Classic Books: Bodies

mercurioThere are few worse feelings than making a mistake in a new job. At best, you will be shouted at and you will waste time and money. If you do an important job, like a soldier or a surgeon or police sharpshooter, at worst someone could lose their life because of your incompetence. It’s this devastation of guilt and culpability that Jed Mercurio confronts in his medical classic.

Bodies is a novel drenched in work. Medical hours are hard, particularly at junior level: rest becomes a sin, leisure a dream, and Mercurio’s narrative is etched in sweat, stress and the vivid magical scenes that come when you’ve gone long enough without sleep for the doors of perception to swing open a little. James Kelman said that something like ninety nine per cent of fictional characters are independently wealthy – well, that’s not the case in Mercurio’s fiction. His nameless narrator is a newly qualified hospital doctor struggling with hundred-hour weeks. In this passage, the exhausted medic for the first time expresses his fear and tiredness and sense of terrible responsibilities:

Shuffling to the tap I run water over the tiny wounds and with my other hand extract shards of glass. Blood pinks the stream as it swirls down the plughole. The cold water numbs the pain and the bleeding eases off and I still want to be a doctor, I still want to do the job and that means staying in this world because it’s the only one there is, but I’m crying, crying like I haven’t since I was a kid, with tears flooding my face and snot drooling from my nose while on the ward normal business continues, it all continues, it all continues.

I’m twenty-three years old.

Inevitably, working nights under a ton of flu and doing ward round on a broken toe, the doctor makes a mistake – failure to notice a pulmonary embolism – that leads to a woman’s death. Broken with guilt, the narrator’s first instinct is to confess, but his SHO convinces him to fake the notes and move on. ‘We all make mistakes,’ the SHO explains. ‘Because we happen to be doctors, our mistakes have larger repercussions, but the process is the same.’

Reluctantly, the narrator does as he’s told, and the decision kickstarts a process of unsettling personal change. When we first meet Mercurio’s protagonist he is a conscientious Christian in a sexless engagement with an office worker. After his manslaughter of the patient he calls the Breathless Lady, the narrator dumps his girlfriend, abandons his faith and becomes a womanising opportunist of the nurses’ floor. It’s not just guilt. Stephen King’s doomed medic Dr Louis Creed, in Pet Sematary, tells his wife that ‘as a doctor, I know that literally anything can happen to human beings.’ No novelist proves that better than Mercurio. Bodies is a book of terrible things happening to bodies. An early grotesque flashpoint comes when his narrator treats a meningitis victim whose hands, feet and genitals develop gangrene and need to be hacked off by the surgeons. The things the protagonist sees jolt the narrator away from pure spirituality and towards an ultimately kinder and stronger creed based on physical safety and physical love. We are matter. No one can stress this enough.

Bodies is also a novel about the power of the community – what Mercurio calls the interior: ‘a city within a city with its own speed limits and language and even its own weather.’ For Mercurio the hospital is not just a place of recovery but its own internal subcivilisation with autonomous culture and rituals and rules. The narrative has this impersonal feeling – we never know the protagonist’s name, the patients are referred to by nicknames and joshing gallows humour (‘Blue Numbers’ ‘Young Headache Man’) colleagues go by their first names and senior doctors by initials (‘I’ll call him Doctor T’) giving the impression that we are reading a suppressed clinical report, something burned from a hard drive.

His hospital bosses cover up mistakes because they want to protect the hospital and the NHS from expensive civil litigation. Juniors do not report misconduct because they can be denied references, rendered unemployable or suspended for years at a time. It’s not a conspiratorial novel, Mercurio’s characters mostly do the wrong thing for the right reasons, but their negligence wrecks lives. There have been shocking revelations about appalling experiences in NHS hospitals and care homes (certainly for someone who has received nothing less than first class care every time I have been ill) but some defenders of the system have been cagey on speaking out because they fear that to do so might give ammunition to people on the other side of the argument who prefer a US-style private insurance model. The debate that follows illustrates Orwell’s quotation:

Whenever A and B are in opposition to one another, anyone who attacks or criticises A is accused of aiding and abetting B. And it is often true, objectively and on a short-term analysis, that he is making things easier for B. Therefore, say the supporters of A, shut up and don’t criticise: or at least criticise ‘constructively,’ which in practice always means favourably. And from this it is only a short step to arguing that the suppression and distortion of known facts is the highest duty of a journalist.

Bodies is a great medical novel, but the storyline could have been set anywhere. Mercurio is writing about institutions. He is also writing about the ageless human drive to belong somewhere. Anyone who has worked long term at any organisation has a measure of professional and personal security, you see it on their faces and in their movements – they have somewhere they can go, where everybody knows their name, they have their place at the campfire, as James Hawes put it. By speaking out against medical negligence Mercurio’s narrator risks not only professional ruin but a kind of personal annihilation. It’s that risk and its consequences that lift Bodies from a procedural classic into a great novel about the human condition.

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