The good: I really resonated with some of the statements made (good and bad).
The not-so-good: Took me a little while to get into, had to finish before my own on call (otherwise nightmares happen, like Kitty’s)
Why I chose it: I am always here for medical fiction! Thanks to Allen and Unwin for the copy.
Publisher: Allen & Unwin
Rating: 9 out of 10
Going Under is such an important, timely book. There has been a lot of media recently in Australia regarding the working conditions of doctors and other health professionals in hospitals. Going Under adds greatly to that conversation in this debut novel of a young doctor’s first year on the job. It asks the question as to who looks after the doctor and sadly, often the junior staff on the coalface are the ones that come last on the list.
Katarina (Kitty) Holliday is starting her first job since leaving medical school as an intern doctor at the rather amusingly named Holy Innocents hospital in Sydney. As a big, busy public hospital, Kitty knows that her year is going to be bursting but she and her friends never thought that they would end up on the rollercoaster ride that was full of dizzy highs and lows lower than anyone should ever expect. Kitty wants to be a surgeon and is excited for her first term in neurosurgery. Unfortunately, her working environment is rarely conducive to learning as she is bullied by the junior consultant who takes delight in belittling her lack of knowledge any chance she gets. Her registrar is just as cold and cutting. Fortunately for Kitty, fellow interns Estelle, Max and ex-lawyer The Godfather are there to support each other – if only they weren’t so bloody tired. Friend and housemate Winnie brings a non-medical perspective to the events happening in Kitty’s life, which aren’t only bullying. The friends also take the opportunity to unwind, generally partaking in copious amounts of alcohol and for some of them, a variety of drugs (legal and illegal). As Kitty and Estelle find out, the way to cope through the events of life and death that are thrown at them with little support align with what a doctor told them during medical school – you just don’t. (Cope, that is).
Going Under gave me a full range of emotions, from happiness to sadness but the one that is still lingering is anger. Anger because this book is by no means an exaggeration (in fact, I felt sometimes the book was watered down to be more palatable to a general audience). When Kitty came off a day shift in a rural hospital and was called back to do a night shift in the emergency department – that’s true. Hospital staff can be asked to work all day and part/whole of the night too and they do it – for the patient. To keep the patient safe and trending towards getting better. But who looks after the doctor who works 60-80 hour weeks? I was further incensed by the author’s note, where it’s mentioned that a colleague was told he was on call for a year – that’s working all day and the ability to be phoned all night, with having to come back to the hospital in case of emergency. That’s not a workplace that is conducive to good health. The lack of support for Estelle’s friend, the subject of a coronial inquest – where nobody came to help because communications systems weren’t working and she had to intubate a child (something she definitely had no training or experience in) alone – was astounding. The overall message of needing a support network to stop losing yourself was strong in this story.
The book also has quite a few amusing moments, as Kitty tries to navigate her way across the city and rural hospitals. There’s love, awkward moments (accidentally sending an intimate pic to a consultant) and the black humour that only those in the know really ‘get’ (which is another way of coping with seeing only the extremes of human frailty). The story gets smarter and darker as it moves on, but that only added to my enjoyment of this debut novel. Here is someone who gets it and has written about the experiences clearly.