A MISTAKE by Carl Shuker — reviewed by Stella

Medical misadventure is the stuff of shouty headlines and third-hand anecdote: told, embellished and finger-pointing. We all know mistakes happen in all professions but when it comes to medicine we are quick to blame and sharply condemn. Accountability is fine, but where is the line between personal responsibility and institutional culpability? In Carl Shuker’s A Mistake, his latest novel, we are in crisis mode from the opening pages. A young woman with severe abdominal pain is in A&E — immediate surgery necessary. Elizabeth Taylor, perfectionist, surgeon, 27 hrs on her feet, is in charge and the theatre is ready — the stage set. We know that this is just the beginning of a disaster, and just as we, the reader, are shunted into the midst of this medical freneticism, the author calls cut and the clapper board comes down and we are taken back to 1986 — to the launch of the space shuttle Challenger. The tension is the same, the anticipation and our watchfulness as the audience just as intense. From the small confines of the theatre and looking down through Elizabeth’s eyes at her patient (well, her patient’s body — her awareness of the woman sometimes seems absent), we are suddenly surrounded by the hype and immensity of space science and we are looking up at the sky in wonder — waiting and on tenterhooks as the countdown begins. Shuker cleverly moves between these two situations building an energetic forcefield — and what some readers will feel is a distraction is anything but: technical language — medical in our hospital theatre and astrophysical at NASA mission control, blow-by-blow action — as the surgeons operate and as the NASA team relay information (the as-it-happens variety), the power hierarchy — who’s in charge in each scenario, and the realisation of the error (too late to save anyone). It all piles up around us — the chaos growing. Yet it is what happens next that will reveal more: the consequences for the medical team and for the engineers. Shuker’s Elizabeth Taylor is not the easiest character to slide along with — she’s a perfectionist, dedicated, frustrating, sometimes a lousy friend, brash, dismissive of fools, and is described variously as a brilliant surgeon and a ‘fucking psychopath’. Yet she's loyal, takes the rap for the mistake and, unlike the bureaucratic nightmare she has to work under, she’s not looking for the ‘good’ PR story even when there is wriggle room for her to distance herself from the crisis. But it’s hard to tell whether she has been altered by the mistake or is ultimately only concerned for her own record. Ego, power and success are themes that you expect in this story, and with these comes the flip side: young doctor burnout and suicide, overwork, failed relationships, doubt, recklessness and the unrelenting pressure to be right always. Shuker’s new novel is a departure in style from his previous work. The Method Actors, his first novel, which I read back in 2005, was a big, brilliant, complex book. A Mistake is sharp, scalpel-fine. Shuker has pared this novel back to bone and gristle, letting the reader feel, by being stabbed repeatedly with attack language, reckless behaviour, fleeting insights and snide dialogue, the intensity of this life and this error. The ending is as abrupt as the start and you will be wounded — but intrigued by that scalpel cut. Long after you read this novel you will have a scar to remember it by. 

[Now, also a film! Directed by Christine Jeffs, the film premiered at Tribeca Festival earlier this month. Interview with Jeffs. Releasing Aotearoa in July NZIFF.]