surgery scalpel clamp medicine doctor
surgery scalpel clamp medicine doctor

BooksMarch 7, 2019

Book of the week: Carl Shuker’s masterful novel about a medical emergency

surgery scalpel clamp medicine doctor
surgery scalpel clamp medicine doctor

Richard von Sturmer reviews the new novel by Wellington author Carl Shuker – a tense, razor-sharp story of a surgeon who makes a fatal mistake.

The story that Carl Shuker tells in his novel A Mistake is delivered in a concise, razor-sharp style without an ounce of fat left on the bone. Such imagery is appropriate: just take a look at the front cover with its blood-suffused viscera being probed with forceps and trocar. A trocar, I learnt via Google, is a surgical instrument with a three-sided cutting point. Its application is central to the novel.

In the first few pages the dialogue is peppered with other medical terms such as tachycardic, McBarney’s point and salpengitis. The back cover tells us that the author is a former editor at the British Medical Journal, and it’s clear that he knows the ins and outs of an operating theatre. What is also clear is that we are present at the start of a medical emergency. A young woman, Lisa, is suffering from severe abdominal pains and is rushed into surgery. Presiding over the operation, and guiding/commanding her team, is the surgeon, Dr Elizabeth Taylor.

Elizabeth is a force to be reckoned with. She comments on the efficiency of the Hasson open technique, the method she employs to puncture the young woman’s stomach, and insists on having a thrash metal song played in the theatre to keep her focused. There’s no doubt that Elizabeth is highly skilled and in control. But the title of the book hovers in the background. The reader knows that something will go seriously wrong, and it does.

As the tension mounts, she instructs her registrar, Richard Whitehead, to insert the last trocar. “Richard pushed the trocar hard into the girl and it sank slightly and stopped. Elizabeth stared up at the screen with the camera handle in one hand. ‘You’re not through,’ she said. ‘Hurry up. Give it some welly . . .'”

That last phrase, delivered in an off-hand manner, will reverberate throughout the book.

The inherent tension of A Mistake, which holds the reader to the page, is the tension between chaos and control. This is highlighted by a parallel narrative that is woven through the text; that of the ill-fated launch of the space shuttle Challenger in 1986, which exploded just after take-off. When lecturing, Elizabeth tells her students it’s a “beautiful story of error”. She’s fascinated by the technical complexities that led to the Challenger coming apart; how an unknowable and unforeseen chaos had manifested itself in the disintegrations of the space shuttle. In summing up her lesson she states: “There are simple problems, complicated problems. And then there’s just chaos.”

During the operation on Lisa, as the pressure mounts, she tells her team, “This is a controlled emergency, not a chaotic emergency.” We don’t know if she regrets those words later on when what happened on the operating table is examined in forensic detail.

After the operation, Elizabeth is drawn into her own vortex with fragments of her life whirling around her: a meeting with the parents, a Ryan Adams concert, a conference in Queenstown, the wonderfully named Morbidity and Mortality meeting, and a sudden trip to Auckland (which will have its own repercussions). Most vividly, there is her reckless, white-knuckle drive on a Sunday morning around the (thankfully deserted) streets of Wellington. The reader could plot her progress on a map of the city as she speeds like a rocket through Island Bay and into Newton.

We view Elizabeth almost entirely from the outside, without directly accessing her inner world or exploring her psychology. Shuker’s writing is so assured that it’s not necessary; we learn about Elizabeth through her actions. While sitting on the toilet seat at home, she recalls a dream of cutting into a young woman’s body and suturing together the lips of the wound. But this is just a replay of the operation on Lisa with little emotional resonance.

Data casts a long shadow in the novel, specifically the government’s proposal to collate and publish data on surgical failures, on patients lost, and in doing so naming and shaming medical practitioners. Where does Elizabeth sit in all of this; is she above or below the line of acceptable outcomes? In fact, on a graph that is reproduced twice in the book, she is beyond the data-funnel, in her own space, floating like an astronaut: “She had escaped the trap. Her dot was free of the limits. Free of all limits. Out there on her own. Out of control. Wrongly machined, wrongly calibrated.”

Is the character of Elizabeth believable? Yes, entirely so. And this is what makes A Mistake a success. We are compelled to stick with her as she defends her conduct during the operation to her superiors or exchanges barbed comments with her colleagues. Is she a brilliant surgeon or, as her friend Jennifer calls her, “a fucking psychopath”? Or both? It’s up to the reader to decide. Shuker passes no judgments. What we do know, reinforced by our last view of Elizabeth – loading slabs of gib plasterboard onto the roof of her car – is that she’ll continue to go her own way with a fierce determination, regardless of what others may think.

Mistakes happen. Outcomes have repercussions. The outer world and the inner world are incredibly complex and overlapping. Perhaps it’s as simple as that. We learn from our mistakes and move on. But did Elizabeth learn from hers? And would you consent to going under her scalpel? Shuker’s accomplished novel raises many questions. His novel will linger with you long after you have finished the last page.

A Mistake by Carl Shuker (Victoria University Press, $30) is available at Unity Books.

Keep going!
Ockham shortlist 2019 featured

BooksMarch 6, 2019

Announcing who made it onto the 2019 Ockham NZ Book Awards shortlist!

