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.