Stephen Fabes is an emergency room doctor at St Thomas’s Hospital, London. Not exciting enough for you? Well, he also spent six years of the past decade cycling six continents (so, all bar Antarctica). His statistics are beyond impressive: 53,568 miles, 102 international borders, 1000+ nights of free camping, 26 bicycle tires, and 23 journals filled with his experiences. A warm-up was cycling the length of Chile with his brother at age 19. After medical school in Liverpool and starting his career in London, he found himself restless and again longing for adventure. The round-the-world cycle he planned fell into four sections: London to Cape Town, the West Coast of the Americas, Melbourne to Mumbai, and Hong Kong to home.

Signs of Life is a warm-hearted and laugh-out-loud funny account of Fabes’ travels, achieving a spot-on balance between major world events, the everyday discomforts of long-distance cycling and rough camping, and his humanitarian volunteering. He is a witness to the Occupy movement in Hong Kong, the aftermath of drought and tribal conflict in Africa, and the refugee crisis via the “Jungle” migrant camp in Calais. The desperate situations he saw while putting his medical expertise to good use in short bursts – e.g., at a floating clinic on a Cambodian lake, a malaria research center in Thailand, a leper hospital in Nepal, and a mental health rehabilitation clinic in Mumbai – put into perspective more minor annoyances like fire ants in El Salvador, Indonesian traffic, extreme cold in Mongolia, and camel spiders.

Wherever he went, Fabes met with kindness from strangers, even those who started off seeming hostile – having pitched his tent by a derelict cabin in Peru, he was alarmed to awake to a man pointing a gun at him, but the illicit gold miner soon determined he was harmless and offered him some soup. (Police officers and border guards were perhaps a bit less hospitable.) He also had occasional companions along the route, including a former housemate and a one-time girlfriend. Even limited shared language was enough to form common ground with a stranger-turned-fellow cyclist for a week or so. We get surprising glimpses of how Anglo-American culture permeates the developing world: For some reason, in the ‒Stans everyone’s point of reference when he introduced himself was Steven Seagal.

At nearly 400 pages, the memoir is on the long side, though I can see that it must have felt impossible to condense six years of adventures any further. I was less interested in the potted histories of other famous cyclists’ travels and would have appreciated a clearer sense to the passing of time, perhaps in the form of a date stamp at the head of each chapter. One of my favorite aspects of the book, though, was the use of medical metaphors to link geography to his experiences. Most chapters are titled after health vocabulary; for instance, in “Membranes” he ponders whether country borders are more like scars or cell membranes.

Fabes emphasizes, in a final chapter on the state of the West upon his return in early 2016, that, in all the most important ways, people are the same the world over. Whether in the UK or Southeast Asia, he sees poverty as the major factor in illness, perpetuating the inequality of access to adequate healthcare. Curiosity and empathy are his guides as he approaches each patient’s health as a story. Reflecting on the pandemic, which hit just as he was finalizing the manuscript, he prescribes global cooperation and innovation for this time of uncertainty.

We’re all armchair travelers this year, but this book is especially for you if you enjoy Bill Bryson’s sense of humor, think Dervla Murphy was a badass in Full Tilt, and enjoyed War Doctor by David Nott and/or The Crossway by Guy Stagg. It’s one of my top few predictions for next year’s Wellcome Book Prize – fingers crossed it will go ahead after the 2020 hiatus.

My rating:

With thanks to Dr Fabes and Profile Books for the free copy for review.