Ockham shortlist 2019 featured

The clock has struck 5:00am – meaning the embargo on the 2019 Ockham New Zealand national book awards has been lifted, and the dear old Spinoff Review of Books is first in with the full list of who has made it.

Okay so here is the shortlist, as immediately follows; drum roll please; do join us at the end of the list for some blather and commentary. But right now the important thing is to find out who has made the cut. To those who didn’t: sympathies, the judges are idiots. To those who did: congrats!

THE ACORN FOUNDATION FICTION PRIZE FOR BEST NOVEL (LOOT: $53,000)

This Mortal Boy by Fiona Kidman (Penguin Random House)

The Cage by Lloyd Jones (Penguin Random House)

All This by Chance by Vincent O’Sullivan (Victoria University Press)

The New Ships by Kate Duignan (Victoria University Press)

THE MARY AND PETER BIGGS AWARD FOR BEST BOOK OF POETRY (LOOT: $10,000)

Poūkahangatus by Tayi Tibble (Victoria University Press)

Are Friends Electric? by Helen Heath (Victoria University Press)

There’s No Place Like the Internet in Springtime by Erik Kennedy (Victoria University Press)

The Facts by Therese Lloyd (Victoria University Press)

THE ROYAL SOCIETY TE APĀRANGI AWARD FOR BEST WORK OF GENERAL NON-FICTION (LOOT: $10,000)

We Can Make a Life by Chessie Henry (Victoria University Press)

Hudson & Halls: The Food of Love by Joanne Drayton (Otago University Press)

Memory Pieces by Maurice Gee (Victoria University Press)

With Them Through Hell: New Zealand Medical Services in the First World War by Anna Rogers (Massey University Press)

OH LOOK THIS ONE ISN’T SPONSORED. THE AWARD FOR BEST WORK OF ILLUSTRATED NON-FICTION (LOOT: $10,000)

Tatau: A History of Sāmoan Tattooing by Sean Mallon with Sébastien Galliot (Te Papa Press)

Fight for the Forests: The Pivotal Campaigns that Saved New Zealand’s Native Forests by Paul Bensemann (Potton & Burton)

Wanted: The Search for the Modernist Murals of E Mervyn Taylor edited by Bronwyn Holloway-Smith (Massey University Press)

Birdstories: A History of the Birds of New Zealand by Geoff Norman (Potton & Burton)

 

Right then. The winners are:

The power and range of the modern New Zealand novel. In the strongest field in many years, the shortlist for best novel at the 2019 Ockham New Zealand national book awards has narrowed it down to three books by very distinguished authors, and one by Kate Duignan, who is no naif, either, and certainly no slouch. She might take the big prize ahead of Lloyd Jones and Fiona Kidman and Vincent O’Sullivan but surely not; surely it’s going to be one of those elders of the NZ Lit tribe.

Penguin Random House. Yeah yeah, Victoria University Press have got eight titles in the shortlist of 16 books, good for them, it must be nice to have secure funds and the backing of the academic civil service – but full credit to good old Penguin Random House, which has published two of the four novels up for consideration in the fiction prize. VUP come close to a monopoly in New Zealand letters and that can’t be good or tolerable so it’s great to see Penguin, and Potton & Burton, make it onto the Ockham shortlist as the only two publishers outside of the universities and museums.

Victoria University Press. Congrats, VUP! The Spinoff Review of Books is picking Chessie Henry to win the non-fiction prize for We Can Make a Life, her great book on the Christchurch earthquakes. We’re cautiously picking Vincent O’Sullivan’s novel All This by Chance to win the fiction prize – maybe, possibly, we don’t know, it could just as easily be Fiona Kidman or Lloyd Jones. But we’re very confident indeed that an author from VUP will win the poetry prize.

Massey University Press. It’s barely out of short pants but in the brief time it’s been up and running, and under the spell of publisher Nicola Legat, MUP (ugh!) has charged ahead to claim a strong presence in New Zealand literature, and fully deserves its two nominations in the 2019 Ockham shortlist. Mind you, they probably won’t win.

White people. Here we go again, with #ockhamsowhite. The number of brown authors who have made the shortlist and will be welcomed at the 2019 Ockham prize ceremony is exactly two: poet Tayi Tibble, and Sean Mallon, the co-author of Tatau: A History of Sāmoan Tattooing. Still, no doubt there’ll be a karakia and that for whitey to feel they’re honouring diversity.

Mitochondria. Wha? Mitochondria research company MitoQ, founded on breakthrough cellular research undertaken at Otago University, is now a global success story – and is giving back, by sponsoring the best first book awards at the 2019 Ockhams. Nice one! DNA rules.

The Spinoff Review of Books. New Zealand’s liveliest and most thorough literary section ran reviews of all four shortlisted novels (This Mortal Boy, The Cage, All This by Chance and The New Ships), published all four shortlisted poets (Helen Heath, Tayi Tibble, Erik Kennedy (sort of lol), and Therese Lloyd), excerpted the two best books in the non-fiction category (We Can Make a Life and Memory Pieces), and ran cool photos from our pick to win the illustrated non-fiction category, Tatau: A History of Sāmoan Tattooing. We will most certainly be present at the awards, held on May 14, to report on the most important thing – what the authors are wearing.

All the shortlisted titles are available at Unity Books.