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Friday, 7 August 2009

Review: Making the Cut, Mohamed Khadra (2007)

The book is very uneven in quality. This is because Khadra is a very boring man, although sometimes his insights are brilliant. When he is good - especially in the initial parts of the book - he is very, very good.

But when he lets go of the narrative thread and gives his prejudice its head, he can be very bad indeed. This is especially true in his grumbling about - what he thinks is - a crumbling health care system. ‘Old school’ is the epithet that comes most readily to mind.

Nevertheless, Khadra is a good prose stylist and he has a knack for turning otherwise nominally interesting material into coherent stories. The chapters are short and many have a definite arc that ties together the beginning and the end. Occasional wooden passages, such as are found in the story about his mother’s death, are offset by sparkling dramas such as the story of the rich surgeon with a drug habit.

Doctor stories are inherently interesting. The tug of drama is ever-present. Partly this is because the world of doctors is closed to most of us. It is an opaque oasis of ethical behaviour and gravitas where destinies are defined and the best and worst of people emerges, despite themselves. We are drawn to the inherent pathos.

Khadra turns much of this on its head. Naturally, as a practicing clinician, he is in a privileged position vis a vis the base material. No TV scriptwriter has equal access to the bones and marrow of the universe of ward and gurney. In turning upside down what is otherwise unfathomable, Khadra is deft with his assumptions of our own knowledge. He doesn’t scoff at it but he also doesn’t take anything for granted.

He seems quite candid. But there’s the danger. In fact, Khadra has very definite views about what he experiences in a lifetime of medical service. Equally, he is quite sure of the kind of appearances he wishes to engender in our minds.

Like the patient on the slab, we are at his mercy.

Overall, he is ethical in his dealings with us. On occasion, however, he wavers, stepping across the line that marks out the distinct territory of the observer from that of the grudging participant. Yet there is knowledge to be gleaned even from reading those passages in which he rumbles most menacingly in his chest at the evils of a profession that seems to be going to the dogs along with everything else we treasure in this world.

He’s probably wrong. One day, a patient will die of sepsis contracted by a dirty ward, a lawsuit will ensue, the hospital will be forced to pay a large compensation package, and things will start to change. In sum it is probably fair to say that some things were better in the old days. I guess that some things are better now.

But Khadra is not going to be the author-doctor to admit this. He will have the last word. And who are we to question him?

There’s also something very prosaic and unsubtle about the aspirations and tenor of the book. One example is the way the poems that are tacked onto the start of each chapter relate to the chapter that follows. Khadra says often that art and literature helped him to survive not only the grueling preparation process that led to his accreditation as a surgeon. They also help him in daily life to deal with patients who are, after all, humans.

But just adding a clip of poetry to a chapter does not true wisdom make.

Khadra’s eminently down-to-earth foibles (the BMW, the comfortable house) also make me wary of his motives. It is as if a politician were suddenly to attempt to make his persona seem less formulaic by writing an opera in Italian, a language he had learned since his university days. Imagine if Kevin Rudd were to write a treatise on T’ang pottery.

In fact, it is frightening how hollow an average surgeon seems to be compared with, say, some of the more flamboyant lawyers we see in TV crosses to the courthouse steps. A lawyer I can imagine writing a book about love-life in Constantinople in the ninth century. A surgeon’s way is a little closer to the way of Jack Smith from the body shop in my view.

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