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David Payne: Doctors in Mugglemarch

12 Nov, 12 | by BMJ Group

David Payne My last encounter with a JK Rowling novel was an abortive attempt to get through a Harry Potter boxed set given to me as a present ten years ago (why did nobody have the guts to tell the world’s most successful author to make the Goblet of Fire and subsequent volumes shorter?). 

But I was attracted by her first novel for grown-ups, despite its mixed reviews. I particularly liked the post on the Guardian newspaper website which describes A Casual Vacancy as “Mugglemarch,” a reference to George Eliot’s “study of provincial life” and the term used in the Harry Potter series to describe non-wizards.

This was probably a throwaway line, but there are similarities between the two books. They both describe communities facing change. Middlemarch had Tertius Lydgate, a reforming but proud young doctor whose hopes of establishing a medical school to rival London’s and Edinburgh’s come to nothing after a disastrous marriage. He narrowly escapes bankruptcy but dies early, professionally unfulfilled.

In A Casual Vacancy, Rowling, who dedicates the book to her husband, an anaesthetist, gives us Parminder Jawanda. Parminder is a Sikh GP and parish councillor in the picturesque south west town of Pagford. She is embroiled in a bitter fight to keep a local drug rehabilitation centre open and ensure the boundaries aren’t redrawn so a deprived council estate, The Fields comes under the neighbouring city of Yarvil.

In the absence of fellow councillor Barry Farebrother, whose death triggers the casual vacancy alluded to in the novel’s title, Parminder’s campaign is made more difficult and pits her against reactionary forces on the council.

The friendless doctors’ nemesis is fellow councillor Howard Mollison, an obese deli owner who nicknames her “Bends Your Ear Bhutto.”

Rowling’s depiction reminded me of a recent conversation I had with a former colleague and his wife, both of them now GPs. They both felt that doctors no longer command the respect they once did. Certainly this is Parminder’s experience. Like Lydgate in Middlemarch, she is treated with suspicion by the locals.

But whereas Lydgate’s professional reputation rises after successfully treating his future wife’s brother Fred, Parminder is blamed for the death of a local heroin addict’s grandmother, and called a “Paki bitch” in her own surgery.

Rowling tells us that Pagford’s old guard resent her for her arranged marriage to Vikram, a dashing cardiologist with little patience for local politics and “the most gorgeous man in Pagford…tall and well made, with an aquiline nose, eyes fringed with thick black lashes, and a lazy, knowing smile.”

Pagford forgave Vikram the crimes of “brownness, cleverness, and affluence,” but not Parminder, with a reputation for being niggardly with antibiotics and repeat prescriptions, a Birmingham accent, still strong after 16 years in the south west town, and her “ hard and high pitched” voice.  Worse still, they live in the Old Vicarage, one of the town’s most beautiful buildings.

Like Lydgate, Pagford’s two doctors are flawed characters. Vikram hardly gets mentioned, but they both come across as emotionally detached parents, intolerant of their bullied daughter Suchvinder’s adolescent struggles. She lacks their academic prowess and seeks release through self-harming.

Kay, the book’s social worker, escapes unpunished after breaching client confidentiality in a scene reminiscent of Mike Leigh’s Abigail’s Party. Parminder takes confidentiality seriously. She reprimands two surgery staff for discussing a patient, but is ultimately suspended from the medical register after a public row with Mollison.  Mollison may disagree with the GP’s politics, but would he really be so unpleasant to the wife of a cardiologist who saved his life?

A Casual Vacancy has fewer laughs than ten episodes of EastEnders. I admire those reviewers who waded through it in time for its publication last month, although it gave Daily Mail columnist Jan Moir a chance to claim Rowling, a Labour Party donor, is “on a mission to portray the poor underclasses as plucky but blighted, and the British middle classes as a lumpen mass of the mad and the bad.”

Not to be outdone, her colleague Amanda Platell rounds on Rowling for being vindictive about the middle classes, even though she was raised, shock horror, in “a Grade II listed cottage in Gloucestershire.” Class hatred oozes from its pages, she adds.

I think they’re wrong. Rowling’s underclass characters (racist patients, a child rapist, a wife-beater) are far less lovable than its middle class ones. She seems more preoccupied with racism, sexism, and child abuse than class warfare.

I once saw Rowling contribute to a programme about Caroline Aherne’s TV comedy The Royle Family, which she clearly loves for its portrayal of a close-knit working class family who gather round the TV every night. But there is no equivalent of loveable Jim and Barbara Royle in A Casual Vacancy.

Forget Middlemarch. The novel is more like Winifred Holtby’s South Riding. Holtby’s novel, like Rowling’s, is about local government and public health, with lots of illness and death and poignant portayals of children and adolescents.

The novel reminds me of my first job as a local newspaper reporter I spent many evenings at local parish council meetings. This tier of local government is virtually powerless, so getting a decent 300 word news story was often a real challenge.

Hats off to Rowling for squeezing a 512 page novel out of a parish council byelection. Or thumbs down to her editor for not editing it more ruthlessly.

David Payne is editor, bmj.com

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