John Gibb
The Royal Free by Carl Shuker (Te Herenga Waka University Press, 2024 and Counterpoint, 2025), 312pp, $38
Both The Royal Free, Carl Shuker’s latest novel, and its predecessor and fellow medical drama, A Mistake, memorably demonstrate the paradoxically truth-telling power of fiction. Both show that what is ostensibly false and ‘made up’ can become more persuasively meaningful and truthful than some statements that are ostensibly ‘true’.
Compelling truths about life emerge from fiction in these books, but they also reveal truths from a seemingly unlikely quarter: fiction based on aspects of the public health system in New Zealand and, in this latest novel, the United Kingdom. (The book’s title alludes to The Royal Free Hospital, a major north London hospital commonly known as ‘The Royal Free’.) Studying the public health system may seem an unpromising place for truth to emerge, but Shuker has realised this is the novel’s opportunity to prove contemporary relevance by probing perceptions.
Shuker lives in Wellington with his wife Anna Smaill and their two children. He is a former editor at the British Medical Journal in London and currently manager of scientific publications at the Te Tahu Hauora Health Quality and Safety Commission. He is the author of six novels, the first of which, The Method Actors (Shoemaker & Hoard, 2005), won the IIML Prize in Modern Letters in 2006. Intertextual links are apparent between The Royal Free and A Mistake and the works of English novelist J.G. (James Graham) Ballard, in particular his best-known novel, the controversial Crash (1973), which tracks a group of car crash fetishists inspired by fatal car crashes of celebrities.
The protagonist of A Mistake is Elizabeth Taylor, a gifted surgeon at a New Zealand city hospital—whose name is also that of a celebrity referred to in Crash. One day, while operating on a young woman in critical condition, something goes badly wrong, leading to a fatality. The book was adapted into an eponymously titled medical drama film, written, directed and produced by Christine Jeffs, and released in 2024. Although it captured some of the drama, it simplified the psychological complexity of the original novel.
The protagonist of The Royal Free is James Ballard, and the book’s blurb claims it is ‘an exuberant, dark, wildly entertaining novel about death and copy editing’. A multi-genre perspective is characteristic of Shuker’s fiction, and The Royal Free’s blurb doubles down on this, referring to the novel as ‘equal parts workplace comedy, home invasion thriller and literary conundrum’. The ‘literary conundrum’ arises from the fact that J.G. Ballard also uses James Ballard as the narrator’s name in Crash. Gestures towards nominative determinism aside, the James Ballard of The Royal Free is not directly related to the novelist but rather is a recently bereaved single father to a baby daughter, as well as a medical editor tasked with saving ‘the third oldest medical journal in the world’, the Royal London Journal of Medicine, from the mistakes no one else notices—the misplaced apostrophes, the Freudian misspelling, the wrong subtype of an influenza strain (H2N1 or H5N1?). ‘His job is utterly boring, but—or so he tells himself—totally crucial: the Royal London is a stronghold of care for the human body, a bastion of humanism in a disintegrating world.’ In the London outside of the office, the prognosis for the body politic is bad. Civic unrest is rife and the metropolis is poised on the brink of riots. ‘Attempting to grieve for his lost young wife, while haunted by a group of violent North London teenagers in a collapsing city, James is brought to crisis.’ We might see in this a glancing nod towards author J.G. Ballard’s 2003 novel The Millennium People, which is about chaos, riots and panic in a collapsing city.
Appropriately, in The Royal Free editor James Ballard has taken on the huge task of revising, in electronic form, the Royal London Journal of Medicine’s ancient and monumental style book, which, in a semi-metaphorical way, also becomes a kind of co-protagonist. So, The Royal London Journal has a character role. Sections of it are interspersed throughout the narrative, adding to the richness of the text and its subplots. This new novel again highlights Shuker’s exploration of intense inner worlds, but in a bigger, denser book, we move beyond the singular portrait of surgeon Elizabeth Taylor in A Mistake to a more expansive, more epic novel.
