Weyler förlag, 2013.
Reviewed by Anna Paterson in SBR 2013:2
Review Section: Non-Fiction
Reviewed with Maciej Zaremba's Patientens pris
Elsewhere in the issue (SBR 2013:2), I write at greater length about these two books; here, as a reviewer, I shall just discuss them briefly. They were published in close conjunction, as if the publisher wanted them to be seen as two sides of a prism through which to view ill health and death. Kristian Petri’s low-key but passionate, very personal account of his father was, at least in a sense, made possible by his father’s fatal cancer. Maciej Zaremba has written an objective, fact-laden but equally passionate account of conflicting financial and care goals in the Swedish health services. Petri is a writer and filmmaker, much admired by people who take such things seriously, and Zaremba has achieved nationwide recognition for his work as an investigative journalist.
Both books are arguments as much as works of literature, inviting thought about what illness means to the individual and his/her nearest, as well as presenting, at times obliquely, the issues raised by attempts to organise health care on a massive scale.
Petri is an imaginative individualist, whose restless mind often turns inwards to observe and, in a curious way, empathise with himself, with his past resentment as well as with his present confusion and grief. His thoughtful but relentless examination of his own relationship with his dad has annoyed critics in Sweden, who feel that the book contains too much about the son and too little about the father. But Petri is being scrupulously honest, also about when and why their relationship foundered. Impending death changed much, but not that. Genuine compassion filters through in many passages, and never more strongly than in a sustained, furious attack on the ‘care’ home where his father died. The unhappiness he describes has had a wider effect on public debate and professionals in palliative care have taken what he writes seriously.
Zaremba argues that public debate about health care, with lay as well as professional input, is precisely what has been lacking since the 1990s. In Patientens pris, he has returned to old hunting grounds: in 2004, he upset many with his reportage on the (mal)functions of the county-based health boards and of care of the elderly in particular. In the 2013 series of articles that form the core of his book, he wolfishly stalks another health service quarry. Illustrated by a wealth of upsetting, sometimes dramatic case histories, his book scrutinises the so-called New Public Management (NPM) principles as they have been applied to health care. Zaremba shows that in Sweden, where the notion that ‘what’s best administered is best’ is widespread, truly unfair and damaging examples of how health should not be managed are alarmingly common.
NPM is a set of dictates, lightly disguised as a benign concept. The idea is that by costing health care interventions and ‘marketising’ the service, public spending will be under control and the messy process of looking after the sick will become an efficient business. Anyone heard that argument before? It is further examined at the end of Zaremba’s book, where an oncology consultant, now retired from Stockholm’s Karolinska Hospital, and two leading political scientists from the University of Uppsala, make well-informed and fascinating contributions.
We are all deeply concerned about health and ill health, perhaps more at present than ever before. Together, the works by Petri and Zaremba, by respectively a romantic, melancholic, introverted writer and a realistic, argumentative, extroverted journalist, make a perfect combination for those wanting to get a grip on their own issues with ‘the system’. Read Pappan for its literate empathy and Patientens pris for inspired investigative journalism.