The Night Interns: A tense tale of hospital anxiety in the small hours
Austin Duffy’s third novel is a hard little gem that tells its story both economically and with suspense
Weighing in at a slimline 197 pages, Austin Duffy’s heart-stopping third novel may prove quite long enough for the faint-hearted. Such is the raw intensity of the emotions portrayed, “visceral” is for once the only appropriate word to describe the reader’s experience. Not that anyone should be put off, because The Night Interns is a hard little gem of a book that sheds light on our phobic relationship with hospitals and sickness.
The epigraph from Dante gives fair warning, promising a journey to “a strange land where sighs and moans and screams of ruined men fill the air beneath a sky”. Nor does Duffy default for a second on that promise. Here are three young surgical interns on the night shift, each striving mightily to meet head-on the life-and-death challenges hourly confronting them. “Tense with anticipation”, they languish within their own “private zones of blankness”, dreading the summons of a beeper breaking the silence. Buckle up, because this could get ugly, the author seems to suggest.
The action is set mainly at a hospital, not in the bustling daytime workplace but in the depths of “the long empty night stretching out ahead with no end in sight”. Duffy’s portrayal of this eerie nocturnal hinterland is infinitely subtle. The reader experiences deep empathy with the three interns whose anxiety we come to share directly. As taut as any thriller, the novel achieves its unsettling effects with a kind of seamless artifice. No jarring plot manoeuvres or narrative trickery here. As Clive James used to say: “I always found ordinary realism quite magic enough,” and this is as real as it gets.
There are some terrifying scenes in these pages. A mistreated patient dies with “blood gushing out of him like a geyser”. A junkie with no veins left loses patience with a doctor and draws his own blood. Routine tasks such as inserting IV lines and cannulas frequently elude the competence of fumbling medics. Urban myths circulate of interns who pronounce patients dead when they’re still alive. Duffy convinces us that medicine is no different from other professions. “Being a surgical intern was something to be endured and survived,” and some won’t make it.
Even so, there is black humour to be found in this Grand Guignol. Attention to the recently deceased can wait, for they have nowhere to go. An intern and an eccentric female patient share a joke about the tales her IV machine might tell. “Can you imagine… the stuff it has witnessed down the years?” “Monty bleedin’ Python,” she quips. These jokes never land, though, because the reader is still convalescing from the last harrowing anecdote.
The lead characters’ troubles do not end there. “Rank was everything and being an intern placed you at the bottom of the ladder.” Bullying, sexism, and racism are casually inflicted by the officer class on the poor bloody infantry. Sharif, the registrar, threatens to “personally strangle [an intern] by the throat,” if he is called for anything less serious than “a leg hanging off”. He in turn is horribly abused by the malevolent consultant Lynch, who calls him “a f**king fool, lazy and incompetent,” and tells him: “You’re not in f**king Arabia now, you know.” Later, a certain schadenfreude sets in when Lynch is admitted as a patient.
The popular fascination with stories of hospital life in television dramas such as Holby City and Casualty, or the recent memoirs of Adam Kay, seems limitless. Duffy’s novels, however, are a cut above. He’s not playing it for laughs. Sentimentality is off the menu. His day job as an oncologist may grant him unique access to his subject matter, but none of that would matter if the writing failed to convince. In The Night Interns, it very much does. Duffy writes with the economy, style and quiet authority that marks him out as one of the most exciting voices in contemporary Irish fiction.
The Night Interns by Austin Duffy, Granta, €18.15