There are cryptic stories interleaved: a potential love story where the love is buried so deep and buttoned down so tight that the young woman and man concerned are both aware and not aware that they are sometimes catching the same bus. The young woman is the medical journalist Annabel Pitti, who secretly hates writing:
Which was tough, for a writer. She struggled with her stories. They opened horrifically, her first drafts, like a drunken actor moaning themselves out of a nightmare, barely even English. They would shout about the stage a bit, gesturing here and there, trying to hit their marks. Then abruptly, as if in injury, they would end. Trip over the scenery. Step off into the orchestra pit. Metaphors mixed. Similes would burst and leak like hernias. Sentences wriggling on the page, metastatic, non-homogeneous, like fast tumours. They mutated horribly when she tried to fix them, hold them down, apply the chemotherapy of her concentration.
Annabel makes a mental note to ‘cultivate’ the technical editors and ‘talk to James Ballard more’. To tell him she’s seen him on the bus now and again, ‘but don’t be creepy’.
Another character, Oliver, reflects on the growth of ‘fiction’ in his life:
What I was thinking was all our lives are to a large extent fictions we’ve assembled, anyway, aren’t they, but though most don’t get so thoroughgoingly debunked by someone … What we remember, what we want, what we report upon, what we were told and taught, why we now do all these things the way we do, goals, plans, ambitions, our pasts. That’s all essentially fiction … What we fear is being reviewed maliciously. The hostile read. Being really found out.
By contrast, though, there is ‘hoping for the grand and generous exegesis of love over time, ha, ha. The close, sympathetic read and the lengthy, benevolent review.’ These switch-backed confidences, the contrapuntal musings, and indeed the events Shuker creates as his characters move around the great city emulate those of J.G. Ballard’s characters in a kind of metafictional dance between novels. For example, the Ballardian interest in car crashes in Crash is echoed in the bizarre and ugly foot injury that Annabel Pitti receives when she is hit by a van during London riots, after alighting from a bus.
In The Royal Free we also find mythic and somewhat mystic paradoxes, and a nursery room inside an old north London building that is subject to flooding, despite a plumber suggesting that water should not be able to enter. Similarly, autumn leaves mysteriously pile up inside a domestic interior, also with no apparent way of entering the domain of James’s baby daughter, Fiona. ‘Dong … Dong’—James is woken in early morning darkness by a mysterious repeated sound, drawing him to the nursery. Father and baby are also further haunted by the appearance of a Rhodesian Ridgeback dog deep inside a locked building.
Language emerges as perhaps the real hero in this book, with fresh, nimble, ambitious writing that captures moods and underlying realities and deftly summarises not only incidental sounds and events but also the largely hidden forms and shapes below the apparent normalities of daily life. A striking feature of The Royal Free is the credible and subtle way it investigates the fraught ambiguities and contradictions of human behaviour in the modern urban office, in this case, via the specialised, complex realm of a medical journal.
Interviewed in the Victoria University of Wellington online journal Turbine | Kapohau in 2013, Shuker was asked about the role of work as labour in his writing, and he said then it was ‘a huge part of this current novel I’m working on, which is about editing as a job’. He added, ‘We have to structure our lives around some kind of accommodation between work and Work … Work being what we want to do; work being what we have to do.’ Back then he was working on a project he described as being about ‘relationships in an office, and what’s hidden behind codes of professional behaviour. How what is hidden leaks out over time from even the most stultified, determined compartmentaliser of their work and private lives … How in order to deal with the rage and funk of monotonous work—or work of any kind—we pick apart and dissect and investigate and hate and love and lust after the people that are around us eight hours a day.’
The sense of this theme—the rhythm of work—has been strongly rendered in The Royal Free:
The pulses of work in an office. The thrumming of coming and going. The constancy of language always, in the rising of voices and the smiles and the leaned back chairs, in the falling of voices and the brutal clatter of keys. In the early morning, the sense of a long quiet sigh being gone about collectively. Motivated, dedicated, decent. Beeps and clatters like plastic somethings sucked down a vacuum cleaner tube. This was another morning of greetings at their most minimal.
Despite what might seem a paucity of visual clues, minute social observation is acute in The Royal Free:
John Mayer opened the door and James looked up from the style guide. John went by him as if he were not there. At Helen Jackson’s desk Mayer stopped, and she swung around in her chair and leaned back and looked up at him and they chatted. The easy intimacy of those who exercise hard together, who know each other at a deep and wordless and unbarriered level. She said something, made some unparsable gesture, and he held up his right hand swathed in a bandage, and they laughed.
