The Ministry of Bodies

by Seamus O'Mahony

In The Ministry of Bodies, Seamus O'Mahony charts the realities of life in a modern hospital over the course of a year. From difficult births and unexpected deaths to moral quandaries and bureaucratic disasters, O'Mahony documents life in the halls that all of us will visit at some point in our lives with his characteristic wit and dry and unsentimental intelligence. As the Coronavirus crisis demands more and more of the medical profession and the people who support it, Seamus O'Mahony describes his work on the front lines of a pandemic in a harrowing final chapter. This is not a conventional medical memoir: it's the collective biography of one of our great modern institutions, the general hospital, through the eyes of a brilliant writer who happens to be a gifted doctor.

Genres: Nonfiction, Memoir, Medical, Medicine, Science

320 pages, Hardcover

First published March 4, 2021

Reviews

[Petra X · Rating 3 out of 5]

I always find it hard to review books that are neither really good nor bad. Although this book is enjoyable, nothing about it stands out, or perhaps there was nothing memorable. In non-fiction I am always looking to learn something or see something I know in a different way. I didn't really get that from this book which is a series of anecdotes joined only by the fact that the author was the doctor, the gastroentrologist at the centre of the stories, there was no overriding theme.

To sum up, it was just another medical memoir and a good read, the author writes well, but not an outstanding one. Nice cover though and I think the author has a great name.

[julia childs · Rating 1 out of 5]

This is a series of anecdotes, as such, it lacks a cohesive narrative thread and reads as rather piecemeal.
The author’s attitude comes across as high-handed and I would caution against reading this if you have ever experienced clinical disbelief.

[Jennifer (JC-S) · Rating 5 out of 5]

‘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

[Caroline · Rating 2 out of 5]

As an occupational therapist working in an acute hospital, I resonated with some of these stories. However, I found the narrator the typical "only I know what's right" type of consultant, dismissing the ideas of dieticians and speech and language therapists as pointless and causing problems and saying sepsis is hokum and just a marketing ploy in a way. His constant naming of the hospital "the ministry" grated on me after a while.
Though some good insights into hospital work, overall I've found other similar memoirs to have a lot less arrogant of a narrator and recommend them instead.

[Rachel · Rating 5 out of 5]

While I question the wider appeal of this book, I personally enjoyed it very much. I happen to have worked in the ‘ministry’ in question for seven years and knew Seamus O’Mahony well by reputation. I wrote him off as one of the ‘angry’ consultants that it was a pain to have to request anything of – you always hoped he wasn’t the one scoping when you had to beg for an urgent endoscopy. After ten years in the trenches, coming to the exact same mordant conclusions about hospital bureaucracy, patient psychopathy, and ‘sepsis’ as O’Mahony, I have a lot more empathy for his anger. Also this rang such a bell for me:

“Medicine, more than most careers, colonises the lives of its practitioners. […] circumstances decreed that I should spend four decades pursuing a profession for which, when I started training for it as a teenager, I had no outstanding aptitude or ability, apart from a knack of doing well in examinations.”

Ouch. Know that feel.

I enjoyed recognising other people I worked with or for in the book, as well as the patients. I don’t mean that I know who he’s talking about, just that I know exactly what he means when he says:

“I have spent far more time listening to the dietary concerns of people with abdominal bloating than I have spent attending to the needs of the dying. Sir William Osler was more forgiving: ‘Deal gently then with this deliciously credulous old human nature in which we work, and restrain your indignation.’”

Or:

“I silently invoked the spirits of the great statisticians, epidemiologists and prophets of evidence-based medicine, from Major Greenwood to Austin Bradford Hill to Archie Cochrane to David Sackett to John Ioannidis. Come, I said to them, come to my clinic and see for yourself how little science matters! This is what my patients think of evidence!”

Same goes for his despair in his colleagues:

“Asher wrote an essay for the Lancet in 1949 called ‘The seven sins of medicine’, which he listed as: obscurity, cruelty, bad manners, over-specialisation, love of the rare, common stupidity and sloth.”

