“Going Under”

by Sonia Henry

Allen & Unwin ISBN 978 1 76052 957 4 (2019)

Sonia Henry’s debut novel called “Going Under”, described as a novel of sex, death and doctors, describes the life of a junior doctor in a large teaching hospital in Sydney.

The teaching hospital is Holy Innocents Hospital, a thinly disguised  St Vincent’s Hospital in Darlinghurst is the scene of the action.  The heroine of the tale is Dr Katrina ‘Kitty’ Holliday.  The novel as a work of fiction,  describes the anxiety and tension suffered by junior doctors in the Australian medical system.  At a time during the COVID-19 crisis, when focus has been placed upon the medical profession, this novel casts a sharp light upon the travails of junior doctors.

The junior doctors appear to be in a constant, heightened state of anxiety.  One understands why they are put under such pressure because if they fail in their job, patients can get sicker or in unfortunate cases, die. However, the pressure and close scrutiny under which they are placed can be counter-productive The fact that some of the  senior doctors within the novel are referred to as “the Joker, the Smiling Assassin and the Shark” gives a good indication of the esteem in which they are held by the junior doctors.

This novel gives focus to a very important workplace.  A safely functioning hospital system is crucial for our society and equally important are those who work within it.  The fact that such junior doctors are exposed to such pressure reflects the fact that they have been students who have reached the pinnacle of their academic career, but also reflects the fact of the importance of what they do.  When their actions can have life and death consequences, one can understand why their superiors may put them under  pressure.  However, in doing so, those above them need to exercise due restraint so as to maximise the result but also to minimise the fallout from such intense demands.

Henry has written an important book, but also a funny book, and a book filled with great literary merit.  In another life Henry, who is a junior doctor, could have been a great English academic or indeed a great journalist.  She is a writer whose career perhaps has only been shortened by the fact that it is dedicated to medicine, rather than a literary career.  An example of her deft touch can be found when the heroine of the novel Kitty repeats a  conversation from her radiology registrar:

 “‘Look being an intern is fucking shit,” he says, kindly ignoring my bloodshot eyes and dripping nose.  ‘There are a lot of dickheads in this place, just don’t worry about it.  I’ve gotten used to it.  Some of the surgeons who come in here hassling me for scans, one minute they’re nice, next minute they’ve flicked the prick on.  Only takes them half a fucking second.”

 Kitty also talks about having been balled out by a registrar as producing the following result:

“A lone tear betrays me and tracks down my face.  I use the cap to wipe it away, then walk quickly to the patient toilet on the ward.  I shut the door, turn on the tap and splash my face with water.  Then I go to the cafeteria to buy the Smiling Assassin a coffee, feeling ridiculously sad.”

The life of an intern in a hospital is demanding, full of unpaid overtime and great highs and lows.  Only certain personalities can survive such a system.

When I was a student I shared a house with two junior doctors.  My recollection is they worked inordinately long hours.  One of my flatmates informed me that during an operation in which he was assisting, he was so tired he fell asleep standing up.  On another occasion I came home to find his car in the garage with its lights on. Thinking he had left the lights on, I went to turn them off. He had succeeded in driving the car home only to find that he had fallen asleep in the garage.  One wonders whether this is really the best system to train our doctors. There must be massive burnout and disappointment for the cohort who go through such a system.

Henry has provided a great social commentary a modern equivalent to Emile Zola’s Germinal for coal miners in France and Charles Dickens’ Bleak House for the 19^th Century English legal system. Both novels lead to reforms in both industries. This novel may itself lead to changes in the way junior doctors are taught and treated.

The difficulty of being a junior doctor is tempered by the support they receive from their colleagues and kindly senior doctors.  Kitty Holliday is described and loved by one of her friends as ‘half surgeon, half writer’.  That is a very apt description of the author of this novel.   Henry has done junior doctors, but also Australian society a great favour by writing this no holds barred novel, full of wit and pathos.

Jeffrey Phillips