Hospital dramas abound on TV – Holby City, Gray’s Anatomy, ER, House – they’re not quite as ubiquitous as crime but it seems odd that they’re notable by their absence from fiction given their enduring popularity. Its setting was partly what attracted me to Austin Duffy’s novel; that and the fact that he’s a practising oncologist. I was hoping for something along the lines of Gabrielle Weston’s quietly elegant Dirty Work with its compassionate story of a gynaecologist who performs abortions. Rather a lot to expect but Duffy’s novel doesn’t fall too short of that with its clear-eyed but humane story of a clinical researcher brought uncomfortably face-to-face with the disease he’s studying.
Our unnamed narrator has been working in his New York hospital for a couple of years having left Ireland shortly after his marriage ended. He spends his days tucked away in a lab monitoring cancerous mice injected with either the current drug under observation or a placebo. Not, as he muses, that mice are likely to experience a placebo effect. Sitting outside on the smokers’ bench one day, he meets a young Russian woman who introduces herself as a translator, a volunteer who helps the many Russians who find themselves in the hospital unable to understand what’s happening to them. Soon she’s popping up all over the place in her canary yellow sweater, making notes at lectures, attaching herself to rounds and translating oncologists’ prognostications, often choosing to soften them. Our narrator has his own preoccupations – it seems that his estranged wife is pregnant, possibly with one of the embryos they left frozen – but he can’t help but be interested in this attractive young woman given to wry pronouncements about doctors and their well-meaning uselessness. It seems their friendship might become something else until the real reason for Marya’s presence in the hospital becomes apparent.
There’s a welcome vein of quietly dark humour running through Duffy’s novel. Marya has a nice line in dismissive comments about doctors and their inability to help their patients. Our narrator is a man well-suited to the forensic observation needed for his work yet compassionate enough to have sought research as a retreat from clinical practise after Mrs X collapsed and died within minutes of him declaring her clear of cancer. His cool, slightly melancholic tone fits the novel beautifully. Duffy is very good at showing us what it’s like to be a doctor, unable not to assess everyone in terms of the symptoms they display: ‘If possible I would like to lose that skill’. His descriptions are striking if sometimes disquieting: an autopsy is often ‘like coming across a burnt village in the middle of nowhere, every inhabitant and piece of 
wood charred black. All you can say for certain is that there has been a fire or some other cataclysmic event’ while Mrs X’s liver has ‘”a large tumour burden” as if it were a working animal, unable to support the weight of disease’. It’s an unusual novel, a story well told in a setting unfamiliar to the fortunate among us and it does that thing that good fiction so often does – educates us and helps us understand what it’s like for others. I’ll look forward to Duffy’s next novel, if he has time to write one.
And for anyone interested in how my wishes scored with the Baileys Prize judges, I managed three which gives me lots to explore on the longlist. Naomi and her team will be valiantly shadowing the panel, working their way through the ones they’ve not yet read and reporting back. I’ll be cheering from the sidelines.
Great review. Sounds like an interesting book but not one for me despite the NY setting.
Thank you for the link. I got started on the reading yesterday so reviews will be coming as of next week. Excellent stuff, so far.
Was thinking of you at the Picador Showcase last night as I picked up a copy of Wilful Disregard.
Thank you, Naomi. Very little of New York in this one – it’s much more about the human condition and how we so often don’t deal with it. I’m sure you’ll devour Wilful Disregard in an hour or so!
What an astute observation about the apparent lack of hospital dramas in literature… while capsules of a medical episode often feature in books you’re right, I can’t think of one based wholly in that situation. Food for thought… and market research! One of my WIP is predominantly in a hospital setting
I really like the sound of this one… with both sides of the scenario familiar I’m keen to see how Duffy’s version relates.
Great review Susan☺
Thank you, Poppy, and I’ll be interested to see what you come up with. Is it a short story?
It’s probably more long short story or even Novella… although has the potential to be one strand of a dual or even triple narrative novel with two others. I’ve got the 3 key characters ‘in a box’ and they do have a common connection. I’m sleeping on it (literally as box under bed) waiting for their nagging to turn into that eureka moment when they tell me how best to wield their stories… individually or as one.
That sounds great. I’ll look forward to reading it. Hope it’s not disturbing your sleep!
I would love more literature about medicine – I wonder why there isn’t more of it? Maybe the atmosphere of it lends itself better to the screen. But this is going on my list, for sure. The only other book I can think of right now that has quite a lot of doctors and scenes in the hospital or operating rooms is Cutting For Stone, and I loved that part of it.
I’d forgotten about Cutting for Stone, Naomi Thanks for reminding me – I enjoyed it very much. Odd isn’t it. The emotional drama of medicine lends itself to the screen, I suppose, although the reality is very different I suspect. A bit like spy dramas!
This sounds very interesting. Thank you for the review, I’ll look out for it. Interesting that there isn’t, as you say, so much literature about medicine. Verghese’s Cutting for Stone is great, though I really love his first book even more, My Own Country, a memoir about being an infectious disease specialist when AIDS was just beginning,,,this makes it sound grim, but it is brilliant (if sad, of course, in many parts). Everyone is currently readdnig and raving about When Breath Becomes Air, by the late Paul Kalanithi, a surgeon who suddenly became a patient…
I think there’s much more non-fiction around in this area – Henry Marsh’s Do No Harm springs to mind, for instance. I’ve been eyeing the Kalanithi. A tough read, I’m sure, but well worth steeling yourself for by the sound of it. Thanks for the mention Of My Own Country. I hadn’t come across that but will add it to my list.
The only hospital set book that comes to mind is The Good Doctor by Damon Galgut. It’s funny that such an often dramatic profession isn’t depicted in literature.
Yes, it’s odd, isn’t it. All sorts of opportunities for drama and character development.
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