“So easy to start treatments, so difficult to stop. Everyone involved treated this woman correctly and by protocol; collectively, we had inflicted only suffering.”

“To practice medicine is to have a permanent feeling that you’ve forgotten something.”

“Trotter: ‘Uniformity of thought is an increasingly apparent goal and demand of civilization. Still there burns on in most of us a small wild spark. I advise you to nourish it as a precious possession. Really to think for oneself is as strange, difficult, and dangerous as any adventure.”’

He can also be funny:

“Heroin addicts – who tended to lose their appetites – were enthusiastic users, consuming the supplements as an alternative to food. It also freed up a lot of time in their busy days.”

“I have a theory […] that many people get liver cirrhosis because they don’t get hangovers. […] One man […] when asked the hangover question, told me, ‘I did once. After a wedding.’ This wedding has long held a special place in my imagination.”

I read some reviews from (presumably) patients who were disgusted at his attitude to the sepsis ‘fad’ or ‘clinical disbelief’. They are definitely not the target audience, which is really ‘disillusioned fellow doctors’. Whether the greater patient population likes it or not, disillusionment is an almost-universal state of being among doctors. So there’s certainly a market.

[Tina · Rating 4 out of 5]

A wonderfully cynical account of his career as a gastroenterologist.

[Richard Smith · Rating 5 out of 5]

I had a chance to read this marvellous book before it was published, and here's a link to my review:

https://blogs.bmj.com/bmj/2021/03/04/...

[Rebecca]

O’Mahony retired in February 2020, just before he turned 60 and the pandemic hit, having written these fragmentary reflections over the final eight months of a long career in NHS gastroenterology. He acknowledges that the book is based on notes rather than a proper diary, and it retains the format of bitty anecdotes and memories. Fine for glancing through, but not compelling to read, especially as I hadn’t been hugely impressed by his The Way We Die Now.

Favorite passage: “I felt a tenderness for my younger self: I could not have known better or done it differently. The multiple potential permutations of my lost and irretrievable past were as chaff. There was no parallel universe where I didn’t make those mistakes, where I was a better, kinder, wiser person. I am as I am, the world is as it is. It was the best job in the world; it was the worst job in the world. Lurching between boredom and terror, no other career gave you so many opportunities to fail.”

[Alex · Rating 2 out of 5]

I found myself grappling with a mix of anticipation and disappointment, leading me to rate the book 2 out of 5 stars. The premise, delving into the realities of hospital life, promised an intriguing exploration. However, O'Mahony's writing style, characterized by the liberal use of notes, often felt more like a hindrance than an enhancement. Many of these annotations seemed out of context or unnecessarily inserted, detracting from the narrative rather than enriching it. It was as if these notes were sprinkled throughout the text merely to fill pages, which, for me, disrupted the flow and coherence of the reading experience. While I anticipated insightful reflections and cohesive storytelling, the book's execution left me wanting, making it a challenging read that struggled to fully engage my interest.

[🌶 peppersocks 🧦 · Rating 4 out of 5]

Reflections and lessons learned:
“The key to success in general practice, he averred, was turnover - “get them out the fucking door within five minutes”. His turnover well into the millions…”

A more narrative led version of a ‘This is going to hurt’ style patient by patient insight into a Doctor’s working life, in this instance an Irish Consultant. From a fairly normal year leading to the finishing of O’Mahoney’s standard career which coincidentally ends just before the start of the pandemic, this covers the extremes of humour, pain and ridiculousness of working in one of the most random and complex vocations of healthcare. As lovely and heartbreaking as you’d expect

[gerard brangan · Rating 4 out of 5]

While reading this excellent book I have thought of the author as being in turns, cold, sarcastic, detached, pessimistic: but in truth, by book's end the man who emerges from the whole sorry mess reminds me of Camus' Dr. Rieux who walks away from it all having done his best and with an enduring sense of decency foremost in his mind. 'Thank you for your expertise, Professor'.

