So, a very big thank you to Polly Morland and to our unnamed colleague, the wonderful subject of ‘A Fortunate Woman’, for inspiring us this year and giving us hope for next. A Fortunate Woman’ sets out in compelling detail the relationship-based care that will be lost forever if we do not act to support and revitalize a profession under threat. It is a vibrant and authentic portrait of the rural family doctor in these difficult contemporary times. Trisha Greenhalgh, Professor of Primary Care, University of Oxford I know this not because I am a doctor myself, but because I’ve spent the last two years studying one. Over many months, I observed a remarkable female GP at work in the same rural practice portrayed in A Fortunate Man, John Berger’s classic account of a country GP in the mid 1960s. In the course of around 130,000 patient encounters over more than 20 years, she has built something that many doctors no longer enjoy: high-quality, longstanding relationships with her patients. This beautifully crafted book drew me in immediately by reminding me of so many reasons why I became a general practitioner in the first place…a compelling narrative based on patient stories. I loved it. Professor Dame Helen Stokes-Lampard

A Fortunate Woman: A Country Doctor’s Story - The Top Ten A Fortunate Woman: A Country Doctor’s Story - The Top Ten

I thought this book was brilliant. In all honesty, I assumed when I first saw the title that it was a straightforward memoir by a country GP, written by her, the usual run of the mill type stuff. Little did I know it was linked to a previous book A Fortunate Man: The Story of a Country Doctor, and the GP practice in Morland's title is the same one as featured in that book.This focus on the whole person, while valuable in all medical disciplines, is bread-and-butter work for GPs. Their role as the keeper of patients’ stories is what most of them love about their job, or what they used to. Because the world has turned, and with it the dynamics of primary care. Few of us attending the doctors’ surgery these days expect to see the same GP twice. We don’t know our doctors like we used to, and they don’t know us, a situation only compounded by Covid and the default to remote consultation. Shared stories have, in many cases, given way to medical transactions. As patient numbers have risen, speed of access to a doctor – any doctor – has become the overriding priority At the college’s threescore and 10, outgoing president Martin Marshall offers a sobering assessment of how the profession is bearing up. “There has to come a point,” Marshall says, “where doctors decide, I can’t do my job any more, and then the situation will spiral out of control. I would use the term crisis: so many parts of the NHS are under such enormous pressure that they are unable to provide the personal care that patients need, unable to provide effective care, and increasingly unable to even provide safe care.”

A Fortunate Woman by Polly Morland, Richard Baker - Waterstones

Christina Patterson, Sunday Times The doctor's kindly, hollistic approach - she makes time to investigate her patients' social as well as physical needs - seems to evoke a lost world . . . Morland's book contains a profound message for the future at a critical moment for general practice and us all.This book deepens our understanding of the life and thoughts of a modern doctor, and the modern NHS, and it expands movingly to chronicle a community and a landscape – “the valley” itself is a defining feature of people’s lives. It explores the choices the doctor made in her young life, and the difficulties, decisions, risk assessments, ethical questions and occasional spells of anguish that make up a GP’s normal day, as well as the jokes, tea and levity. There are farmers so stoical they can go on calving for ten days despite a broken femur, babies with earache, transgender teenagers, bewildered elders, blood and, eventually, Covid. All her patients seem to agree their doctor is “a good listener”. All human life is here in this evocative portrayal of the challenges and joys of rural family doctoring in modern times. Enthralling and uplifting. James Le Fanu, author of The Rise & Fall of Modern Medicine The anonymous inspiration of Morland’s book – who becomes a kind of emblematic GP everywoman – is Dr Rowena Christmas. I spoke to her about some of the book’s implications, and her current practice in Monmouthshire. She outlined the weight of medical evidence that supported Morland’s argument. “If you have an ongoing medical problem, you’re better to see the doctor that you’ve been seeing regularly. Studies that show that patients who’ve seen the same GP for a year or longer are 25% less likely to use out-of-hours services or be admitted to hospital in emergency, and have better outcomes in all sorts of ways.”

A Fortunate Woman by Polly Morland, Richard Baker - Waterstones A Fortunate Woman by Polly Morland, Richard Baker - Waterstones

Morland writes about nature and the changing landscape with such lyrical precision that her prose sometimes seems close to poetry' - Christina Patterson, The Sunday Times Every reader will meditate on their own encounters with GPs. Of her doctor, Morland writes: “Her life’s work is not simply about the application of a body of knowledge to an assortment of human objects… it is a pursuit meaningful in and of itself.” The word “relationship” is often used. The doctor says that hers is the only branch of medicine founded on relationships. It’s the boiling frog analogy,” Hodges says. “The water’s not been comfortable for a decade, but it’s now very noticeably warmer. It will soon reach a threshold where there is a collapse.” Care and Compassion. Dedication. Resilience. Adaptability. Crisis management. Continued learning. Family and community based holistic care. Above all a keen interest and mutual respect for her team and patients. So many wonderful foundations for an excellent example of what many of us want from “our doctor”.A beautifully written book, both moving and humbling. Lissa Evans, author of Crooked Heart and Old Baggage

A Fortunate Woman - Polly Morland

The descriptions of both the people and the place are a delight, beautifully illustrated by Richard Baker’s photographs. Although there is loss and grief in this book, it is also a celebration of what general practice can be at its best. Recommended reading for all aspiring doctors, and especially for those working in health policy, so they may understand and preserve the crown jewels of the NHS. Dr Helen Salisbury, Nuffield Department of Primary Care, University of Oxford That’s one of the reasons there are so few takers. When Hodges got his first salaried GP job there were 50 applicants. Today, all the local GPs I speak to insist that you could pretty much walk into any practice in the county and be hired on the spot. Not surprisingly, young doctors often prefer a few days a week as a contracted locum without the pressure of also being responsible – as here – for the management and livelihoods of 140 staff. The result is a kind of perfect storm of stress on the traditional partnership model – a recent Royal College of General Practitioners survey found that 42% of GPs in England were “likely or very likely to leave the profession in the next five years”, with nearly half of those suggesting burnout or stress as the prime reason.

Revisiting Berger’s story after half a century of seismic change, both in our society and in the ways in which medicine is practised , A Fortunate Woman sheds light on what it means to be a doctor in today’s complex and challenging world. Interweaving the doctor’s story with those of her patients, reflecting on the relationship between landscape and community, and upon the wider role of medicine in society, a unique portrait of a twenty-first century family doctor emerges.