A Mistake

July 22, 2019
Shuker (The Method Actors) grapples with responsibility in medicine in this brisk but middling novel. Exacting, brash general surgeon Elizabeth Taylor performs emergency surgery on Lisa, a mysteriously ill 20-something, at a public hospital in Wellington, New Zealand. In a taut, medical jargon-filled scene, Elizabeth discovers pervasive infection in Lisa’s organs. Elizabeth feels satisfied with the surgery despite some complications while she directed her trainee, Richard. Lisa, however, dies of sepsis less than a day later. Meanwhile, Elizabeth writes a scathing rebuke of the government’s plan to publish mortality statistics for each surgeon in New Zealand. Her concerns over damage to careers intensifies when, after a tense meeting with fellow doctors and hospital administrators during which she took full responsibility for Lisa’s surgical failure, she is placed on restricted duties. Elizabeth displaces her rage on home improvements and destroys relationships as she struggles to cope. Shuker’s almost frantic prose builds tension, but leaves facets of Elizabeth undeveloped, like her secret relationship with Robin, a nurse at her hospital, and the narrative is weighed down with digressions comparing the mistake to the Challenger shuttle explosion. Shuker’s unlikable main character evokes a visceral reaction, but the book does not reach the depths required for his heady exploration of guilt and the fuzzy line between error and malpractice.

July 15, 2019
Where does responsibility for a mistake lie: with a system? A circumstance? An individual? Shuker's staccato recounting of an operating room mishap reveals as much about the iconoclastic surgeon leading the team as the doctor herself wants anyone to know: She plays thrash metal on repeat while she works, she's curt and demanding in the OR, and she's a brilliant, accomplished surgeon. The complicated aftermath of the surgical error, committed by a junior colleague, seems almost inevitable given Dr. Elizabeth (Liz!) Taylor's propensity to do things her own way despite the confines of the misogynistic medical community of the novel's setting, Wellington, New Zealand. In a parallel to the surgical story, Shuker unfolds the events leading up to the space shuttle Challenger disaster, an event Taylor uses to illustrate the implications of "massive systems failure" to her surgical students. Taylor tells them there can be simple problems, complicated problems, complex problems...or chaos. (Her own assessment of the operating room error as a "controlled emergency," not a chaotic one, is one example of her sangfroid.) A pending initiative to publish the results of medical outcomes lends additional drama to Taylor's predicament; data alone is subject to misunderstanding and misinterpretation by nonphysicians, and a sole bad outcome can skew the results of years of hard-won successes. Shuker's spare narrative leaves substantial room to theorize about Taylor's emotional life as well as the ultimate assignment of blame for the surgical calamity. Scattered clues to Taylor's past allow insight into her relationship status, bisexuality, and temperament, but Shuker succeeds in providing a main character whose idiosyncratic self is most fully realized in the operating room and who has only herself to rely upon to survive the repercussions of a mistake. A character study and a morality tale wrapped up in a medical thriller.

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August 1, 2019
At 42, Elizabeth Taylor has come to be respected as the only female surgical consultant at her Wellington, New Zealand, hospital, though she's not liked for her abrasive manner. While she is performing surgery on a young woman with an infected intrauterine device, a mistake is made, and the patient dies the following morning. At the same time, plans are underway in the country to make public the results of all surgeries. Shuker explores the consequences of the mistake made in the operating room in parallel with the mistake that caused the Challenger space-shuttle disaster in 1986, a tragedy that, ironically, Taylor liked to tell her students was the most beautiful story of error she had ever read, as she lectured them about solutions to simple and complex problems. New Zealand author Shuker, who works for the British Medical Journal, presents a concise portrayal of the consequences of mistakes that result in the loss of life, along the way displaying knowledge about medical practices and the difficulties facing a woman entering a man's world. An intriguing account of irresponsibility and its aftermath.(Reprinted with permission of Booklist, copyright 2019, American Library Association.)