Human error, Stephanie Johnson

A Mistake
Carl Shuker
Victoria University Press, $30.00,
ISBN 9781776562145

Carl Shuker is a writer who is not afraid to take risks. His previous four novels were all hailed for their innovation in form and espousal of post-modernism. He is, as far as any definition of genre can be trusted, a truly literary writer.

A Mistake is set vividly in Wellington, Shuker’s hometown. It is possibly less risky than his previous novels, having conventional structure and character treatment. Exceptions are occasional illustrative graphs and short chapters concerning the disastrous early-1986 flight of Challenger, the American space shuttle. Thematically – but not in any other way – these scenes link in with the central story. All signals indicate a story about human error.

Elizabeth Taylor is a contemporary consultant surgeon at Wellington Hospital. Shuker gives us no reason for her famous name, except that once or twice other characters react to it with a smile or momentary surprise. Perhaps great things are expected of Elizabeth Taylors, the movie star, the novelist and, also, this particular surgeon, who is overworked and constipated, struggling to excel in an under-funded city hospital. At the novel’s opening, Elizabeth and her registrar Richard Whitehead meet a mortally ill young woman who requires urgent abdominal surgery. Shuker describes her as a “white girl, small and thin and turning in her pillows, selfish, inward in her pain.” Already, on the first page, here is an example of how he will choose a word that fits only in an impressionistic sense. The reader is pulled up short. Selfish? Or self-absorbed? Do doctors expect patients in agony to be more generous in their response to bedside manner? Or, it could be that he wants us to understand that Elizabeth can gauge a patient’s nature in the first minutes of meeting her.

Elizabeth’s constipation is described on the next page with the observation that this is a useful state to be in for operating. A couple of pages later we are told: “Elizabeth bore down, she focused, and the solution came, as it always did for her, when she bore down.” This, again, is a stumble – bore down, as a woman does in labour? To cure her constipation? Or to focus, which is the more likely meaning, since it follows immediately – but still, it is a misleading phrase, since it makes the reader stop and wonder, inanely, what exactly it is that he means.

Stylistically, Shuker is reminiscent of certain American writers, in particular Rick Moody. Readers may remember the extended coloratura opening of Purple America. Shuker uses long sentences strung together with many “and”s, which give the narration a breathless, skipping tone. They also provide rapid pace as the eye skims over the conjunctions to get to the meaning. An example from early in the novel reads: “She placed the scalpel back on the tray and took the forceps and reached inside the wound and grasped a piece of tough tissue under the belly button and pulled it up through the hole she had made.” At this point, the surgical procedure has not yet gone wrong, but the tense, rapid-fire delivery of action anticipates that it very soon will.

A Mistake is dense with medical detail, which non-medical readers could find either interesting or tiresome. Because Liz is a senior consultant and Richard is still in training, Shuker enters into her role as a teacher, which is just as well, since the detail is sometimes baffling. There are also authorial descriptions of stages and implements used in the operation, such as that of a trocar: 

It was a short blue pipe with taps around a handle like a thick screwdriver and she took the retractor from Robin and used the retractor like a plank to ease the pipe into the hole in the girl’s belly on a diagonal.

In his acknowledgements, Shuker thanks not only IIML luminaries Emily Perkins and Damien Wilkins, but also a number of Wellington health professionals. His research is thorough, which gives the narrative a sense of security – this author knows what he’s talking about – but it is also perhaps at times too fully utilised, weighing heavily on the page.

Liz’s personal life, understandably since she works so hard, is sparse. She has a married friend, Jessica, with whom she attends an Adam Ryan concert. This is one of the standout passages of the book, a skilful and affecting manoeuvre through the stages of Liz and Jessica’s worship of the artist – they gasp and stare as he starts on certain of his songs – through to Liz’s remembering how “she didn’t believe he meant things”, through to her realisation in the homeward-bound taxi that she would “never go to another concert, for the boredom and insult of the audience performance and passivity…” This points to Liz’s tough character. She is almost unlikeable – but easily forgiven for her prickliness. She has endured years of casual sexism while patients look behind her for the real (male) doctor, and now she must be tougher than ever to endure the struggle, after the titular mistake, to maintain her position at the hospital. 

Liz has a woman lover, Robin, one of the theatre nurses who assist her in theatre. An opportunity to show Liz’s softer side through this love affair is missed. Oddly, there is no sense of their physical relationship – no kissing or handholding, let alone love-making. The latter may be excused – after all, Liz is exhausted and stressed – but the reason could also be a squeamishness or reluctance on the part of a male novelist. We live in twitchy times, when the time-honoured principle of good writing bearing us bravely into the hearts and souls of fictional characters of different gender or race to the author is under threat. 

Hospitals are busy, crowded places, and Shuker deals well with minor roles. The brilliantly drawn clinical coding manager, Liz’s nemesis, comes complete with unshaven neck and hairy cheekbones: “He was English, stale and stank of bachelor” and, further on, Liz finds that she “hated him so much she could taste it like a Granny Smith apple.” There are small flashes of humour like this. Baby-boomers are referred to once as frequent fliers, which is so perfectly definitive that it should catch on in the wider world. 

There are some tics in the writing that irritate – the self-conscious repetition of words and phrases: “She gave him her eyes” repeats as “She gave them her eyes”. Were she flesh and blood, Liz would be an unnerving woman. There is power in this simple description of a steely character meeting the gaze of others, but, just as I did sometimes with the long, conjunction filled sentences, I wished an editor had picked up the flaw. 

A Mistake has throughout the sense of veracity: these are real people in a real place. The only false note strikes when Liz takes the corpse of a dog to the vet. Surely she would know that it was dead – she would not need another medical professional to tell her so. The dog’s death mirrors Richard’s tragic end, and is a demonstration of her work-induced exhaustion resulting in carelessness. It will likely not reduce readers’ affection for her, but increase their sympathy.

Writers are sometimes asked by publishers to try to identify their readerships. If Shuker was asked this question, it is possible that he hoped for that mythical beast the general reader. I found I increasingly skim-read the Challenger chapters, being far more interested in Liz’s ongoing drama. I would not dare, in these aforementioned twitchy times, to assume that the majority of other women readers would do the same. 

A Mistake is a big novel – not so much in wordage, but in the themes that Shuker takes on. As Liz writes about her experience for a medical journal, she contemplates “What it feels like to be good, how somehow abashing. The versions of the truth. The long tail of shame.” 

In the end, there is no singular, moral interpretation of Liz’s mistake and the dilemma that arises from it, not for her, or her nurses and registrars, nor the top-heavy bureaucracy of the hospital. Shuker presents us with the evidence and allows us to reach our own conclusions.

Stephanie Johnson is an Auckland writer and critic whose most recent novel is The Sisters’ Lover, published under her pseudonym Lily Woodhouse.

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