[Frank · Rating 5 out of 5]

A witty and sharp insight into a Doctor's life in the months leading up to his retirement.
I've often wondered what a Doctor was thinking, knowing that what they wished to say would be inappropriate and can only be conveyed by a look, but this book puts words to those "Hmms" and slight narrowing of eyes. An enjoyable read, I'll have to reread it.

[Ellie · Rating 1 out of 5]

A series of rambling anecdotes which rarely, if ever, resolve into anything satisfactory. The author comes across as a misanthrope with cynical contempt for anyone who cannot be easily fitted into a simple diagnosis, and a Luddite mistrust of newfangled things like "food intolerances" and "not wanting people to die of sepsis".

[Nadine · Rating 4 out of 5]

Wry practical & with humour

[AmyAmyAmy · Rating 5 out of 5]

Having worked in and around the NHS myself for over two decades, this book is a little bit of me!

Brilliant.

[Riona · Rating 2 out of 5]

*audiobook* Nice book to listen to. A book made up of short stories and anecdotes. Interesting to hear about his past. Found many stories missing a punchline or not too funny. I also found some mildly offensive ways of addressing patients, which I didn't feel fair and definitely did not need to be published in 2021. I wonder if the author collected these notes (over 8 months prior to retirement I believe?) for the purpose of writing a book.

[Beckie · Rating 3 out of 5]

The calm cynicism and slight bitterness of this book are combined with wit and observation. It appeals to the battle worn doctor. I think Prof O’Mahoney has a rather small view of GPs, and in the current climate would do better to understand and promote their work rather than constantly bashing them. There are many excellent little epithets, however, within this text, and a must read to understand the workings of modern hospitals and the climate of medicine today.

[David Bowles · Rating 3 out of 5]

I worked in ministry of bodies hospital for a few years so found it interesting to read about familiar places, people and things.

Seamus speaks with compassion, humour and insight but also with cynicism about the hospital and working in one, the frustration he felt.

I struggled a bit with the format and would have preferred to read fully about patient where possible. Also I am a little uncomfortable with confidentiality.

Did find the book fascinating though.

[Anne Ward · Rating 1 out of 5]

A very disappointing read. As stated in the introduction, 'this book is based on notes'. That's exactly what it consists of; pages and chapters of notes that he kept over 8 months prior to his retirement.

Whilst he gives a good insight as to how the health service in Ireland operates, I found his writing lacked cohesion.

[Sheila · Rating 1 out of 5]

Interesting topic about a year in the life of a doctor in a hospital. But I found it dry, boring and didn’t give me much faith in the healthcare system.was shocked by the way the drug companies try to influence everyone by providing free lunches as an incentive to hear about the new drugs.

[Joanne · Rating 2 out of 5]

Horribly cynical and bleak.

[V · Rating 2 out of 5]

A collection of anecdotes. Some quite condescending. Fine.

[Shelleyrae at Book'd Out · Rating 3 out of 5]

“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?

[Paul O'Brien · Rating 4 out of 5]

The tradition of doctors chronicling their experiences dates all the way back to Hippocrates, the father of medicine (even if experts doubt he wrote all the works attributed to him). In modern times, medical memoirs frequently make it to the bestsellers list. Seamus O’Mahony’s book deserves to be among them. A chronicle of his final eight months as a doctor in a busy and well-known teaching hospital in Ireland, it is a sober and striking reflection, full of candid, wry and occasionally despairing insights about his profession, its politics and the patients at the centre of it. “Those who have nothing to do with hospitals assume that the people who work in them are saintly and, since the pandemic, ‘heroes’,” he writes. “They may be surprised to learn that they are no better, and no worse, than themselves.” Whereas Isaiah Berlin famously divided the world into hedgehogs and foxes, O’Mahony prefers Julian Barnes’s bipartite division of people into narrativists and episodicists. “Narrativists believe that life is a story, with an arc and a meaning; episodicists (like me) see no unifying theme or meaning; stuff happens, then more stuff… For the episodicist, the defining characteristic of human life is absurdity.” Even though the book is in standard diary format, its literary quality elevates it to a higher level – one suspects Barnes himself would approve.

