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On the Mend

Sam McManus

Flesh and Blood: A History of My Family in Seven Maladies, by Stephen McGann, Simon & Schuster, 336 pp, £8.99, ISBN: 978-1471160813

The doctor`s consultation begins with taking a history. This involves not only asking about the patient’s symptoms and their past illnesses but also their family history, their work, their habits, and so on. It is an exercise in narrative, the doctor’s role being to listen to and interpret story. By the end of the consultation the doctor should be able to place the patient’s problem within the greater context of their life.

In a sense illness is narrative. In Stephen McGann’s book Flesh and Blood: A History of My Family in Seven Maladies he tells the story of the generations of his Liverpool Irish family through the prism of the illnesses they suffered. McGann is an actor, from a family of actors, the best known of them being his brother Paul, the “I” in Withnail and I. Explaining the structure of the book, he quotes Stanislavsky: “real life is a constant state of responding to things that happen to us, to challenges we face or the wants we feel, and then taking action”. Life is a drama between hero and antagonist, McGann writes, and in his book the antagonist, the means by which the hero’s actions can be understood, is illness.

The book has seven sections: hunger, pestilence, exposure, trauma, breathlessness, heart trouble and necrosis. Each of these are divided into what he calls “a medical exploration” of the ailment, then an account of a corresponding period of his family’s life, followed by a personal testimony from a member of the family.

The opening of each section, the descriptions of the ailments themselves, are the least successful. Medicine is, or at least strives to be, a rigorous science. This is an actor writing about medicine and there are some errors. In the section entitled “pestilence” he claims that infectious diseases’ “characteristic is that they are transmitted from one person to another”. What of insect-borne or water-borne infectious diseases? At another point he describes how as a child he received “intravenous injections” in his buttocks. He of course means an intramuscular injection. Even an intern on his first day on the job would hesitate to attempt to find a vein in the thick muscle of the buttock. These moments in the book stand out when read through jaundiced professional eyes, and perhaps are not noticeable to a general reader, but they cast a little doubt over the rest of the book.

McGann then spins a metaphorical meaning from each malady. This allows him to explore the wider social and psychological context of his family’s history. His account of their arrival from famine-struck Ireland to a teeming and pestilent Liverpool is particularly well done. His description of life in the cramped “courts” of the city, where dozens of families lived in straitened circumstances is vividly drawn and an enlightening piece of social history. The diseases that killed these famine refugees after they arrived in England: smallpox, TB, and in particular typhus fever, which became known as “the Irish fever”, he connects to the enduring idea of the Liverpool Irish poor being somehow symbolically pestilent. He draws this line through the twentieth century to the point where he is standing in the terraces at Hillsborough watching his fellow Liverpool fans being crushed to death. He convincingly relates the Sun’s infamous headlines in the aftermath of the tragedy to the nineteenth century public perception of the crowds of sick and hungry famine sufferers arriving on the docks in Liverpool 150 years previously.

McGann is an amateur, but very adept, family genealogist. In one section he follows his great-uncle’s life working as a coal trimmer in the early twentieth century great steam liners. His role in the darkened depths of these ships was to “trim” or even out the coal as it was used, to stop the boat becoming unbalanced. He then strikes genealogical gold when discovering that his great-uncle worked on the Titanic, and survived, finding an account of the sinking he gave in 1912 to The Yorkshire Post. In it he relates with glee how he survived by climbing onto the upturned hull of a lifeboat and the almost too good to be true anecdote of an entitled gentleman survivor who also managed to clamber on asking one of the lowly coal trimmers for his hat as he was cold ‑ to which he received a short and firm reply.

The arc of his family’s history, traced from a nightmarish famine-ravaged Roscommon, where “evicted raiths haunted their communities, living like wild creatures in bog holes” to the improved social housing of the prewar years, the 1950s lower middle class experience of Butlin’s holidays and Morris Minors, to McGann and his brothers’ success and their ascent into the London media class, mirrors what has been the hero’s ongoing triumph over his antagonist. The collectivisation and systematisation of a modern inclusive health and housing service and the great leaps in medical and pharmaceutical science have meant victories over maladies that were fatal to previous generations.

“Humans live as long as the stories they tell,” he writes early on. McGann, a storyteller in his working life, and a lyrical writer, is eager to give these forgotten members of his family an opportunity to tell theirs and live again. The McGanns are a normal working class Liverpudlian Irish family, or at least were until Stephen McGann and his brothers took to the stage, but the stories they tell are fascinating. What you are left with is the impression that the life of every family, in their battles with illness and circumstance, is remarkable, and that they all have a story worth telling.


Sam McManus is a writer, doctor and co-director of Irrgrønn Productions, a company that produces music, theatre and literature events. He has previously had his journalism published in The Irish Times, Village Magazine and Irish Medical Times. He has recentl been nominated for the 2017 Hennessy Prize for Fiction



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