The NHS, friendship as soldiery and moments of the ridiculous: a Q&A with Francesca Segal

EVENT: Francesca Segal will be at the Bookshop on Thursday 6 June to discuss her new memoir Mother Ship with Olivia Laing. Book tickets here. Below, Segal answers our questions about the NHS, her experience of it as a patient, and the power of friendship and humour to help you through it all.

There’s a wonderful passage about a third of the way into the book in which you praise the ‘sheer moral courage’ of the National Health Service, and mention the daily cost of the care of each of your daughters (around two thousand pounds). Did your experiences in hospital with your girls change the way you felt about the NHS as an institution – do you think it made you more political at all?

It is a powerful experience to stand in the middle of a ward day after day, to look around and to think – we are all cared for equally here, whatever our background, circumstances, financial resources, country of birth – there we were together, and our children were privileged to receive pretty much the best care possible, worldwide. We couldn’t have paid for better. The NHS takes such a beating – I think often it is treated like a parent, bemoaned and taken for granted because we have all grown up feeling so safe and secure in its care that we presume the love goes without saying. But it cannot be taken for granted. It takes care of us and we must take care of it.

You’re particularly good at capturing the disorientating experience, as a patient, of feeling ignorant and impotent, almost irrelevant, in the face of experts who one is expected simply to accept, respect and trust, no matter how brusquely they treat you. Can you say a bit more about that experience, and how your feelings about it evolved over your twins’ time in hospital?

I can’t speak for anyone else but before I had my own children I had no idea what I was doing with babies under the best of circumstances. And so I suspect I would always have panicked about my own incompetence when the girls were born, even if they’d been full term. But when one’s babies require twenty-four hour medical intervention to stay alive one’s own incompetence is stark and unavoidable. I was entirely unqualified to take care of my own children – that was the reality. Slowly and painfully, as the weeks went by, I learned to take charge, first of trivial matters – nappy changes, taking their temperature; eventually I came to understand that I was in charge of making more fundamental decisions too, and that I had a right to assert myself on the ward. But it was a steady dawning, and probably inelegantly won.

This is a book full of generous people: the women who knit hats for premature babies, the doctors and nurses at the local hospital to which you move, and especially, the other mothers you meet. I was reminded of Rebecca Solnit, writing in ‘A Paradise Built in Hell’ of the extraordinary qualities of friendships forged and labour undertaken in great adversity. Do you think the bonds of friendship are stronger as a result of that shared experience of pain?

Yes, without a doubt. It is as close an experience as I can imagine to being in a unit of soldiers. We were fighting the same battle, shoulder to shoulder, and to have a huge amount of shared territory and experience meant that we could immediately speak in a shorthand that spared us explanation. Old friends were wonderful, don’t get me wrong. But in the throes of a crisis that changed hour to hour let alone day to day, it was often too much to have to catch people up with latest developments in order to be able to talk about whatever had most recently happened. The women on the ward were there, living through the same. It also made it safe for us to laugh together – it was taken for granted that we were not trivialising or diminishing what was happening, and were safe therefore to appreciate whatever moments of black comedy came along.

‘It was some time, after that, before we laughed again’: this sentence at the end of the Preface (Day Minus One) completely floored me. You have a great eye for the bright sparks of humour that fly up even in the darkest of situations; how much of that do you remember noticing ‘in the moment’ and how much was hindsight (in the spirit of comedy & tragedy + time)?

I think a reasonable amount of it was funny even at the time. Which is not to say that it was exactly a laugh a minute. But a crisis that goes on and on is inevitably replete with moments of the ridiculous. They are the gifts and you must seize them.

Francesca Segal’s ‘Mother Ship’ is published by Chatto & Windus, price £14.99. Francesca Segal is in conversation with Olivia Laing at the Bookshop on Thursday 6 June. Book tickets here.