Long time followers of the Library blog will be familiar
with, and may have even been members of the Book Club in its previous form,
facilitated by our now retired colleague Alison Millis.
Like all other facets of life in this post-pandemic world,
we in the Library and Knowledge Service have had to adapt and innovate to
continue to meet the needs and expectations of our library users. One
particular innovation, (for which we cannot claim originality!) was brought to
our attention during a virtually-delivered National Library Networking event
attended by the whole team. Our colleagues at Surrey and Sussex Healthcare NHS
Trust (SASH) Library and Knowledge Services had developed a virtual book group playfully
named, ‘SASH Bookworms’ who met regularly on Twitter to discuss questions
relating to a title chosen by their followers. Impressed by the innovation and
keen to restore a previously well revered library staple, we did what all good
Library and Knowledge professionals do, and stole their idea with pride.
A project team was formed, headed by Clinical Librarian
Hayley Beresford and supported by Tunbridge Wells Library Assistant Danielle
Lake and the plans for MTW’s own Twitter Book Club were laid. We decided for
the first meeting, our chosen title should be drawn from the Medical Humanities
genre. For those unfamiliar with the term ‘medical humanities’, The Oxford
Research Centre in the Humanities defines the discipline as:
“Medical humanities uses ideas, tools and methods from disciplines such
as history, art, philosophy, theology and literature to help create innovative
strategies for understanding and improving health and healthcare.
Drawing on sources that typically cut across and complement prevailing
modes of health-related thinking, the field seeks to explore the social and
cultural context surrounding the purposes and challenges of medicine and
healthcare. Decisions about whom to treat or when to treat them, how to prevent
disease, and how to fund and develop health services cannot be made on the basis
of science alone. They remain contentious ethical and political judgements,
reflecting economic realities, contested histories, cultural norms, future
aspirations and socially-conditioned perceptions of risk. Medical and health
humanities brings these judgments to light and enables us to examine them
critically.”
We took to Twitter (@mtwnhslibrary) to poll our
followers, first to gauge an interest in regenerating the Book Club in this new
format and also to allow those interested to vote for the first title out of a
possible three. And thus it was decided, we would be reading When Breath Becomes Air by Paul
Kalanithi. Allowing time to read the book and consider topics of discussion, we
set the date for the first meeting as Monday 11th October 2021,
12:00-13:00.
The marketing campaign to promote the relaunch set out the
format – those partaking in the discussion could respond to a question with
their thoughts by quoting the question number and using the hashtag
#MTWBookClub. We would be following the hashtag during the hour but welcomed
responses at any time. A full transcript of the discussion questions and the
responses received can be found below:
Q.1 – How did you come away feeling, after reading this book? Upset?
Inspired? Anxious? Less Afraid?
Paul talked about language &
‘human relationality’, where words only have meaning between people, and life’s
meaning being found in our relationships. His story and words are an example of
this. I felt his story could have been mine, or a loved one's. I cried
#MTWBookClub
Quite uncomfortable- it’s very
personal, felt like I was intruding at points #mtwbookclub
I felt really inspired by the
calmness that pervaded the book; he wrote it knowing the likely outcome and his
calm acceptance shone through his prose. No anger or bitterness. It was a
really humbling read #mtwbookclub @MTWnhs
I agree! I was trying to think of
the right word, and I think 'humbling' is exactly it #MTWBookClub
Q.2 – As Paul is reflecting on his time studying at Stanford for his
English Literature Masters, he says he sees “all disciplines as creating a
vocabulary, a set of tools for understanding life in a particular way,” – a
“physiological-spiritual” vocabulary. What tools has your discipline/speciality
or experience given you to understand human life?
Paul says knowledge grows in our
relationships with others and the world. It cannot be held within a single
person, but must be shared. As a #librarian my job is to help people find, use,
and communicate knowledge.
#KnowledgeIsPower #MTWBookClub
Arguably the pursuit of knowledge
is the meaning of life and is what sets us apart as humans. I think we can see
this in Paul's ambition and drive to become a neurosurgeon-neuroscientist
#MTWBookClub
Interesting Q for a history/
information sci grad - but Paul started academia in literature and not
medicine! As a librarian, skills to find/read/analyse/interpret info and
support clinicians to do the same deepens understanding #mtwbookclub @MTWnhs
Q.3 – Time is a common theme often discussed with relation to a
terminal diagnosis and end of life care. Could you feel the passage of time?
