Sometimes the question comes from the other side, from an opposite set of prejudices: sometimes it’s a logistics question. How can a Busy Doctor Have Time to Write Books? There’s a subtext here, an accusation that harks back to that use of the word ‘really’: the notion that a ‘real’ doctor would not bother with anything so frivolous.
And another, different part of me sympathises with this. It’s a question I often ask myself, as any good Methodist boy would — especially late at night, when the work of Making Up Stories often seems rather silly.
I find it’s useful to quote Anton Chekhov in such circumstances, especially to myself: ‘medicine is my wife, writing is my mistress.’
Writing is my Golf Afternoon? In fact, I suspect that my temperament is more suited to writing than to medicine. Ever since I treated a fractured right leg in my first year out of medical school by putting a plaster on the left leg I’ve had a feeling that life held out something else for me beyond medicine. Fortunately no harm was done, except to my ego. I removed the wet plaster, red-faced, and reapplied it to the other side. Creative medicine? Or gross negligence? I blame a wandering mind, a mind too often occupied elsewhere. I like to jot down ideas between patients in a notebook I keep for that purpose. Recently a chemist around the corner returned a prescription to me with the note that while he enjoyed the poem, he didn’t think it one of my best.
And here is one of the advantages of writing as a career: you don’t need to be particularly alert to succeed. You don’t need to know the difference between a right leg and a left leg for instance. Or if you do, then you’ve got a few weeks or even months to think about it, and make up your mind exactly which is which. If it’s about nothing else, writing is about patience.
But if the literary sensibility offers little help in the practice of medicine — and might even prove a hindrance — what of vice versa?
‘I don’t know a better training for a writer than to spend some years in the medical profession,’ Somerset Maugham, a graduate of the Class of 1897, wrote. Perhaps, perhaps not. Medicine, like any work which involves contact with a lot of human misery — and human stupidity — tends to shrivel the heart. To survive, or at least to sleep peacefully, it quickly becomes essential to put some sort of distance between that world and yourself. I think I was happiest during my student years when working in the Emergency Ward of the hospital in which I trained. Emergency Ward medicine is medicine at its most personally distant, disproportionately removed from the extreme pain and severity of the illnesses and injuries which ambulances disgorge into that ward at all hours of the day and night. It’s a world akin to the Mental Arithmetic tests of primary school (I was good at Mental!), a world of inadequate history taking, too-rapid examinations, forced decisions.
I found Emergency far easier to handle, emotionally, than the protracted problems and pains of patients I came to know in other wards, and in general practice since, daily. There is simply insufficient time in Emergency to worry too much about any single person; there is always another stretcher arriving, another set of rapid decisions to be made.
It’s a world oddly free of worry; far too busy for the luxury of worry.
I imagine that many medicos have been in the same emotional boat, if only because the selection processes for medical schools favour (or used to favour) applicants who are good at Mental Arithmetic, and not necessarily good at coping with pain, theirs or others.
That doctors often come to see the suffering, or dying, of their patients as an intellectual puzzle to be solved is one way of handling the pressures of such an emotionally overwhelming world.
It’s a mind-set easy to caricature: the heartless medical students of Pickwick Papers; or Herman Melville’s Surgeon-Of-The-Fleet Cadwallader Cuticle come to mind: ‘He walked abroad, a curious patchwork of life-and-death, with a wig, one glass eye and a set of false teeth … They say he can drop a leg in one minute and ten seconds from the moment the knife touches it. ’
Humour, of course, is another way of maintaining distance: medical school gallows humour. We all, supposedly, remember our first day at school with clarity — psychiatrists lay great store in the emotional content of those childhood recollections. I’m sure that all medicos remember their first day at medical school, which is also their first day in the Dissecting Room, with even greater clarity. For some that first visit lasts only a few seconds before they bolt for the door; for most curiosity reaches a delicate balance with nausea.
I managed to resist throwing up until I arrived home to face dinner — when some variant of Murphy’s Law ensured there would be cold pork on the table, that night of all nights.
Cold short pork.
Organ fights, or flesh fights, were not unknown in the Dissecting Room — although such irreverence was harshly dealt with by the authorities. I clearly remember being hit on the head by a stray human testicle one sun-drenched afternoon. It’s not the kind of event you easily forget.
Richard Gordon (‘Doctor in the House’ etc.) made a fortune out of books filled with such undergraduate pranks — but it’s the opposite defence against the unspeakable that is perhaps more interesting to a writer; the defence of coldness, of denial. Over a period of years, working long hours, and with no sabbaticals to allow a refilling of the reservoirs of compassion, the gallows-humour process in many doctors goes too far, and becomes its own caricature: cynicism, indifference.
I’ve often parodied that too-clinical voice in my own writing — in part such self-parodies are an exorcism, or an attempted exorcism, although this is not always the way reviewers see it. This, from a review of one of my books by Andrea Stretton in the Sydney Morning Herald:
This sparse and understated prose brings out this reader’s bloodlust: the desire for one of these fictional medicos to undergo major fictional surgery — without an anaesthetic.
A little more favourable, from The Weekend Australian:
His style has an initial bedside manner before slitting open a dark underbelly of irony.
