Fergus Shanahan<\/p>\n
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This Living and Immortal Thing<\/em><\/p>\n By Austin Duffy<\/p>\n Granta Books, 2016<\/p>\n <\/p>\n If authors write what they know, then Austin Duffy knows a lot, but This Living and Immortal Thing, <\/em>his first novel, blends experience with fiction and offers more than informed opinion and insight to medicine, science, life and death. This is a story. The story teller is an Irish doctor who has left a childless, stagnant marriage to specialise at a famous cancer centre, recognisable as Memorial Sloan Kettering in Manhattan. As a post-doctoral trainee, he is comparatively mature in his mid-forties, and contemplates life and events in his new surroundings. Thinking of his younger brother Donal back in Ireland, he notices that America differs from home in having relatively few cases of Down\u2019s syndrome. \u201cThey would not have allowed him to be born\u2026with their blood tests and ultrasounds and amniocentesis needles\u2026\u201d His brooding juxtaposes several contrasting images: the bustle of the city ignoring a lone street protestor; the urgency of the clinic versus the controlled environment of the research laboratory; and a bored, hung-over clown employed to entertain sick children, bald from chemotherapy, reminds us that for the hospital staff illness is routine, but for the patients it is crisis.<\/p>\n At first, there is a trace of glibness in the narrator\u2019s clich\u00e9s but these are progressively replaced by more heartfelt prose that unfolds like a diary. His jadedness is jolted by the freshness and allure of Marya, a young Russian immigrant who volunteers as a translator in the hospital. Their dialogue is clipped, droll and loaded with sexual energy. She uses irreverent and refreshingly direct language. \u201cSo what sort of doctor are you anyway?\u201d \u201cYou\u2019re like, what…forty five? Are you homosexual?\u201d He reveals his story with typical Irish reserve. But this is no ordinary flirtation; she has a secret. She seems hurried and doesn\u2019t bother with his name – \u2018post-doc\u2019 will do. Post-doc is both intrigued and attracted, and his scientific mind repeatedly notes that men are seldom distracted from sex for long, regardless of the context.<\/p>\n \u201c\u2026doctors, they\u2019re so stupid!\u201d exclaims Marya, frustrated after witnessing a tactless communication of bad news to a patient. \u201cI don\u2019t translate word for word but only some\u2026.\u201d \u00a0Silently, post-doc reflects how difficult it is to explain things properly though a translator but also easier because one is removed and less responsible for one\u2019s words. He likens it to a high altitude bomber out of range from the sights and sound of the horror inflicted below. He is dispassionate about his experiences with terminally ill patients: \u201cFor the most part,\u201d he says, \u201cthere is nothing to do except sit across from them and be kind.\u201d In a commentary on communication, the eminent medical scientist Robert Brook once defined a physician by the following equation: physician = emotion + passion + science. Post-doc surely has emotion and recently switched from clinical to laboratory science, but may have lost his passion.<\/p>\n While grieving the physical and emotional distance from his own potential progeny, his care for the experimental animals is tender and touching, with each identified by name. He is opinionated about what it takes to be a good scientist, and is respectful but deeply critical of his supervisor Dr. Solter. Like all good scientists, post-doc is attentive to detail, painstakingly recording his observations, with a measure of humorous humility when Henrietta, his favourite mouse, is pronounced to be male by the visiting vet.\u00a0 On the sole occasion when post-doc says something kind about Dr. Solter, it is to concede how well Solter communicates with the next of kin of a terminally ill patient. Curiously, he doesn\u2019t seem very excited about the promise or impact of his own research; he bores a group of students when he is called to explain his project. Perhaps this is disillusionment or perhaps it is the key point: the scientific method is slow and repetitive and gives the lie to the popular misconception that science is fun.<\/p>\n There is, of course, no mystery about where the story will go, but this doesn\u2019t detract from the parallels between the laboratory mice and the patients, the cancer cells and the frozen embryos from post-doc\u2019s marriage, and a vigorous new cell line from a once vibrant donor. Along the way, the story is speckled with informed commentary on topics ranging from cancer to clinical arrogance. Some of post-doc\u2019s asides are authoritative, like those on the poetry of W.B. Yeats and the music of Brazil. Others are enigmatic: \u201cThere comes a time when all there is to do is worry\u201d and \u201cIllness makes for an oddly insubstantive discussion,\u201d whereas other pronouncements are quirky: \u201cGenerally you are better off when things are not resolved at all. You only have to ask any one of my previous patients that. It is rarely in your interests.\u201d<\/p>\n If this is a book about cancer, then it is also about life, death, loss and replacement, and a book about medicine. With each, there is uncertainty. Medicine is the art and science of managing uncertainty. Post-doc has moved from the clinic to the research laboratory where it is \u201cmore controlled and predictable\u2026in contrast to clinical work, where you have only an illusory or \u2013 at best \u2013 superficial control over things.\u201d When questioned by Marya, he is vague on the reason for his change: \u201cHumans are tricky, I suppose\u2026 Unpredictable.\u201d In the research laboratory: \u201cYou set your own conditions and, to a large extent, the future is predetermined.\u201d Is this self-serving? Is post-doc a reliable narrator? Later, he claims: \u201cGiven the choice I would take uncertainty over certainty every time.\u201d He believes that a true scientist\u2019s mind should move slowly and should \u201cquestion everything.\u201d He is critical of people like Solter whom he believes \u201chas too much certainty\u201d to be a natural scientist and whose mind is \u201cmoving too quickly for science\u2026\u201d Since childhood, post-doc has had a searching mind and was described by his school teacher as \u201ca fan of distraction.\u201d Now, he wants to slow things down in his life, to focus and to cope with the passing of time, and this, in his view, is as good a reason as any for going into the laboratory, where he can focus on the continual cycle of life, death and replacement.<\/p>\n This is a book that I expected not to like, much of it too familiar to me. Now, I miss the accented penetrating language of Marya and the distractions of post-doc.<\/p>\n","protected":false},"excerpt":{"rendered":" And so it goes\u2026this thing called life Fergus Shanahan This Living and Immortal Thing By Austin Duffy Granta Books, 2016 If authors write what they know, then Austin Duffy knows a lot, but This Living and Immortal Thing, his first novel, blends experience with fiction and offers more than informed opinion […]<\/p>\n