[Barbara Clarke · Rating 3 out of 5]

Refreshing is the only word I can find that describes this book by retired doc Seamus O'Mahony. All else is bits and pieces of patients, docs, O'Mahony's career, and how efficiency is no substitute for medical care anywhere.

I worked in healthcare for 12 years and would have struck a medal if any doctor I ever met at a meeting said: "Despite these feverish protestations, (altruism) young people still become doctors for the same reasons as previous generations: status and a good living. There is a lot of humbug: medical school app0licants rarely put down social work or nursing as their second choice."

I saw a recent survey of NHS docs that 84% felt that the current schedule of seeing patients put their patients' lives in jeopardy. Some profession!

I'm on a search (for my memoir wip) to find what it would take for doctors to take medicine back from the bean counters, venture capitalists, and others in the US. Either a strike or a miracle?

[Lucy Anderson · Rating 3 out of 5]

this was a good book! enjoyable for sure, though i felt like the authors cynicism really shone through and not always in a funny way - he almost completely disregarded why a lot of patients might act in certain ways, and dismissed holistic care entirely. though many of his observations were funny, they lacked cohesion and sometimes left me hanging with their endings - and confused. he also dismissed allied health professionals a LOT. as a speech and language therapy student this was quite discouraging, as we’re already intimidated by consultants so this kind of just reiterates the validity of that. i did think there were many profound moments and i overall enjoyed the book, and o’mahoney seems like a very caring and talented doctor. 3.5/5 it couldn’t help but feel like an underwhelming version of this is going to hurt

[Amy Ursula · Rating 2 out of 5]

I've read several books written from the Doctor's point of view. I find all of them are written with elements of sadness & frustration, as well as humour. This book was on the heavier side. Lots of medical terms which were interesting, but the stories were brief & rather dry.
I did appreciate the short chapters (not necessarily featuring stories of a similar theme), and that Seamus linked bits from other chapters (you had to pay attention so as not to miss them).

Overall, I found his account lacked hope & made him seem wholly let down by The Ministry.
I don't wish for him to write something untrue to his emotions & experiences, but I didn't find it an absorbing or very pleasant read.

[Toni Kely-Brown · Rating 1 out of 5]

I was really looking forward to this book after reading two other books by this author. It's a short memoir and I knew it was written as a series of diary entries and notes captured by the author 8 months before he retired.

The author provides some context to the Ministry which is a teaching hospital in Ireland, but the format was jarring as there wasn't any thread or theming to the entries. It almost felt like stream of conscious at times (which I don't enjoy) and also there was some repetition and cross-over with his other book "A cure for Medicine".

I wouldn't recommend this one but would definitely recommend "A cure for medicine".

[Donal Healy · Rating 4 out of 5]

Not quite an indictment of my future profession, but definitely a well rounded prodding and critiquing of medicine in Ireland. Seamus runs a fine line between capturing the valid flaws of our healthcare system without digressing into the excess cynicism of someone at the end of their career, and for the most part he gets the balance right.

A quick read, this book is a mosaic of O’Mahonys final year in the hospital. The reader is rewarded for enduring a blunt and pessimistic view of the system, with the keen insights of wisdom that can only be gained after a long and diverse career.

[Paul Snelling · Rating 4 out of 5]

Seamus O’Mahony’s previous book was an enjoyable polemic against modern medicine. In this, his third book, he details his final months as a consultant gastroenterologist (an ologist, not an ician) as part of a health system sorely creaking even before Covid. Episodically he describes his patients and their ailments, miniature pen portraits full of wisdom and concern. But it’s a sad book as he draws his life’s work to a close. He’s curmudgeonly and weary, bemused by the management speak and the attitudes of some of his colleagues. They are easy targets. ‘Are we ever going to fix this?’ he is asked by a young man in a tutorial. ‘My generation failed. Over to you.’ I don’t think that he has failed – but it’s definitely time for him to move on.