Most memorable is this, from a review by Brian Matthews in The Adelaide Review:
Ask not for whom the bleeper bleeps, it bleeps for thee.
I find all this use of medical metaphor mildly irritating. But its probably better to be a doctor reviewed by writers, than a writer reviewed by doctors. This is what happened to Jonathon Swift’s Gulliver’s Travels when it was discussed in an issue of the Psychoanalytic Quarterly:
Jonathon Swift showed marked anal characteristics (extreme personal immaculateness, secretiveness, intense ambition, pleasure in less obvious dirt, stubborn vengefulness in righteous causes) which indicate that early control of his excretory function was achieved under great stress and perhaps too early.
3.
If we remember our first day in the dissecting room clearly, we also remember our first day in labour ward. Being present at childbirth is to share in a huge joy — there is so much joy to go around, a little spills over into all but the most jaded heart. It is always, as if for the first time, to experience a thrilling shock — for there is something shocking, and dislocating, in the final emergence of that new small slippery being.
The image in the film Alien, as the pupal-stage alien bursts from the chest of the host human, captures some of the weird other-worldly shock of the first childbirth I ever saw.
Paradoxically, as a doctor, I find my greatest satisfaction now comes from the treatment of, or more accurately the offering of assistance to, the dying. Satisfaction may seem an odd word for this work, which is often emotionally harrowing — but its satisfactions are deeply nourishing. Palliative care, in the argot, has recently, and not before time, become a growth specialty. Being present at death — death at home, among loved ones, from which pain has been banished, and in which the dying person has been granted time and space to come to terms with the fact — to be part of this, in however small and peripheral a way, is a huge and humbling privilege. To write about it is near-impossible: firstly, to decide if you have the
right, secondly, to tread the fine line between mawkish sentimentality, and too-clinical distance.
Several times I’ve used a female doctor persona to represent the ‘feminine’ side of these feelings: the caring side. Its opposite, the objective ‘masculine’ practitioner, has variously been transformed into a pedantic Latin scholar, and, more recently, a mathematician, obsessed by that purest of the sciences, a world free from any human contamination.
In part such representations are another exorcism, and no doubt somewhere between the two is an ideal narrator: a narrator who can handle all the stories of horror, squalor, stupidity, death — and occasional transcendent courage, or love — for which I can’t yet find a proper focus, or tone.
Of course, death is not easily house-trained; it is rarely so amenable to human management and control — to the schedules of an idealised Good Death. It’s more often sudden, or violent, or cruel, or painful, or terrifying.
And its world, and the stories from that world, are almost unfathomable.
A mother injects her baby with poison, repeatedly, to gain it admission to hospital. As soon as the baby is separated from the mother, it improves — back in her care, it deteriorates. She denies everything, and almost certainly believes herself.
A doctor saves a choking friend’s life in a restaurant, and the saved friend cannot bring himself to speak to his saviour again — the debt is too great to acknowledge, or even admit.
A woman brings in photographs ‘of my accident’ — photographs of herself, a seriously injured road victim, being extracted from wreckage, bandaged, loaded into an ambulance. The inevitable question is asked: ‘Who took the photographs?’ The answer: ‘Oh, my husband took the photographs.’
My husband, the amateur paparazzo.
What to make of these true, baffling stories? I’m not even sure that they are my business. They do provide a different scale of priorities of importance; an idea of what is, finally, ‘really’ important, to borrow back that same criterion I tossed up earlier in this piece.
And perhaps this is part of the reason I cannot get enthusiastic about much of the highly-praised writing in this country — and others — in recent years. So much of it belongs in those underrated literary categories: Plain Silly, or Dead Boring.
Including most of my own. For these are the categories of the puritan, of course: the Methodist boy in me who I have also attempted to caricature, but seem unable to shake off entirely. Too many years of medical training, perhaps, have cemented it permanently in place. If part of me likes to see itself as an upper-case Writer — a narcissocrat, a junior member of the priest caste of our silly Art-worshipping culture — another part is always accusing: Fine, But What Are You Going To Do When You Grow Up?
And yet turning these stories into fiction might help towards some kind of understanding, towards finding some essence, beyond curiosity, or voyeurism. Fiction is above all a re-ordering process, a sense-making process, even when it’s black comedy. Jokes, too, are a form of fiction; albeit a particularly poetic form. ‘Undoubtedly the world is, and her riches can never be circumscribed by art’ the Polish poet Czeslaw Milosz has written — but we have to make a start, especially under immense pressure from the emotions that surround death. Sometimes, to use an old truism, if we don’t laugh, we cry — and sometimes even both at the same time, our worst jokes and favourite fears tangled hopelessly together.
PETER GOLDSWORTHY 1993
REVIEWS
When Jesus Wants Me For A Sunbeam was first released in the collection Little Deaths in 1993 it received considerable acclaim and attention.
Following are a number of reviews that discuss the power and importance of the novella.
‘Death in the suburbs mirrored in irony’
ANDREW RIEMER, Sydney Morning Herald, 1993
Peter Goldsworthy is probably the most stylish of our writers. His work is distinguished by elegance, by sharpness of observations, by nicely judged ironies and by memorable, aphoristic turns of phrase. He is a most careful craftsman, who hones and polishes his work, paying close attention to nuances and implications.
