The adage “write what you know” comes to mind as first-time novelist Mira Harrison centres this around a troubled NHS junior doctor, James Hartman, working in Thatcher-led Britain. Harrison trained in both the hospitals (Southampton and Portsmouth) portrayed in One in Three and captures with real power the long shifts, sleeplessness and stress of a doctor’s life.
Harrison – who is now a doctor and writer working in Dunedin – gives us a revealing, and often riveting, real-time peek into life on the wards: “... the oncology patients … huddled by the main entrance. Whatever the weather, they stood in their thin hospital gowns, or sat in wheelchairs, attached to bags of chemotherapy on metal stands, chain-smoking until they were taken inside again.”
Not everything is done by the book. We see James practise intubation on a recently deceased woman and meet a senior surgeon who is entirely out of his depth and relies on the skills of his junior colleagues – whom he sexually harasses – to clean up his mistakes.
Harrison also details a “cash for ash” scheme that pays doctors for filling out forms that allow their patients to be cremated, and the ever-cheerful morticians who while away their days drinking tea and listening to top-40 radio.
Indeed, James, who has been a doctor for only a matter of months, is still adjusting to the amount of death that surrounds him daily: “There had been so many deaths. Since Friday morning, when his shift began, 14 patients had died. He could not count the number lost during the last seven weeks.”
Despite the author’s note asserting that all characters are works of fiction it’s hard not to associate Harrison with the smart, no-nonsense New Zealand doctor Ainslie, who appears in the second half of the novel. She’s a welcome adjunct to the brittle James, who deals with the pressures of the job with brief – often work-time – visits to the nearby red-light district, where he seeks out a sex worker called Jenny.
We also get an insight into his dreary family life. His father, recently made redundant, seems to live in front of the TV; his mother fusses over him, proud that her son is a doctor, and does his washing on his rare weekend visits.
Along with Jenny, James has hookups with random women, but none seem to give him much pleasure. His life appears empty and lonely. When a patient dies due, in part, to a mistake in the treatment he gives, his sense of ennui increases. The only non-sexual relief he gets is from listening to classical music and driving his sports car.
If the first few chapters suggest this is another existential health worker noir, à la Joe Connelly’s Bringing Out the Dead, the second half of the novel switches into a far more conventional romance narrative as James meets Ainslie and Harrison details his growing infatuation with the pixie-like Kiwi medic who turns up at his door one day and asks for some ibuprofen. That relationship will be tested by some of the things James has got up to in his past.
The result is a beguiling, if uneven, novel, one that might have benefited from a more compelling narrative drive to tie the two halves together.
One in Three, by Mira Harrison (The Book Guild), is out now.