And then, as the subtle rhythms of life and work continue, some members of the journal’s executive, including a certain Mr Death, lean in further towards allegory:
The sun over Gordon Square, coming in the windows in rare golden oblongs and bleeding down the walls over the lieutenant editors. Thirty seconds of sun a summer, on Death’s desk. The constant chatter of keys—here rising the sound of language, the cups of tea accelerating it, managed, manipulated language accumulating, in the service of more managed, manipulated language. What process is it like? It was like they were technicians hard at work resalinating the entire world’s seawater to slightly different parts per thousand. Diligent, focused, self-reflective. Bagged of eye, foul of breath, hungover, underslept—did Death ever feel like death in the morning? He gave the impression of a drill sergeant who drinks a gallon of bourbon in celebration of some dark emotion, wakes on time, sits bulk upright, shits, showers and shaves to schedule, steps into his clothes to run to work without breaking so much as a sweat.
And further speculations inevitably arise:
No one in tech ed knew where he lived because no-one in tech ed had ever seen him go home. No one had ever seen him in the street. Ever. He would never die. Was he an angel?
The Royal Free, in some ways a treatise about Londoners written by a visiting New Zealand anthropologist, accurately captures both details and philosophical meanings in office dialogue and remains alert to the crackle of humour, the sly approach of aphorisms, limericks, other poetry, and various gnomic sayings: ‘A cricket team in their hospital whites—from far away doesn’t a cricket match look like someone is inefficiently being rescued?’ And, ‘Their relationship consisted … in discussing if it existed.’
There is, too, an aspect of melodrama to office politics, where menace and malice slug it out, with high comedy for light relief. Adrienne Morrissey has a five-year-old child to raise, but is ‘facing in the coming weeks of her day job, a series of meetings where the executive, HR and her co-workers were, in intent and effect, conspiring to put her out of work and send her away from them forever, like a medieval expulsion’. And, ‘The message they’d roughed up was supposed to be a covert limerick, designed to trap D2 in a public shaming over his elocution, with a mass group-laugh as a punchline that he wouldn’t see coming, and would humiliate him …’ James experiences a moment of realisation: ‘Already the stupidity of the idea hitting him. The waste. It was then he realised they were speaking to each other more or less in poetry.’
You can also see The Royal Free as a meditation on the life and literary work of J.G. Ballard, who died in 2009 when Shuker was living in London. Ballard’s wife, Mary Ballard, died of pneumonia in 1964 during a family holiday in Alicante, Spain, leaving the novelist to raise their three young children, James, Fay and Bea, by himself. In Ballard’s 1974 introduction to the French edition of his novel Crash, he stated:
We live in a world ruled by fictions of every kind—mass merchandising, advertising, politics conducted as a branch of advertising, the instant translation of science and technology into popular imagery, the increasing blurring and intermingling of identities within the realm of consumer goods, the preempting of any free or imaginative response to experience by the television screen. We live inside an enormous novel. For the writer in particular, it is less and less necessary for him to invent the fictional character of his novel. The fiction is already there. The writer’s task is to invent the reality.
Shuker delights in exploring similar territory, homing in on brittle edges of everyday dialogue, including among people working under deadline, tracking through mood swings, and the ambiguous clatter of voices. Friends and frenemies are also among those striving to understand and involve themselves in what is happening in the office. They might respond with wellsprings of affection and goodwill or perhaps with cruelty and schadenfreude. Emily Forman, in her mid-sixties, has a new amanuensis whom she is vigorously grooming to replace herself: ‘Goodbye tension—hello pension’. Everywhere, language is doing the heavy lifting and keeping us engaged and amused, as in a close encounter with editors further up in the hierarchy:
He circled the atoll of editors surrounding the lagoon of the immense pine veneer conference table, in the centre of which floated malignantly the dead black squid of the conference phone apparatus.
JOHN GIBB is a Dunedin writer and poet and a former journalist for the Otago Daily Times. His third poetry collection, Surprised by Hope, was published by Cold Hub Press in 2022.
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