Was there an urgency or a sense of resignation?
There is both urgency AND
resignation. At several points Paul wants to KNOW where he lies on the
Kaplan-Meier curve. He wants to weigh up writing vs surgery based on his
prognosis, making the most of this time. I think I’d opt for writing over
neurosurgery #MTWBookClub
I completely agree with this,
aiming to find that balance between both was a struggle but he had to make that
decision based on his current prognosis. I’d be the same
Do you think his decision to
write rather than attempt to complete residency was fuelled but the knowledge
that it would be a more lasting legacy for his family and friends? #mtwbookclub
I didn't think of this! My
thinking was that writing, unlike neurosurgery, was less physically demanding -
that it was a practical decision. But arguably, his writing, and this book, has
had a much longer-lasting, and wider, impact? I mean, we are reading it!
#MTWBookClub
p196 - the birth of his daughter.
He writes 'Looking out over the expanse ahead I saw not an empty wasteland but
something simpler: a blank page on which I would go on'. I found this
acceptance of life continuing without him profoundly moving #mtwbookclub
@MTWnhs
Q.4 – What did you think of Paul and Lucy’s decision to have a child,
in the face of his illness? When Lucy asked him if he worried that having a
child would make his death more painful, and Paul responded, “wouldn’t it be
great if it did,” how did that strike you? Do you agree that life should not be
about avoiding suffering, but creating meaning?
deciding to have a child in this
situation was incredibly difficult. I really felt for Lucy, knowing she will
become a widow and a single parent must have been so daunting for her - dealing
with her own grief and supporting Cady through hers #MTWBookClub
If I were faced with Paul and
Lucy’s situation I think I would have made the same decision. Is there anything
more meaningful in life than creating a life? Cady is part of Paul’s legacy.
However, I can imagine this feeling quite bittersweet for Lucy #MTWBookClub
p143 - they agreed that life was
not about avoiding suffering and it became a decision that involved the whole
family; I wondered if death is easier to face if you have the lasting legacy of
a child? A hard decision for them both to make #mtwbookclub @MTWnhs
Q.5 – How did this book impact your thoughts about medical care? The
patient-physician relationship? End of life care?
I thought it must be hard for
clinicians to be treated by their peers, and that clinicians must have to
change their approach when dealing with patients who may know as much as they
do. It must increase empathy on both sides of the relationship #mtwbookclub
@MTWnhs
Agree. I thought Emma, Paul's
Oncologist, was really good at navigating this relationship. Knowing when to be
a doctor and when to be a peer. Paul did say he was grateful knowing that he
didn't *have* to have the responsibility of his own care #MTWBookClub
I think as patients we forget
that doctors are human too and susceptible to the same stresses and illnesses
as we are. For me, it stripped out the hierarchical nature of the Dr-patient
relationship (in some cases), and made me feel like we’re all in this together
#MTWBookClub
Q.6 – Given that Paul died before the book was finished, what are some
of the questions you would have wanted to ask him if he were still here today?
If Paul had survived I would have
asked whether his experience had brought him any closer to understanding the
“the Physiological-Spiritual Man’. Exactly how does the language of life
interact with the language of neurons, and heartbeats etc #MTWBookClub.
I’d want to ask him if he felt it
was worth it? Did he feel like he made the right decisions on how to spend his
time, energy, relationships, and his role as the writer and analyst vs the
surgeon? What would he have done differently if he’d had the chance?
#MTWBookClub
It is hard to narrow it down and
pick just one question to ask, especially to someone so accomplished and with
so many experiences in a relatively short life #MTWBookClub
I'd ask if there was anything he
would change about his life pre-diagnosis if he had known he would die at 36. #mtwbookclub
@MTWnhs
We were pleased with the response and with the discussions
had and are already well underway with planning for our next meeting. If you
are interested in taking part, there is no commitment required beyond a desire
to read a book as voted for by our followers and to log onto Twitter at the
meeting time to share your views by using the #MTWBookClub hashtag.
For our next meeting, in acknowledgement of Black History
Month, the book we will be discussing will be chosen from the Diversity and
Inclusion collection available as e-books to all NHS staff and students via
Kortext. Follow us on Twitter @mtwnhslibrary
where we will shortly put up the poll for you to vote on the next book!
