gripping behind-the-scenes novel set in a busy Irish hospital – The Irish Times

Night trainees

Author: Austin Dufy

ISBN-13: 9781783788330

Editor: Granta

Guide price: £12.99

Philip Larkin would make a fine patron saint of hospitals, if Austin Duffy’s captivating new novel The Night Interns is to be believed. In an unnamed hospital in Dublin, man certainly passes misery on to man in a dysfunctional hierarchical system that only seems to benefit the few.

Told by a young doctor, one of the maligned interns, the book unfolds as a silent but insistent questioning of the moral code within the hospital, where pain and suffering are as common among staff as in Services.

For the three surgical interns at the heart of this book, the dreaded night shift is by turns frenetic, monotonous, stressful, endless. Thanks to Duffy’s skillful portrayal, the hospital appears as a harsh world of ugly paradoxes. Interns follow orders from superiors who do not tolerate questions or calls for help. They are expected to learn on the job, but also to know enough to carry out their work. They live off takeout and inconceivable amounts of coffee while advising patients on healthy eating. They are terribly sleep deprived when doing work that requires the utmost attention. They are left alone in the trenches, then held accountable by their superiors when they inevitably get it wrong.

The most infamous of these boss figures is the senior officer of the narrator’s household, Sharif, who goes from furious rant to windy nonchalance with alarming speed. He is all ego, concerned only with his own image and career progression. As for the sick? “You can try fifty times as far as I’m concerned. Turn their arm into a pincushion for everything I care about. On another occasion, Sharif pushes off a patient’s death overnight, delighted that he is not guilty. Such behavior is particularly nauseating when contrasted with his flattering approach to consulting physician, curmudgeonly Professor Lynch.

A similar hierarchy exists for nurses, who defer to consultants but treat interns as skivvies. Even among the trainees, there is an obvious hierarchy: brave and capable Lynda; our intermediate narrator; then the timid and ineffectual Stuart.

Duffy’s terse prose style and penchant for long paragraphs evoke a living nightmare. It lulls us into chaos, the narrator’s sense of dislocation and isolation, dangling like a single lifeline in a sea of ​​seriously or chronically ill people. It’s a hugely immersive reader experience, with repetition used effectively to highlight the endless workload: difficulties with IV lines; catheters; body in distress; Cheyne-Stokes respiration; and multiple suicides among staff. The detached tone in the middle of the frenzy is akin to reporting. A Dublin hospital at night, a war zone.

This book will cement Austin Duffy’s reputation as a wise chronicler of the medical world and the difficult lives of its practitioners.

There’s a desperate irony in the way interns are told to look out for each other: “Exactly what we were looking for was never clear. Signs of stress? Worry? Insufficiency and total fear of God? We already had all that. Instead, the narrator approaches the change “like a prisoner convicted and sentenced for an unspecified crime that hasn’t even been committed yet”, before turning to drink on his nights off.

Although the book’s story arc can be tighter at times, with a certain fleeting quality to the scenes, the details of the work are always visceral: “An awful smell, the smell of moist, infected flesh.” Anyone with a fear of needles, meanwhile, should stay away. The Night Interns is like a quieter version of Adam Kay’s This Is Going to Hurt, which isn’t to say the book has a dour tone, but rather that Duffy uses humor less frequently and in less overt ways. His jokes are morose and tongue-in-cheek: his offer to Lynda to share a spare syringe of medicine; barter with an addict to create his own line; or even this exchange with a nurse after pronouncing a death: “She’s dead, I said. – No shit Sherlock. Go now and document it, will you? »

A practicing oncologist, Duffy is the author of two previous novels, Ten Days and This Living and Immortal Thing, who was shortlisted for the Kerry Group’s Irish Novel of the Year. This book would cement his reputation as a wise chronicler of the medical world and the difficult lives of its practitioners. In a story where not much happens – apart from the affairs of life and death – there is a surprising fulfillment in the final sections, which are full of little moments of revelation.

The curtain is drawn, the divine characters dismantled, a realization “that surgeons were just plumbers at the end of the day, technicians who didn’t understand what they were dealing with most of the time”. The Night Interns is a disconcerting and demanding account of what goes on behind the scenes of a busy Irish hospital. Captivating, if you can bear it.

Irene B. Bowles