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.