Heavy Years is Augustus Young’s most recent volume of autofiction, or fictionalised memoir, following from his highly praised Light Years and the more recent Brazilian Tequila. In this book, the unnamed narrator is a medical graduate, not quite a doctor, from Cork who moves to London to work for the NHS as a freelance researcher/process improver. He’s an idealist whose philosophy is summed up in a quote from Rudolf Virchow that serves as an epigraph to the book: ‘Medicine is a social science, and politics is nothing but medicine on a larger scale.’ The arc of the book describes the journey from this belief that the NHS and the politicians whose role it is to fund and nurture it should be focused in health rather than illness, prevention before cure, through a slow absorption into the status quo to a kind of resignation and the ‘redemption by default’ of early retirement.
Our narrator is employed on the recommendation of a senior consultant called Mal Combes whose intention is to use his protégé as a constructive disruptor who will challenge established patterns of behaviour within the health service to the benefit of patients. It’s a job he takes on with initial enthusiasm, and in the process he constructs a map of the NHS hierarchy, from ’the mandarins’ at one end to ‘the humans’ at the other, and decides to focus his efforts on the front-line staff who, he feels, are most likely to share his view of the proper role of medicine and less likely to be involved in politics for its own sake. All of this is accompanied by a Greek chorus consisting of the talking in his head.
He decides to use his outsider status as an Irishman to his advantage:
What could be seen as a disadvantage was an asset. I could use my Irishness, and English colleagues couldn’t. at least not directly. I did not disguise my accent, but spoke very distinctly (like my mother on the phone). I decided it was a magical weapon like Fionn MacCool’s gae-bolg (spear). It entered my enemies like a javelin and its barbs opened up inside.
[It hardly detracts from this to point out that the gae-bolg was Cuchulain’s spear.]
On balance, things go pretty well at first, until the election as Prime Minister of the woman he calls Mrs Sybil, known in the real world as Mrs Thatcher. The new, market driven, politics before health means he has two options, unemployment or compromise, and he settles for the latter. He had, in any case, begun to have doubts about Virchow’s ‘big idea’, having come to the conclusion that sickness, at a certain point, is inevitable as we grow older and that the inevitable outcome of a health-focused policy would be an aging, ill population. And so, he moves on to the ‘little idea’ of removing the patently incompetent from the system through a series of disciplinary proceedings. This, while generally effective, is unpopular and ultimately induces a kind of paranoia in the unnamed one as the higher powers in his hierarchical tree begin to take more interest in his actions. It also leads to a sense of change without progress, and as he moves closer to the higher powers in the system, his idealism is further diluted.
In a sense, this is close to the character of another Young doctor, Pedrinho Diaz, whose transformation from idealistic young medico to corrupt politician is at the heart of Brazilian Tequila. This, of course, leads to the uncomfortable conclusion that the NHS jungle is very much like the Brazilian rainforest, at least where the integrity of medical administration is concerned. It’s a conflict that also resonates through another recent book by Young, The Invalidity of all Guarantees: A Conversation between Bertolt Brecht and Walter Benjamin, where Brecht’s pragmatism is set against the purity of Benjamin.
Alongside this tale of woe, we see glimpses of the Irish wing of literary London, the scene of Young’s earlier autofiction Light Years. This mostly revolving around pubs, with some interesting sightings of the near-legendary figure of Donegal poet and aspirant bag-lady Madge Herron. It is in these low relief passages that Young’s characteristically rambunctious style is most in evidence:
She was built like a chick albatross, and her vocal range was that of a starling, calls varying from chortled warbles to alarming squawks with tender little trills in between.
It is also here that the elements of the Venn diagram that links the narrator, his inventor Augustus Young, and Young’s inventor, Dr James Hogan fully overlap, bringing the nature of the autofiction into focus. Hogan, after all, was a consultant epidemiologist in the NHS and, unlike the lone bachelor narrator, a married man. And so, the story takes on something of the nature of that most particular genre of fictional distortion, the fable. But what, if any, is the moral? Here is the tale of an Irish doctor working for the NHS in London inspired by the work of a German thinker and, in real life, whatever that is, retiring to writerly seclusion in the South of France. It is, in short, a European fable. Given the post-Brexit prospects for the NHS, the following passage seems particularly prescient, whether intentionally or otherwise (I suspect the former):
Newly formed companies were scrambling for consultancy work. Interest in the American health system included exchanges of visits by professionals. I could see on the horizon competitive tendering by multinationals for service takeovers. The talking shook its head sadly, ‘How long, O Lord, how full of cant you are. A nation of shopkeepers is never going to go global.’
