We usually think of hospitals as somewhere safe, where patients get better or move on. The quote from Dante’s The Divine Comedy prefacing Austin Duffy’s latest novel implies an extreme version of this liminal space. This is underlined when his protagonist suggests his workplace resembles “one of those medieval paintings of hell, swarming with devils and the wretched”. The demons are the medical staff “directing the show”, the wretched are their helpless patients.
The unnamed narrator is one of a trio of surgical interns on call during the hospital’s gruelling night shifts. They prefer to patrol as a group, although it makes sense to take turns to sleep. Two, however, are anxious about several rudimentary procedures such as “putting in lines” or conducting a blood gas test. The inexperienced interns are wary of practising on the sick: “They didn’t know that we didn’t know anything, and it was probably better that way.”
In the hospital hierarchy, surgeons reign supreme while night interns are on the bottom rung. The surgeons snipe at the registrars and both belittle and blame the juniors at every opportunity. We learn of two suicides among the staff and the narrator begins to wonder why he has chosen this career: “Being a surgical intern was something to be endured and survived, a staging post on the way to other things, but what these things were remained invisible… and all of the likely eventualities were undesirable.”
Duffy is a practising oncologist, and his uncompromising use of medical language such as “Cheyne-Stokes breathing” adds authenticity as well as unease. Life on the frontline for medical trainees could have made grim reading but Duffy’s vivid portrait is immersive – I feel the interns’ exhaustion – and their determination to succeed against all odds is poignant. There’s also plenty of gallows humour. The neat final twist underlines the fundamental humanity that drives Duffy’s characters.
The Night Interns by Austin Duffy is published by Granta (£12.99). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply