Polly Morland Longlist Author Interview

How does it feel to be longlisted?  

It’s both a thrill and a great privilege to be keeping company with some of the extraordinary storytelling recognised by the Baillie Gifford Prize over the years. My book is a love letter to a landscape and a community, but above all to a model of medical practice that’s now critically endangered. A Fortunate Woman is, at one level, a miniature, the story of one country doctor and her patients, but it also tells a much broader story about what it means to be a doctor at a time like this; it’s about the nature of medical vocation, the process of care and  how fundamental the doctor-patient relationship is to both. If we can only come to understand its value to both patients and doctors, then perhaps we stand a chance of saving it. That is why it’s so hugely gratifying to feel that this story resonates beyond the valley where it unfolds.  

  How did you conduct your research?  

The documentary method, with its emphasis on close observation, has formed the spine of my research for A Fortunate Woman. This approach elicits a very particular kind of story, one that blends intimacy and distance in a way that’s proved vital to this book. It’s built around a year of observation and conversation with the doctor whose story it tells, above all, the many hours we spent walking together through the woods of the valley where the book is set. In part, this was a practical response to the safety concerns of the Covid pandemic, but it turned out that the dynamics of these long walks opened up the story far beyond the emergency of the moment, allowing the doctor to talk about her life. I also conducted numerous interviews with patients, colleagues and many local people, several of whom knew the doctor in John Berger’s A Fortunate Man. Because, of course, this is the valley and the community where I live too, so that meant a level of immersion in the life of this place that’s central to how the narrative unfolds. The days between interviews were spent buried in medical papers and core texts, in order to understand the context, history and current research around the practice of family medicine. From time to time, when lockdown permitted, we were also joined in the valley by a long-time collaborator of mine, the documentary photographer, Richard Baker, whose images are woven into the storytelling.   

What aspects of medical life in the countryside have changed between 1967 and today?  

Primary care has changed beyond recognition since 1967 when John Berger’s A Fortunate Man was written. The nature and sheer scale of those changes—in medical science, practice and outcomes, but also right across society, class, gender, the nature of rural life and community—is, in some sense, what A Fortunate Woman is about. Perhaps most significant of all is the gender shift within medicine, general practice in particular. In 1967, less than a quarter of family doctors were female. That changed slowly at first and since the millennium, at speed. By 2014, the majority of the GP workforce was female and that figure is set to rise further. The archetypal figure of the ‘Fortunate Man’ is now in fact a ‘Fortunate Woman’. And to me, it felt like high time to regard her with a female gaze.  

To what extent do you think the pandemic exposed pre-existing cracks in our healthcare system?  

Undoubtedly the pandemic forced a number of crisis issues to the surface, most particularly in the already beleaguered relationship between many family doctors and their patients. Covid had the immediate and savagely deleterious effect of further disrupting the human connection between doctors and patients, with the loss of touch, empathy, trust and later, the sheer difficulty of getting an appointment at all, as the service reeled under unprecedented demand and a workforce crisis. But make no mistake: continuity of care was already in steep decline long before the pandemic struck. In spite of a growing body of evidence linking good doctor-patient relationships to better health outcomes, the shift towards a primarily transactional model of healthcare was already well underway. My book explores the human story behind all this, in order to show (not tell) exactly what is at risk of being lost. Because, of course, the doctor in A Fortunate Woman is, in many ways, one of the lucky few. She has managed to build and retain longstanding and warm relationships with many of her patients, their lives and stories entwined with her own. She is, in that sense, a rarity and a very fortunate woman indeed.  

What are you working on next?  

I’m in the very early stages of researching a new book. I can’t say more than that at this stage