I was extremely glad when Lizzy suggested we go for an extension of #ReadIndies month once more, as like her I was running out of time to squeeze in all the books I wanted. In particular, I really wanted to cover a new book from a favourite indie by an author whose work I absolutely love – the publisher is lovely Notting Hill Editions, the author is A.J. Lees and the book is “Brainspotting: Adventures in Neurology“.

NHE have featured many, many times on the Ramblings, with their beautiful clothbound hardback editions of works ranging from classic essays to modern meditations, which bring in so many authors and subjects I love – Montaigne, Perec, Wilde, Woolf, Milne, Priestley, Shostakovich, Dogs, Cats, Walking – well, I could go on, but you get the picture! They’ve previously published two works by Lees, “Mentored by a Madman” and “Brazil That Never Was” and I absolutely adored both books.

Touch comes before words and is the first and last language. It is an essential constituent of healing and another way of listening that never lies.

As I’ve previously mentioned, Lees is an award-winning neurologist; according to Wikipedia, he’s been named in the past as the world’s most highly cited Parkinson’s disease researcher, and a quick look down their entry for him reveals that he’s been responsible for a number of breakthroughs in the treatment of that disease, as well as overseeing all manner of different branches of research. As well as all that, he’s also a marvellous writer, and his previous two NHE works have been wonderful explorations of his life and career, his beliefs, the influence which Brazil and William S. Burroughs had on him, and how medicine and the care of other is as much an intuitive thing as the ticking of boxes. His new work is just as brilliant and was such an engrossing read.

As I cast my mind back to those halcyon days, it is the harmonious discord of birds that evokes my sweetest memories of our garden and the dark wood, the four-note lullaby of the wood pigeon, the death rattle of the magpies and the cuckoo I never saw. A year after…the diggers and steamrollers came over the tops, and a gleaming new housing estate with high-rise blocks and semi-detached palaces stood where the skylarks had once plummeted to earth: the meadow was now a transformed landscape of lost freedom.

You could regard “Brainspotting”, I suppose, as a follow-up to “Mentored” as in it Lees looks back on his career in medicine in a series of autobiographical essays focusing on pivotal points in his life. From his youth, learning to spot birds despite suffering from a form of colour blindness, through his training and learning how to recognise symptoms by close observation, to his thoughts on the modern world and ‘machine medicine’, Lees is an erudite commentator and always fascinating to read.

Memories are random and volatile and defy logic. They are made in the dendritic canopy and appear and disappear as they wish. Some memories exist like delicately folded magic carpets; others lie covered in dust and forgotten in the kasbahs of the mind.

It’s the keen observational skills that stand out most in the essays, skills which were obviously honed when he was young and learning to recognise those birds despite the confusion between the greens, reds and yellows. Lees looks back to the history of neurology, the great pioneers like Charcot, and his own teachers to explore the relatively young science of neurology, and always in terminology which a lay reader like me can understand. The Charcot sections were particularly fascinating as I have an extended family member who was once given a diagnosis of that disease so I was very interested to read more about its discovery. Lees’s tales of his training are also fascinating, with pen portraits of his various mentors and entertaining stories of travelling on the London Underground’s Circle Line (when it was still possible to go round in a circle), observing fellow travellers for symptoms!

My clinical tutors reminded me that medicine was a calling requiring self-sacrifice and courage. A physician’s work was to prevent disease, relieve suffering and, if possible, cure the sick. Treatment should be evidential, but clinical care was always personal and intimate. They stressed to me that when there was no cure a good character and kindness were powerful healing forces.

As with Lees’s other books for NHE, “Brainspotting” features a beguiling mix of the personal and the professional. The author’s life and career have obviously been so fascinating, and his memories of his time in the various hospitals in which he trained and worked brought back a lost world, much at odds with the modern one. And that’s one of the strongest messages I took away from this book – how much medicine has changed, and not always for the better. Of course, we all know that the NHS is stretched beyond belief, but unfortunately modern doctoring seems so often to involve simply ticking boxes and prescribing a pill without really giving enough time to search for a proper diagnosis. The kind of care offered by someone like Lees is staggeringly different; years of training and observation have given him an acute ability to recognise the slightest of symptoms or physical indications and give a possibly unexpected but accurate diagnosis. That’s something that’s probably very rare nowadays, sadly, and the kind of intuitive response he can give to his patients obviously must make him a treasured doctor.

The changes that were happening in the National Health Service were now forcing me to be to become a smiling handshaker who got on well with people, especially managers and governors.

His kind of ‘holistic neurology’ as it’s called seems to me a much more human and humane response to illness than simply seeing what box you can fit someone’s symptoms into. Lees has mentioned his love of Sherlock Holmes in previous books, and the book’s epigraph is a quote from the classic sleuth. In many ways, the great medics are akin to the great detective: learning to observe closely, look beyond the obvious and make inspired and unexpected connections. Certainly, I would trust someone like Lees much more than I would a box-ticking medic only motivated by money; as I mentioned in my review of “Mentored”, his humanity shines through at all times and that’s something which inspires confidence in the doctor-patient relationship and which is often missing nowadays.

Private hospitals are there to generate income and all the rhetoric of quality, safety and patient satisfaction is in truth no more than a public relations exercise.

As you might guess, I loved “Brainspotting” as much as I’ve loved Lees’s other books; it’s utterly fascinating from start to finish, full of reminiscences, insights, history and, I’m afraid, the occasional icky bit (I’m slightly squeamish when it comes to dissection). There are lots of quotes in this post, and I could have pulled out more, but I make no apology – this is a really wise book. Comparisons are often made between Lees and Oliver Sacks (and in fact both men were friends), though I can’t comment on that because I haven’t read Sacks. What I will say is that the three books of A.J. Lees are some of my favourites from Notting Hill Editions; he’s a captivating writer who always has something fascinating to say, and even if you think you’re not interested in neurology I reckon you would find this engrossing from start to finish. A wonderfully written, thoroughly engaging book – absolutely loved it! 😀