Mark Reece's Blog - Posts Tagged "essay"

London Review of Books by London Review of Books

My rating: 5 of 5 stars


This review is for the 'After Martha' article that appeared in the 25 September 2025 issue. The article details the aftermath of the death of Martha Mills following a bike accident, and the efforts of her parents to understand the medical errors that significantly contributed to what had happened.

It was an outstanding essay that demonstrated exceptional emotional restraint and even handedness given the circumstances, in addition to employing very carefully reasoned analysis. Sadly, the parents had to struggle for many years to cut through bureaucratic investigative processes that often served to obscure rather than illuminate events. Although there was never any suggestion of deliberate harm, there was often a grotesque mismatch between the obvious sorrow of the parents on the one hand, and the insistence of many of the doctors and administrators to view what had happened in arid organizational terminology, often speaking of the need (for example) for doctors to 'reflect' on what had happened.

There was also an interesting discussion of the way that the (not inherently unreasonable) desire to avoid 'blame culture' can be used to hide accountability for medical staff's actions. I was struck by the amount of times throughout the article where the author related how medical notes relevant to an investigation had 'gone missing', and how often doctors changed their accounts without professional consequences.

The author also gave a fascinating glimpse into medical culture, in which there exist hierarchies that would be mysterious to outsiders. For example, he described how liver specialists in the hospital where Martha died were considered an elite due to both their reputations and their ability to generate research funding. Apparently, in the past senior doctors sat in a different part of the canteen. These cultural practices, although comic, have the potential to cause patients serious harm.

Happily, some small good came out of Martha's death, in that the parent's campaigning led to 'Martha's law', which grants patients the right to request a second opinion. It is sad although perhaps inevitable that in large, complex institutions like the NHS, only tragedies will be sufficient to generate reform.



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