‘Physician, Heal Thyself’. A biblical quote that can be applied to pretty much any of the cast of Michael Honig’s ‘Goldblatt’s Descent’. It is a dark satire of the politics and pressures faced by young doctors on the hospital ward. The book is seven-tenths high quality fiction and three-tenths cathartic vanity project. The result is a good, if overlong novel.
Malcolm Goldblatt is a locum registrar (maybe – I forget his exact title). Having been a locum for approaching two years, he is now in the last chance saloon. If he is ever going to force his way up the next step of the ladder (becoming a permanent Senior Registrar in a good hospital), he had better do it soon. For now though he his plying his trade in craziest ward imaginable. I sincerely hope that Honig’s tale is over-embellished, because it is hard to imagine being treated by such a crazed bunch of venal, insecure egomaniacs. Goldblatt is the sole voice of reason (more or less), and as a result nearly everybody takes exception to him.
Above everything else, this book is satire. It pokes fun at the absurdities of hospital life. The rituals, the ridiculous hours, the gallows humour. It peels back the skin of the system and pokes its fleshy parts with a pointy instrument. It makes for some uncomfortable reading. If you are thinking of becoming a doctor, it might be a good idea not to read this book, it will surely put you off. If you are thinking of becoming a patient at any point, then it might be best also to give it a miss. It will make you queasy.
So having ruled out pretty much everybody in the country from reading the book, I should really say, that if you have ever had even passing interaction with the NHS, either as a provider or a user, you will find this book hits the nail on the head. Honig dissects the absurdities of the system, but also highlights everything we, the British people, love about the NHS. Yes there are some terrible doctors, but there are some bloody good ones too.
It details why doctors might fist-pump air if a patient dies in the ambulance. It demonstrates how humanity’s petty-mindedness and general vindictive streak is ever-present in medical personnel. You’d hope it would be surpressed, but Honig suggests that if anything it’s enhanced, by stress and long hours.
House officers, who work deathly 50+ hr long hour shifts, must do so because nobody will change an obviously broken system. A reason for not breaking the status quo – because their superiors did it, and now they can bloody do it too. (Mental note, check that Michael Honig isn’t a pseudonym for my mum). Towards the end of the book Goldblatt goes for an interview, where the lead consultant is a known ball-breaker. These chapters are incisive but also black-comedy gold.
Goldblatt’s Descent is not without its flaws. The central plot is thin, and it can’t support a novel of this length. It’s at least a couple of hundred pages too long. Honig clearly has a great number of gripes about the system and was keen to include them all. I can’t help feeling less may have been more. The characters aren’t deep enough to be sustained over 500 pages. At first I was impressed, but by the end, they were in danger of becoming caricatures of themselves.
Honig is not helped by the sheer amount of exposition required. There are many technical aspects to the medical procedures that need to be described, and the ward systems and politics would be impenetrable to the uninitiated without explanation. It gives the reader an idea of the care and thought that lies behind modern medicine, but interesting thought it all is, it slows the novel’s pace. It may be that without some interest in the novel’s subject, you would find it hard going.
But this is unduly negative. In the main I enjoyed Goldblatt’s Descent. It’s an unusual subject matter, comprehensively tackled with compassion and sharp wit. The characters may not have been as rounded as I would have liked, but they are certainly memorable. This is an ambitious debut, that is mostly successful at what it sets out to do. Now Honig has been through his catharsis, I would certainly read his next novel. It will be interesting to see what he comes up with next.
Many Thanks to Corinna at Atlantic Books for sending me a copy of the book to review