"Shadows in Wonderland"

I have been an avid reader for as long as I can remember, and even my day job, which involves trawling through articles, reports and media releases, many of them rather poorly written, has not killed my enthusiasm.

On the other hand, I probably wouldn't pick up a book about serious illness and hospitals if it hadn't come my way for review - but having started reading it, I found that I couldn't stop.

"Shadows in Wonderland" is written by Colin Ludlow and published by Hammersmith Press. It is his account of how he was found to be suffering from bowel cancer, his treatment at London's Royal Free Hospital, and how it all went terribly wrong. At the same time, it is a thoughtful analysis of the state of the health service in this country, how far apart are our expectations and the reality.

Colin Ludlow was a television producer before his illness, and his acute visual sense brings the hospital environment alive, in all its grimness. He makes the point, which had not occurred to me before, that our expectations of hospital are largely shaped by TV dramas, which condition us to expect a lot more action - and definite answers - than real-life medical treatment generally delivers.

His own experience, which he relates honestly and without self pity, is that medical interventions bring consequences, which may well be much worse than the patient imagines when starting their treatment. If we understood completely ahead of time, perhaps we would be much more reluctant collaborators in the process. So his initial surgery to remove a tumour in the bowel - a routine, albeit fairly major intervention - is followed by severe internal haemorrhaging, a dose of MRSA, and months of drip feeding, which sets off an unsurprising series of problems with his digestive system.

In reading this book, I learned that there is a word for illnesses caused by medics - iatrogenic - and also why it is necessary. The hospital environment itself, dreary, confusing and inadequately provided with simple facilities, such as comfortable waiting areas and natural light, is shown to be an obstacle to recovery. It is telling that the first time the writer finds himself in a hospital building which is bright, welcoming and restful, he realises that he is in a hospice wing for the terminally ill: you have to be dying before the NHS treats you like a human being.

"Shadows in Wonderland" is a compelling read, whether you are a healthcare professional or a "consumer" of the increasingly business-oriented NHS services. It clearly illustrates the fact that patients are more then just a set of medical conditions, and hospitals should be more than just a collection of facilities. Until we recognise this at the deepest level, treating the whole person in an environment that makes a positive contribution to wellness, the NHS is not likely to deliver the sort of results that we should aspire to as an affluent society in the 21st century.

In Sickness and in Health

I spend rather more time reading and listening to the radio these days, as my arms remain determined to pursue their status as redundant appendages, rather than reliable tools. I continue as editor of this website, using iListen, voice recognition software, which despite hiccups along the way, as we learned to accommodate each other's foibles, has now become an indispensable part of my working life. Although still not 100 percent reliable, the fact that it can make possible a job that formerly required hours of keyboard and mouse use, is a testament to the progress that has been made in this area.

And when I heard Alan Johnson, the health secretary, announcing that in future doctors should be issuing well notes, rather than sick notes, to encourage employers and employees alike to think about what people could do, rather than what they couldn't, my own situation seemed to provide an interesting illustration.

Almost certainly, if I had an employer, they would have stopped me working many months ago, when overuse of the computer first made my hands and arms too painful to continue. Rest is always the first prescribed treatment for repetitive strain injuries, and - perhaps also with an eye on some very large tribunal awards for work-related disabilities - responsible employers take no chances with the long-term well-being of their people.

But not having an employer, I don't have anyone telling me I mustn't work. Independent Living is my passion, and I'm not about to relinquish it.

So, rather as the government minister is recommending that occupational therapists should be assessing how much and what type of work someone can do when they have been ill, I have run a uniquely qualified eye over my own situation, and acquired the necessary tools to help me keep working. I am not as productive as I used to be - but given that high productivity almost certainly contributed to the problem, maybe that isn't so bad. And most importantly, instead of adding mental health problems of stress and depression to my woes, I do wake up most mornings, focused on what I can do, rather than what I can't.