Books: Pain and Prejudice: a Call to Arms for Women and Their Bodies: The Plea to be Heard

1. Keitt SK, Fagan TF, Marts SA. Understanding sex differences in environmental health: a thought leaders’ roundtable. Environ Health Perspect 2004;112(5): 604–609. 2. Schiebinger L. Women’s health and clinical trials. J Clin Invest 2003; 112(7): 973–977. 3. Soldin OP, Chung SH, Mattison DR. Sex differences in drug disposition. J Biomed Biotechnol 2011; 187103. 4. Anderson GD. Sex and racial differences in pharmacological response: where is the evidence? Pharmacogenetics, pharmacokinetics, and pharmacodynamics. J Womens Health (Larchmt) 2005; 14(1): 19–29. 5. Wu J, Gale CP, Hall M, et al. Editor’s Choice — Impact of initial hospital diagnosis on mortality for acute myocardial infarction: a national cohort study. Eur Heart J Acute Cardiovasc Care 2018; 7(2): 139–148. 6. Khamis RY, Ammari T, Mikhail GW. Gender differences in coronary heart disease. Heart 2016; 102: 1142–1149. 7. Plataforma SINC. Medical textbooks use white, heterosexual men as a ‘universal model’. Science Daily 2008; 17 Oct. 8. Henrich JB, Viscoli CM. What do medical schools teach about women’s health and gender differences? Acad Med 2006; 81(5): 476–482. 9. Roberts Y. Samira Ahmed’s victory has taught us a lesson: it’s still gender that fixes our pay. Guardian 2020; 12 Jan: https://www. theguardian.com/commentisfree/2020/jan/12/ samira-ahmed-victory-taught-lesson-still- gender-fixes-pay (accessed 2 Apr 2020). 10. Thomas C, Quilter-Pinner H, Harvey R, Wastell D. Revealed: GP gender pay gap as high as 35 per cent. IPPR 2020; 10 Jan: https://www.ippr. org/news-and-media/press-releases/revealed- gp-gender-pay-gap-as-high-as-35-per-cent (accessed 2 Apr 2020). physiology are aimed at a non-medical readership but there is much to learn for clinicians, especially for doctors dealing with medically unexplained symptoms (the highest risk factor for which is being a woman). As Jackson states, ‘I gave myself the title of hypochondriac before it became a complaint whispered behind my back.’ She is not alone. Women need to exert greater control over their health and this starts with being heard. Fiona Baskett, Fellow and Retired GP, Wiltshire. Email: [email protected] @FMB_fiona DOI: https://doi.org/10.3399/bjgp20X709757 * * * * * The Man in the Red Coat Julian Barnes Jonathan Cape, 2019, HB, 280pp, £20.00, 978-1787332164 A RICH AND WITTY TOUR OF BELLE ÉPOQUE PARIS, VIA THE LIFE STORY OF THE PIONEERING SURGEON SAMUEL POZZI This biographical account of the famous doctor in the life-size picture produced at the time of the Belle Époque in France (1871 – 1914), is a tour de force by Julian Barnes. The oil painting in ravishing red hues by John Singer Sargent celebrates a young surgeon who is going places and knows his mind. The scarlet cloak with dangling tassel and delicate doctor’s hands with assured visage was deemed too scandalous to exhibit in France. Perhaps this was due to the fact he was a very successful gynaecologist (and womaniser who is presumed to have slept with some of his celebrity patients) or perhaps because he was from Jewish Protestant Italian parentage. This did not sit well with Catholic aristocratic France. Remember this was at the time of the Dreyfus Affair, which split France in half and caused societal turmoil similar to Brexit Britain. Dr Samuel Pozzi married in his early thirties to a young French Catholic heiress and had three children, but the marriage was not a success and in his later years he had a long-term mistress with whom he travelled extensively. He did not leave any diaries of his life so Barnes has had to extrapolate from material written by others such as his daughter’s diaries and gossip magazines. Dr Pozzi was an impressively modern surgeon who worked in a public hospital. He attended lectures and ward rounds by Lister in Edinburgh, who described his aseptic and antiseptic procedures as well as advanced surgical techniques, such as catgut sutures, which Dr Pozzi applied in France. Women with fluid-filled ovarian cysts were common in Paris and Dr Pozzi was one of the first in France to operate successfully to cure benign versions of this condition. He did insist on full bimanual examinations on his female patients, which were frowned on by his colleagues. Nevertheless, he became the first Professor of Gynaecology in France. He consistently applied modern scientific

in the care of his patients and built a hospital in France with the latest medical ideas from the US, Germany, and England. He commissioned beautiful frescos to adorn the walls and corridors, and warned against the then fashionable use of ovariectomies to induce menopause for the treatment of female mental ill health. He was famous for his medical achievements and even joined other notable Frenchmen whose photographs adorned upmarket confectionery boxes. Dr Pozzi was an aesthete with fashionable tastes and went on an ‘intellectual and decorative shopping‘ trip to London with two of his aristocratic friends. These closet homosexual dandies were important gateways into the upper reaches of French society. Wisely, Dr Pozzi kept hospital bed number one especially for lady patients referred by the Count Robert de Montesquiou-Fezensac, who was a key figure in Paris society. Homosexuality was not a crime in France so it became a safe haven for Oscar Wilde and others. Perhaps here the book dwells too much on wider Parisian society and not enough on the medical and personal matters of Dr Pozzi. No lady patients ever complained about his care, although in his sixties Dr Pozzi was killed by a disgruntled male patient who shot him three times: in the arm, the chest, and the gut. Dr Pozzi had survived duels and attended duels as a personal doctor, and worked as an army doctor, but death was to come in his consulting room. Despite attempting to assist at his own operation to deal with his own mortal wounds, he died. Dr Pozzi may not be remembered in medical history but his legacy is an artwork of himself in his prime that has transcended time. Nigel Masters, Retired GP, Buckinghamshire. Email: [email protected] DOI: https://doi.org/10.3399/bjgp20X709769 * * * * * Heart Murmur Emma Storr Calder Valley Poetry, 2019, pamphlet, £8.70 DEFT, LYRICAL, AND BITINGLY FUNNY Emma Storr’s poetry book Heart Murmur was inspired by Emma’s fascination with the human body. The book contains 27 poems, written in contemporary language. These weave a path through the complexities of medicine, moving from a focus on a specific organ through to a contrite contemplation on clinical trials. These reflective poems are written from both the doctor’s and patient’s perspective. They draw on the ethical, moral, and emotional aspects of medicine. Importantly, the poems consider the effect of disease and management particularly through the uncertainty of everyday medicine. I enjoyed reading ‘Delivery’ with its calm account of the experience of an emergency section from the mother’s point of view: ‘Midnight slipped between their births, the witching hour split in two.’ Moving forward, I felt I was there examining a newborn infant in ‘Six-Week Check’. Here, Emma describes the incredible wonder of the new life, fragile and fresh in her hands: ‘your baked cub-like scent’. Yet I was perplexed by and have not understood ‘Clinical Trials’, with each paragraph ending with ‘you bastard’ . There is discerning familiarity in ‘Repeat Prescription’, which starts with ‘I want to prescribe panaceas for teetering marriages, for kids that disappoint.’ Furthermore, an excerpt from the poem ‘Consultation’ reads, ‘You’ve got a terrible sore throat and streaming nose … Sounds British Journal of General Practice, May 2020 251