Gavin Francis

Gavin Francis’s Intensive Care: A GP, a Community and Covid-19 is out now.

The Head in the Shed: Reading Bones

Gavin Francis, 21 January 2021

IanHamilton once recounted in the LRB (22 October 1992) that ‘when William F. Buckley Jr sent a copy of his essays to Norman Mailer, he pencilled a welcoming “Hi, Norman!” in the index, next to Mailer’s name.’ The index discloses a lot about the nature of a book, and the passions of its author, more than is sometimes realised (‘acknowledgments’ are...

The Untreatable: The Spanish Flu

Gavin Francis, 25 January 2018

It is estimated that five hundred million people contracted it, and that between fifty and a hundred million of them died. Asians were thirty times more likely to die than Europeans. The pandemic had some influence on the lives of everyone alive today. Donald Trump’s grandfather Friedrich died from it in New York City. He was 49. His early death meant that his fortune passed to his son Fred, who used it to start a New York property empire.

Awwooooooooooooooooo! Lycanthropy

Gavin Francis, 2 November 2017

‘The patient stated that he had known he was a cat since this secret was imparted to him by the family cat, who subsequently taught him “cat language”,’ the psychiatrists wrote. He held down a normal job, all the while ‘he lived with cats, had sexual activity with them, hunted with them, and frequented cat night spots in preference to their human equivalent.’ The psychiatrists had little hope for improvement – his belief had persisted despite various trials of antidepressants, anticonvulsants, antipsychotics and six years of psychotherapy. ‘His greatest – but unrequited – love was for a tigress in the local zoo,’ they concluded. ‘He hoped one day to release her.’

Cerebral Hygiene: Sleep Medicine

Gavin Francis, 29 June 2017

An​ apnoea is a cessation of breathing. When sufferers of sleep apnoea enter deep sleep, their airway becomes blocked by the tissues around their throat. They may gasp for air, and stir hundreds of times a night to a level just below conscious awareness. People with sleep apnoea wake up in the morning feeling as if they’ve slept normally, but are chronically tired because their sleep...

Diary: NHS in Crisis

Gavin Francis, 2 March 2017

Management consultant initiatives and stealth privatisations have for years set about the NHS like termites, nibbling away at the beams and struts of a once magnificent structure. But the whole edifice is now on the brink of collapse. If the principles of the NHS are to be defended, we will have to find more money.

Diary: In the Morgue

Gavin Francis, 14 July 2016

A detective inspector​ once told me that the key thing to remember at a crime scene was to keep your hands in your pockets; the temptation to reach out and touch a murder victim, or a potential murder weapon, could be overwhelming. He had little faith in forensic pathologists. ‘I was at a scene where a dead man lay slumped over a desk,’ he told me. ‘There was a...

In November​ 1981 at a function in London, Neville Butler, a professor of paediatric medicine at Bristol University, contrived to drop a cup of coffee at Margaret Thatcher’s feet. He stooped down to mop it up, then sprang up and asked her for money. ‘I’m Professor Butler,’ he’s reported to have said. ‘We’re doing a national study looking at...

On​ my morning commute through Edinburgh I pass a herbalist’s shop opposite the old medical school building. It was established in 1860. The windows are dressed at present with hand-made green paper leaves and a cardboard parrot; there are allergy salves for hay fever, iron tonics for fatigue and slippery elm for heartburn. At the back of one of the windows is a more permanent...

Cash for Diagnoses

Gavin Francis, 5 March 2015

For​ the last ten years GPs have been paid, by the taxpayer, to deliver ‘general medical services’ through a scheme based partly on incentives. ‘Quality of care’ is assessed using an ‘outcome framework’ known as QOF, whose parameters relate to expected best practice when treating various long-term diseases. Someone with diabetes, for example, should have...

How many speed bumps? Pain

Gavin Francis, 21 August 2014

I had just seen​ a man about his headaches and was about to call someone about her backache when the receptionist beckoned me over. ‘Mrs Lagnari is on the phone,’ she mouthed in a stage whisper. ‘Her husband is in terrible pain. Will you go and see him?’

