers invaluable, realistic and practical solutions as to how we can adapt the language that we use to improve our ‘conversation time’ with patients.”
––Prof. Deirdre McGrath, Head of School, School of Medicine, University of Limerick
“Absolutely delightful . . . . Elegant, wears its considerable learning lightly . . . and [constitutes] a classic addition to the literature.”
––Prof. Desmond O’Neill is Director of the National Office for Traffic Medicine
“In his excellent book . . . Professor Fergus Shanahan provides an important explanation for the frequent failure of generally well-intentioned medics to provide a better caring experience for their patients. . . . Beyond the carefully and elegantly constructed arguments, it provides a wonderful anthology of writing about life, health, dying and caring. . . . It should be on the mandatory reading list for students of medicine, nursing and all caring professions, and will be of enormous interest to patients and their family members.”
––Professor John Crown is consultant medical oncologist at St Vincent’s Private Hospital in Dublin. He served in Seanad Éireann from 2011 to 2016.
“The Language of Illness is one of the most worthwhile books I've seen in medicine. It is wise, bright, witty, and brimming with insights – and is the antithesis of what the author rightly describes as the ‘banal teaching of communication’. It will make you a better clinician and a better human. Read it early in your career and every few years afterwards. The epilogue, and its matching discussion earlier – not to mention the brief appearance by Madonna – is worth the price of admission on its own.’
––John Sotos, MD, author of The Physical Lincoln
"This book is a treasure, compulsory and compulsive reading for everyone in the caring way – and isn’t that all of us? Caring, or being cared for. Doctor Shanahan, with precision, humour and concern, examines 'the words that turn people into patients . . . healing words, hurting words'. He demonstrates, with wisdom and learning and humanity, how patient and doctor, speaking the same language, work better together: 'I’ve studied disease and experienced illness; I’m expert enough to be wary of experts', he writes. He uses illustrative quotations from every area of human life, from poets like T. S. Eliot and the great doctor-poet William Carlos Williams, to TV series like Only Fools and Horses. An accessible, inviting book: warm, empathetic and deeply compassionate."
––John F. Deane, a member of Aosdána, is a poet, founder of Poetry Ireland/the National Poetry Society, and The Dedalus Press. His latest collection of poetry is Dear Pilgrims (Carcanet Press).
“an impressive work that cuts through the dross of medical parlance and captures our everyday tragedies with compassion”
––Prof. Garret A. Fitzgerald, Perelman School of Medicine, University of Pennsylvania
“It is wonderful to have the issue of language brought into the mainstream by a distinguished Irish
physician, as he explains how well-intentioned medics sometimes fail to provide a better caring
experience for their patients.”
––Dr Muiris Houston, Irish Times
“This book . . . is an exercise in erudition that acquaints the reader with the often over-looked thoughts of medical authors, as well as providing the enlightening perspective on the doctor’s lack of communicative skill as portrayed in the great works of literature. . . . A fascinating
read. . . . A tour de force.”
––Eoin O’Brien, author and clinical scientist
“The literary dimension and finesse of The Language of Illness fit perfectly into the genre of books that we want to develop in our collection.”
––Flore Gurrey, editor at Éditions Les Arènes of Paris, who will publish the French-language edition of The Language of Illness in spring 2022
Fergus Shanahan MD, DSc, MRIA, is emeritus professor of medicine at University College Cork and was foundation director of the SFI-funded research centre APC Microbiome Ireland. A clinician-scientist with over forty years’ experience helping patients with chronic inflammatory bowel disease, he has received international awards for his contributions to medical science and the medical humanities. He was the first recipient of the Hektoen International Grand Prix and is a former president of the Irish Society of Gastroenterology. He has published more than 550 scientific papers and numerous books; Fast Facts in Inflammatory Bowel Disease won the BMA Book Award for gastroenterology in 2006. He featured on the “Irish Life Science 50”, a list of the top fifty Irish and Irish-Americans in the life-science industry, and in 2013 Science Foundation Ireland named him as its Researcher of the Year. In 2016, the Royal Irish Academy honoured him with a gold medal for contributions to the life sciences.
The practice of medicine has advanced dramatically in recent years, but the language used to discuss illness – by medical practitioners, patients and carers – has not kept pace. As a result, clinicians and, just as importantly, patients and their relatives and carers, are not able to communicate clearly in relation to illness. The upshot is misunderstanding and confusion on all sides.
In this ground-breaking book, Dr Fergus Shanahan, an eminent gastroenterologist who has practised in Ireland, the United States and Canada, and published widely around the world, looks at memoirs of illness, and outlines the lessons we can learn from a better understanding of the words we use to describe illness. He looks at the ways in which language can act as a barrier with regard to illness, and proposes practical ways in which we can dismantle these barriers. The book is written for the general reader: as Dr Shanahan puts it himself, he is “enough of an expert to be wary of experts”.
The Language of Illness, part manifesto, part memoir, and part instruction manual, is an appeal for the use of clearer, more holistic language, by all those involved with, and affected by, illness. Like the great American poet-doctor William Carlos Williams, he aims to help us develop a new language by means of which we can develop a new way of living with illness – which is an integral part of the human condition. Put simply, it is a book for all those who care about caring.
Richard Dawkins once wrote, “Let us try to teach generosity and altruism, because we are born selfish.” Francis Collins, former Director of the Human Genome Project, believed that our selfless moral feelings conflict with the evolutionary urge to preserve our DNA, and could only have come to pass as a result of divine intervention. They were both wrong.
In The Pursuit of Kindness, Éamonn Toland provides compelling evidence from biology, psychology, history and archaeology that, for 95 percent of the time that humans have walked the earth, survival of the fittest for our species has meant survival of the kindest. In fascinating, clearly written and entertaining prose, he argues that collaboration is more deeply engrained than competition, and that it is only by working together that human beings can prosper. In an increasingly polarised world, The Pursuit of Kindness offers an optimistic view of human development; it is essential reading for all those interested in the survival of the human species.
The Pursuit of Kindness will be published in May 2021 and is available for preorder now.