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Cold Tea and Tears - it DID happen to a dietitian!

A "Profession Confession" by Mary Farmer
Publisher: Matador
Price: £8.99 paperback Buy on-line from Amazon
Schoolteachers have the Three Rs, dietitians the Three Ps - and I shan't tell you what they are, for fear of putting you off your lunch! Mary Farmer is a retired dietitian with many years' experience of working in the NHS, and she has turned that experience into a fascinating account of life at the "coalface" of healthcare in Britain.
She has a light touch, despite the seriousness of much of her subject matter, and a great sense of humour, which must have been essential to get her through some of the challenges of bringing nutritional guidance to the (often) unreceptive. Both qualities shine through this book, which contains many personal anecdotes, as well as perceptive comments about the evolution of the NHS, from one who was well placed to see the unintended consequences of some of the changes introduced by successive governments.
This is a candid account, written under a pseudonym, and the locations have also been fictionalised rather charmingly, so that the reader finds themselves travelling the lanes of Woodlandshire or Borderland with Mary - often accompanied by her unofficial canine assistant - in her little red convertible, as she motors from clinic to house call to hospital, dispensing sound advice and trying to catch up with a cuppa (invariably cold!) along the way.
Anyone with more than a passing interest in food already knows that what we consume has a major impact on our health. Reading "Cold Tea and Tears" will help you to appreciate the central role of nutrition in recovery from illness and management of long-term conditions. Dietetics is an extremely complex subject, and there are certainly some "science bits" in the book; fortunately never enough to overwhelm the lay reader. But if you were in any doubt about the professionalism and extensive knowledge required by a registered dietitian, you won't be after reading this!
Powerful chapters dealing with anorexia, diabetes, and the difficulties of tube feeding people who are unable to swallow, give an insight into the incredibly varied and valuable work of those whose job has sometimes been unkindly summarised as "telling fat people how to lose weight". Obesity is, of course, a great and growing problem for the health service, and Mary Farmer does not shirk from laying the frightening statistics before her readers, not least the estimated £3.6 billion annual cost of treatment. This is contrasted, however, with the £13 billion cost to the NHS of malnutrition, particularly amongst the elderly. If between 25% and 40% of older people admitted to hospital or residential care are already malnourished, and more become so following admission, we should all be as angry as she is about this manifestation of neglect and lack of care for the well-being of frail and vulnerable individuals.
Although billed as the story of a dietitian, "Cold Tea and Tears" is perhaps equally compelling as a sort of professional Everyman's account of working in an increasingly dysfunctional NHS. The complex and multiplying layers of management are here, as are the unedifying battles over territory and responsibility. The relentlessly rising costs of change and reinvention, and the growth of a culture where protecting your back as a practitioner takes precedence over care for patients. It is a story which is both individual and general; and perhaps one person's account is as telling a portrait as we are likely to get.
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Reviewed by: Frances Leckie, Independent Living's Editor

Coming soon
We are thrilled that Mary Farmer will be contributing articles on various aspects of diet and nutrition to Independent Living. If you would like us to let you know when the first piece appears, just send an e-mail and we'll add your name to the mailing list.