Shuke, Rattle And Roll

A bout of depression, the Challenger space shuttle disaster, editing at the BMJ and stern words for critics are all in the mix as Carl Shuker releases a new novel.

Diana Wichtel

In the sole, ringing endorsement on the back cover of Carl Shuker’s new novel, writer Pip Adam notes that it “feels more like a body than a book – life pumps and glugs and flexes inside its pages”.

A Mistake is the prosaic, triggering title of Shuker’s short, scalpel-sharp tale of misadventure, medical and moral, set in a version of Wellington Hospital. The body reading it may soon find itself pumping and flexing uneasily in unison. When a narrative is punctuated by short sections tracking the remorseless unfurling of the 1986 space shuttle Challenger disaster – “T+2 min 08 sec. Nesbitt: ‘We have no downlink’” – it’s clear things aren’t going to go well.

“I’m halfway through and trying not to have an anxiety attack,” I email Shuker before we chat. “That’s a fantastic reaction,” he replies. “‘I want heart attacks, I want ambulances’, as Alexander McQueen used to say …” Later, he’ll say happily, of the work of Canadian writer Michael Ondaatje, “You’re sort of stabbed in the side and then murmured gently to for the rest of the paragraph and you don’t realise you’re bleeding out till the end.”

Fair enough. Fashion designers and novelists need not heed the dictum “first do no harm”, unlike the medical staff at the hospital where Elizabeth Taylor is a star. At 42, she’s the youngest and sole female consultant general surgeon in a patriarchal institution. She stalks the hospital corridors like a boss, operates to thrash metal and calls nurses with inconveniently foreign names “Betty” or, on a bad day, “You silly c---”.

The book’s forensically observed interactions take on a certain ritualised quality; ER meets Kabuki theatre. “The girl looked at her accusingly … Elizabeth smiled wider for her.” In Shuker’s world, the wider the smile, the less there will be to smile about. Elizabeth has been up for 27 hours. Living on coffee, she’s constipated. “It was useful for operating.” On her watch, an operation on a critically ill young woman is about to go wrong.

This time, Shuker dives right into the pared-down action. “I’m notorious for dicking readers around, taking too long to get to the thing,” he says, of his reputation for postmodern bells and whistles. “I got sick of myself.”

Consequences unreel. It’s not giving too much away to say that the story touches on suicide and at least one animal is harmed in its making.

“Healthcare is like fiction,” says Shuker, on the phone from his home in Wellington. “You have this very high-level fascination with craft. And then you simply have a person in front of you, in their person-ness and their vulnerability. It’s going on at the same time as the highest level of biostatistics.”

He knows a bit about both. He has worked as an editor for the British Medical Journal in London. He is principal publications adviser to the Health Quality & Safety Commission. In A Mistake, Elizabeth is co-authoring a paper for the Royal London Journal of Medicine on the fraught subject of the public reporting of surgical outcomes. As a speaker says at a conference Elizabeth attends, “You’re going to start measuring and putting your surgical outcomes out there into the public sphere and you cannot expect it not to be. It’s gonna be a shitstorm.”

Elizabeth is not for it. She has a point, says Shuker. “We may all want to nail that person to the wall. That’s satisfying some kind of blood lust, a desire for simplicity in us that the real world possibly doesn’t offer us. This is the whole controversy around public reporting of surgical outcomes.”