During their training physicians are urged not to jump to conclusions. They’re supposed to wait until...

Diary: Listening to the Heart

Gavin Francis, 6 March 2014

Before​ stethoscopes were invented, physicians would listen to their patients’ hearts by laying one ear directly onto the skin of the chest. We’re accustomed to laying our heads against the breasts of our lovers, our parents or our children, but once or twice when I’ve rushed out on an urgent house call, leaving my stethoscope behind, I’ve had to rediscover the...

Don’t try this at home: Adrenaline

Gavin Francis, 29 August 2013

There’s a scene in Tarantino’s Pulp Fiction in which John Travolta’s character, a hitman called Vincent Vega, who has escorted his boss’s wife home after an evening out, returns from the bathroom to find her unconscious on the floor. Mia (Uma Thurman) has taken a bag of heroin from his jacket pocket and, mistaking the white powder for cocaine, snorted a line and...

Diary: Among the Neurons

Gavin Francis, 24 January 2013

I was 19 years old when I first held a human brain. It was heavier than I had anticipated; grey, firm and laboratory-cold. Its surface was slippery and smooth, like an algae-covered stone pulled from a riverbed. I had a terror of dropping it and seeing its tight contours burst open on the tiled floor.

It was the start of my second year at medical school. The first year had been a helter-skelter...

From The Blog
1 July 2014

At the Junction bookshop in Thimphu the manager is reading Sartre’s Age of Reason. ‘I’ve been trying to get hold of Nausea for months,’ she says, ‘but the Indian distributors won’t send it up.’ On a stand in the centre of the shop there are glossy photo books: cute, scruffy waifs; austere Himalayan panoramas; a coffee-table celebration of carved wooden phalluses (the Bhutanese strain of Buddhism employs phallic symbolism with zeal). These are the books laid out for souvenir shoppers. On the shelves, there’s a section dedicated to Ancient Greek drama, another to 19th-century Russian novelists (all in English translation). There’s a volume of Elizabeth Bishop, and some Freud. She has sold her last copy of Infinite Jest but still has a copy of The Pale King.


Arthur who?

3 January 2019

It is a customary pleasure of the LRB that, within a single issue, harmonies arise between different pieces, as well as contradictions. Just a few pages after Harald Prins’s letter in the issue of 3 January asserting that King Arthur’s legendary conquests in Iceland and Greenland legitimised British colonial conquest in the late 16th century, Katherine Rundell, in her piece on the narwhal,...

About Penguins

4 January 2018

Regarding the fatal disorientation of penguins, Robert Falcon Scott said of the adélie, the species that interested Werner Herzog, that they show ‘a pig-headed disregard for their own safety’ (Letters, 25 January). I was stationed in Antarctica in 2003 when a British Antarctic Survey pilot told me he’d spotted one more than a hundred miles from safety on the Antarctic plateau,...
Amia Srinivasan’s tentacular essay on octopuses was a treat. She mentions the 2010 EU directive on animal testing, which classified cephalopods with vertebrates, because of their ‘ability to experience pain’. That was 17 years after the UK recognised the sentience of these remarkable animals: in 1993, the then home secretary, Michael Howard, gave the common octopus, Octopus vulgaris,...

Cash for Diagnoses

5 March 2015

Gavin Francis writes: So it’s the fault of GPs, once again the lightning conductors for the nation’s health anxieties. I’m not insulted. What is outrageous is that this initiative specifically erodes patients’ trust in their doctors’ motives, and uses the consulting room to gather data rather than to offer help and support. So there are disparities between London and Belfast,...

Read anywhere with the London Review of Books app, available now from the App Store for Apple devices, Google Play for Android devices and Amazon for your Kindle Fire.

Sign up to our newsletter

For highlights from the latest issue, our archive and the blog, as well as news, events and exclusive promotions.

Newsletter Preferences