Carl Shuker’s ‘A Mistake’ examines – and reexamines – a doctor’s missteps

Maggie Trapp

THE WASHINGTON POST – In A Mistake, New Zealand author Carl Shuker conveys in gorgeous, heartbreaking detail the shock of catastrophe and the ways we try to make sense of disaster after the fact.

The novel’s protagonist, Elizabeth Taylor, is, at 42, the youngest and only female consultant general surgeon at Wellington Hospital. She is also consumed by the long-ago story of the 1986 Challenger space shuttle disaster, the “most beautiful story of error” she’s ever read.

She lingers over descriptions of the catastrophe, “the tower of light and smoke, the cold and the corkscrew of vapour collapsing in on itself and spreading like the skirts of a swooning actor in a period drama as she sinks to the sands … one long white streamer falling to the ocean. The smoke curling, reshaping, morphing. Then it all pauses, at an end, descending, compressing, and fading away.”

Just as Elizabeth is gripped by the timeline of the Challenger disaster, A Mistake asks us to view and review Elizabeth’s own missteps, which, seen from conflicting viewpoints, appear increasingly disastrous.

A Mistake wastes no time with throat clearing. From its first word we’re in the pivotal, high-stakes scene around which all else in the novel revolves. Elizabeth and her surgical team are attempting to help a young female patient with advanced sepsis. The opening sequence is filled with tension as Elizabeth and her team work. We watch as one decision leads to another, each discrete event cascading into the next, creating a string of increasingly catastrophic causality that Elizabeth deems “a controlled emergency and not a chaotic emergency.”

Elizabeth is whip-smart, confident, experienced. She does not crack under pressure. But she is a woman in a system that does not know what to make of her, or she of it, and what follows this initial scene is an extended professional parsing of her choices.

While Elizabeth is being scrutinised professionally, she is also drafting a response to the Royal London Journal of Medicine’s edits on a piece she co-wrote. Over the course of the novel Elizabeth writes her way into an increasingly trenchant argument against the New Zealand Ministry of Health’s upcoming launch of “a system of open public reporting of the ‘results’ of New Zealand doctors and surgeons” – a proposal to name and shame surgeons based on their “outcomes.”

Shuker’s novel is the fascinating and infuriating story of the way various parties interpret and revise what they witnessed, limning events in telling ways. Shuker’s arresting prose renders the inconceivable breathtaking. He interleaves the story of Elizabeth and her surgical team with that of the real-life events that led to the breaking apart of the Challenger, and in both instances we remain transfixed as a cataclysmic mistake unfolds in real time. We are reminded of why we turn to narrative in the first place – our need to know what happened and our very human, if misguided, compulsion to fashion the messiness into a discernible, knowable story.