…Goldsworthy shows wonderful control of tone and implication. These pieces [in Little Deaths] are, without exception, marvellously shaped, often wry epiphanies. Most of them capture moments where the characters must face a bleak future, without hope of consolation. Yet such is the tightly controlled and allusive nature of these stories that we do not, as a rule, catch the character in the grip of suffering or rage. Goldsworthy seems to draw back from the representation of passion or states of extreme emotion. And that, or so it seems to me, is a limitation to these fine, highly civilised stories.
…Jesus Wants Me For A Sunbeam [is] a tour de force of control and compression. Rick and Linda seem blessed with everything fortune can bestow. They are intelligent, cultivated, socially responsible people who approach their duty as the parents of two young children with level-headed seriousness. They seem to stand therefore, as shining emblems of all that is admirable about moderate and well-considered lives — a guarantee, perhaps, of the moral strengths of humanism.
Their life is nevertheless shattered when one of the children contracts an incurable disease. One of the many fine things in this splendid novella is Goldsworthy’s meticulous description — based no doubt on his experiences as a medical practitioner — of the progress of the disease and the fluctuating reactions of those obliged to stand helplessly by. At the end, Linda and Rick are forced to face the implications of death more directly and with more surprising consequences than usual in these stories or in Goldsworthy’s work in general.
When we reach the end of this disturbingly memorable tale, Goldsworthy obliges us to acknowledge something that is latent and expertly implied in the earlier sections. Linda and Rick, those exemplars of the most admirable facets of our world, people keenly aware of the degrading effects of violence and brutality in our everyday experience, are defenceless against the fact of death — especially the death of a child. The most painful recognition this remarkable story brings home is that a sanely secular world crumbles in the face of such a fact.
And all this, I must add, is accomplished in 45 pages. The feat is admirable, yet even here I am conscious of a certain holding-back, perhaps reticence. Why didn’t Goldsworthy let go and write the big, even chaotic novel hiding inside this “little death"?
‘Life and death near and afar’
KATHARINE ENGLAND, The Advertiser, Adelaide, 1993
Goldsworthy’s talent is for the local and particular — each story a polished miniature, an acid-etched Adelaide gem. His scene-setting is minimal: his characters — clones of our intelligent, hard-working, right-minded selves — fill the page, seeming first to have followed the doctor’s traditional injunction: go behind the screen and take off your clothes.
With scalpel-edged prose, Goldsworthy turns back the well-toned tissue, cutting down to a point at which the middle-class gods — education, good manners, real estate, friends, religion, the arts and a healthy, if hard-won, bank account — fail to offer salvation: to the peeled, unsuspected deep point at which something more primitive and wild takes over.
… The heart of the collection [Little Deaths] details another kind of ‘little death’, the death of a child, in a novella with the searing title Jesus Wants Me For A Sunbeam and the epigraph ‘In us we trust’. Goldsworthy describes at length, in a tone that is enigmatic rather than dispassionate, the development of an inward-looking, emotionally self-sufficient little family and their response to the disease which is claiming their six-year-old daughter. This is automatically heart-string-twanging territory, with little scope for wit and the cutting edge: without this balance Goldsworthy’s candid simplicity tends to the maudlin — in the context of a longer story his characters are less well-defined, and the weight of the story is carried uneasily by its emotive subject matter, by every parent’s superstitious, sympathetic fear.
‘Death of a middle-class lady’
PETE
R O’CONNOR, The Age, 1994
… [In Little Deaths] Goldsworthy magnifies the issues of life and our feeble and pointless attempts to construct order and the illusion of certitude against the inevitability of death itself. It is by exploring the presence of death that the author forces the reader into reflecting upon the transitory nature of life with death as the only certainty.
This is not to suggest that his stories are morbid, serious and depressing. In fact, his genius as a writer is that he engages us in a whole range of emotions from humour and farce to profound sadness, each time holding a kaleidoscope up to the existence of death, allowing us to look at it and reflect upon it from many different angles. However, the result is always the same: the inevitability of death against the transitoriness of life.
… It is the novella [JesusWants Me For A Sunbeam] that stands out as the centrepiece of this collection. In this story, he skilfully explores the feelings of an ordered and symmetrical couple who have planned all their life down to their one of each gender child, only to suddenly discover that one of the children is suffering from the incurable disease of leukaemia.
The exposition of the gradual breakdown in belief systems, the utter futility of the Christian response and the final stark and brutal solution of a father committing suicide in order to reassure the child that he will be waiting for her after her death, is simply brilliant and utterly engaging.
In this story and throughout the collection [Little Deaths], Peter Goldsworthy writes with a sort of underlying expectancy of uncertainty, daring the reader to stretch their known boundaries and explore with him unknown and desolate areas of the psyche, including the great unknown, death itself. His masterfully crafted volume challenges us to explore death in a way that leaves one compelled to reflect upon life and the futility of the fantasy of permanence, regardless of what means we use to construct that fantasy.
Jesus Wants Me For a Sunbeam Page 7
