The Night Interns by Austin Duffy: ‘They didn’t know that we didn’t know anything, and it was probably better that way’

Cover image for The Night Interns by Austin DuffyThe Night Interns is oncologist Austin Duffy’s third novel. It takes us back to his workplace, the setting for his debut, This Living and Immortal Thing, following three surgical interns, not long graduated from medical school, working the night shift in a large hospital where they’re expected to avoid calling senior medical staff at all costs, sometimes even to the patients. It’s brief but as is so often the case with novellas, it packs a very powerful punch.

Up until then we had only read about it, but here it was happening right in front of us, pre-death in all its glory.

Our three interns are allocated to different departments in their day jobs attached to doctors for whom they perform menial tasks. Their night shift is mostly about fulfilling the requirements the nurses aren’t authorised to perform. Lynda is the rising star, ambitious, capable and confident in contrast with the hesitant Stuart who dodges decisions, looking to Lynda to take initiative and shoulder responsibility. Our narrator is somewhere in between. Their first shift begins with a woman entering the last stages of dying, her family in attendance still hoping something can be done. Lynda steps forward, a reassuring presence, wielding her stethoscope confidently. As the night wears on, they manage to grab a food break, negotiate their way through the nurses’ calls, assessing what can wait and what can’t, fighting off exhaustion in the knowledge that tomorrow they’ll have to get up prepared for rounds. Most nights are uneventful, but some aren’t. Lynda decides to take decisive action with a man suffering an unnamed virus which ends in disaster, then disappears for a few weeks. Stuart finds himself an ally and a partner in her replacement while our narrator struggles to appease both his mentor and his department’s consultant, well aware of the damage to his career. As the novel draws to a close, another woman lies dying.

Don’t ask me, the nurse said, if you have to do it, do it.

Written in flat, stripped-down prose making it all the more effective, this is a very different novel from both This Living and Immortal Thing and Ten Days. Trudging through layers of fatigue, our narrator has little or no life outside the hospital. The dysfunction of this workplace where buck-passing, sycophancy and bombast are fostered by a hierarchical system based on patronage is both no surprise and jaw-dropping. Our narrator is often left confused as to what exactly his latest apparent misdemeanour is in an institution where gossip and barracking seem to be the favoured forms of communication. By the end of the novel, Lynda’s star continues in the ascendent, Stuart has gained in confidence if not in skill and our unnamed narrator knows exactly what to do with the dying woman he’s called to. It’s an unsettling piece of fiction which leaves you with renewed respect for doctors who manage to get through this punishing training but not for the ones who leave their humanity behind when they do.

Granta Books: London 9781783788330 208 pages Paperback (read via NetGalley)

19 thoughts on “The Night Interns by Austin Duffy: ‘They didn’t know that we didn’t know anything, and it was probably better that way’”

  1. Its sad how workplaces across fields have now become such negative, toxic spaces where one is expected to perform and reach great heights and yet constantly put up with noncooperative coworkers, petty politics, and much else. No space even one performing an essential function as a hospital seems to have escaped

  2. This sounds in many ways an excellent and compelling book. But I tend not to be drawn to medical dramas, so this feels like an ‘ought to read’, rather than a ‘want to read’.,

    1. I think you might, Ali. What I found depressing was that it’s set in Ireland suggesting that the problems are likely to be common to all health services. Duffy’s a doctor and, I assume, drawing on his own experience as an intern.

  3. As an ex-NHS employee I tend to avoid this kind of book on the grounds that I’m doing my best to forget! 😉 But it does sound like a fascinating look at a role that sometimes seems like some kind of endurance test rather than a positive form of training.

    1. I can understand that! As an outsider, I’ve often wondered if it’s a case of older generations of medics thinking they had to put up with it so why shouldn’t today’s interns. In this case it’s the Irish health service but I imagine it’s a universal practice.

  4. I suspect that this novel barely touches the surface of how junior doctors are treated within the NHS. I’ve read 3 memoirs now from medics in different disciplines and they all paint a picture of over-worked, stressed practitioners trying their best to help patients amid bureaucracy.

  5. Madame Bibi Lophile

    This sounds a compulsive read. I worked for many years in oncology (not as a doctor) and I’m sure this would have been too much for me then as it sounds so realistic. But after 6 years in the charity sector I feel ready to give it a shot!

    1. That must have been a tough job, well nigh impossible to leave behind when you finish work. It is quite raw but essential reading for those of us who use the health service but are not employed by it.

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