If the holidays are still ahead of you and you’re looking for something other than the famous “beach book”, you couldn’t do better than Austin Duffy’s new one. Although Duffy’s day job is that of an HSE consultant oncologist, this novel is not about cancer.tells the story of three young aspiring doctors working in an acute care hospital in Dublin. Or maybe they should be described as “survivors”, given the level of pressure they are under.
This pressure comes from the hours they have to work, the constantly interrupted sleep they get, and the variety and intensity of the demands placed on them. The two men and a woman know a different hospital than the hospital patients know: it is an institution with dark, half-lit corridors and working stairs connecting the floors.
The narrator, one of the three, sees the woman as bright, competent and risk-taking and the male colleague as showing far less promise and far more ability to meet challenges. The reader is unsure how good the narrator’s judgment is, given his pervasive fear and pervasive exhaustion, but ends up rooting for the three members of their unchosen group.
This scenario has been explored by other writers, most recently Adam Kay, the British comedy writer/comedian who was a doctor before giving up that profession, earning his living instead by writing and acting on television. A few years ago, Kay wrote a very funny bestseller titledabout his experiences as a young doctor in the NHS. The book was based on journals he kept during this period of his life and manages to be funny and sad at the same time.
Kay belongs to a tradition of mostly non-fiction doctors/writers started by Richard Gordon, who wrote the books that became hugely popular.film series. Gordon’s books ranged from light-hearted fictional personal experience to equally light-hearted stories of medical oddities, including his account of a surgery performed in the pre-anaesthetic days where speed was of the essence, because if you amputated your leg of a patient while that patient was conscious, their agony was indescribable and vocal.
Gordon’s quintessential story from this period involved a surgeon highly regarded for his phenomenal speed.
In this particular case, the major surgery was completed in less than five minutes. True, the surgeon cut the hand of a passerby, who died a few days later of an infection, as did the patient, as well as a surgeon’s aide who fell dead when he saw the wound of the passerby . Gordon noted with regret that although the operation was technically a success, it had a 300% mortality rate.
At first glance, Gordon/Kay’s books and those written by Austin Duffy have a lot in common: unforeseen complications, bulldozing stress, tragic outcomes, and ridiculous/comical situations. But– which will be published Thursday by Granta Books – is much more. It is about skewed perceptions, visceral fears and, above all, a constant and overwhelming belief that something fatally damaging is about to happen to the patients or young doctors involved.
Whether he’s writing about what it feels like in the very early stages of Alzheimer’s disease or the dark cloud cast over other lives by the suicide of a colleague, Duffy does his business quietly, without flashy touches. The reader ends up scarred by the reading experience, holding the paperback, finished and closed, not wanting to immediately rejoin the real world.
Doctors double down as novelists arguably more often than any other profession, with the possible exception of the legal discipline, and even then lawyers or ex-lawyers tend to write throwaway thrillers, rather than jaw-dropping works of literature. Doctors-writers, of course,
include our very own Oliver St John Gogarty, who went on to be a poet, playwright and novelist as well as a lifelong physician and adventurer.
Today and in Gogarty’s time, the doctor/writer has unparalleled access to humanity at its most pathetic, most vulnerable. Axel Munthe, a Swede who spent a lot of time in Capri, and wrote about the clinic he established there inmovingly describes the treatment of local prostitutes and the management of problems such as hereditary infantile syphilis.
Munthe’s book was not a novel — the first successful doctor/novelist was probably Somerset Maugham, whoseexamined the difficult short life of a factory teenager in late 19th century London.
Maugham’s novels became a little less melodramatic as his career progressed, witha harrowing study of an emotional controller.
AJ Cronin, a Scot, has been described as “the prototype doctor-novelist”, although his output has been spotty. While his bestseller —released in 1937 – succeeded in sparking an in-depth discussion of the medical ethics affecting its characters while also generating a blockbuster movie.
Mark Harris, who recorded the wartime experiences of five famous directors innoted that Cronin’s next story, “about a young British nurse who dumps her sister after her negligence causes the death of a child, was contrived and soapy.
“Three writers had worked on the script, but none of them could do much to fix the scene in which an old gossip who threatens to expose the young woman conveniently rolls off a cliff into a bus, or a senseless final act that punishes the culprit sister by causing the 1918 flu epidemic to sweep London.
Cronin’s phenomenal output of over 5,000 publishable words a day may have contributed to his not always delivering, but his work was so enduring that just five years ago, a new collection of short stories he wrote in the 1930s has been published.
His contemporary in the United States was Frank G Slaughter, who wrote nearly 60 books – most were novels, but some were popular medical histories – and sold nearly 70 million copies.
“He was so successful early in his writing career,” writes Ira Rutkow, whosea history of the surgery, just published, “that at the end of Slaughter’s wartime service as an army surgeon, he closed his surgical practice in Jacksonville, Florida, and devoted himself to activities literary.
“Year after year, Slaughter produced one or two novels, writing several thousand words a week.”
This option – to close the medical practice and only work on fiction – is not available to doctors/novelists in Ireland. Which is not necessarily a bad thing, at a time when we lack medical professionals. In addition, maintaining the day job helps maintain a close link with the realities of the hospital floor.
Austin Duffy is currently a full-time medical consultant. Readers should hope he continues to find enough time to continue producing a valuable novel every two years.