Which is, of course, exactly what said shopkeepers and their customers, behind a tattered banner unfurled on the playing fields of Eton, now intend to attempt.
And so, for all its playful poking of fun at human and organisation foibles, Heavy Years is, in the end, a deeply serious book, a story of idealism broken on the wheel of power, but also a finger pointing at the anti-moon of a post-Brexit privatised health ‘service’ whose reality draws ever closer. It may be too late to undo the referendum, but the moral of this fable is that the NHS must be defended at all costs.
An odd little gem.
My review of two recent books by Augustus Young is live on the Dublin Review of Books. The books in question are:
Brazilian Tequila: A Journey into the Interior, by Augustus Young, Matador, 160 pp, £10.99, ISBN: 978-1785899874
The Invalidity of all Guarantees: A Conversation between Bertolt Brecht and Walter Benjamin (1934), by Augustus Young, Labyrinth Books (2017), 222 pp, £6.31, ISBN: 978-1872468853
Aidan Higgins, probably the finest Irish novelist since Beckett, died on Sunday aged 88. To mark his sad passing, I thought I’d reblog this piece I wrote for the Guardian Books Blog in 2008:
The James Frey controversy once again opened up the age-old debate on where the borderline between “truth” and “fiction” in a writer’s use of their own life as material should lie. It’s a question that is forced to the front of my mind whenever I read anything by my favourite Irish novelist since Beckett, the wonderful but sadly neglected Aidan Higgins.
Higgins’ answer would appear to be that the borderline lies wherever the author decides it does. You don’t have to read his books if you don’t want to, but you cannot tell him what to do with his materials, or how he should label the results. His fictions are based on his own life, his memoirs are fictionalised.
Born in 1927 into an impoverished “big house” in Celbridge which was unusual for being Roman Catholic, Higgins lived in England, Spain, South Africa, Rhodesia (both North and South) and Germany, before winding up in Kinsale. His first novel, Langrishe, Go Down, is set in a Catholic “big house” family in Celbridge, which differs from the author’s own family in that the Langrishe offspring are all daughters. The book won awards and was adapted for the BBC by Harold Pinter. It looked like Higgins was set to be a successful literary novelist.
However, his next novel, Balcony of Europe, saw Higgins abandon the conventions of plot and characterisation that had made Langrishe so attractive in favour of an apparently more formless type of narrative writing. Balcony is a first person tale of Dan Ruttle, an Irish painter living in relative poverty in the bohemian community of Nerja, in Andalusia. Ruttle is undergoing an affair with an English diplomat’s wife that precipitates the collapse of his own marriage. Ruttle is, essentially, Higgins lightly disguised and the book, with its blurring of the lines between fact and fiction and order and chaos, serves as a template for the rest of Higgins’ output to date.
Higgins is essentially a novelist of memory and its unreliability. His protagonists are generally alienated from each other by shared experiences differently remembered. He admires Beckett and applies Beckettian methods to a fictional world that more nearly resembles the quotidian than the older writer’s does. Crucially, despite their mutual incomprehension his characters are more like real people than Beckett’s and he admits the importance, the almost redemptive quality, of sexual love into his fictional universe. His 1983 novel Bornholm Night-Ferry is the story of two adulterous lovers, Finn Fitzgerald, an Irish novelist, and Elin Marstrander, a Danish poet. The couple’s affair begins in Nerja and their relationship continues through a series of letters and a number of fruitless meetings. Unfortunately, they manage to construct mutually incompatible fictions out of their shared experiences, with inevitable consequences.
Everything that I have said about Higgins’ fiction can also be said of his three volumes of memoirs, Donkey’s Years, Dog Days, and The Whole Hog, collected as A Bestiary. The books include family photographs from Higgins’ Celbridge childhood and we learn early on that the house he grew up in had previously belonged to a family called Langrishe. The memoirs include retellings of many of the sources of Higgins’ fiction.
However, everything in the memoirs is not what it seems. The protagonist’s family members are not actually named, but referred to by pet name. More interesting still is that this protagonist turns out to be someone called Rory of the Hills, yet another Higgins alter ego. In fact, the memoirs are effectively an inverse of the novels; they are fictions disguised as factual accounts.
Boundaries between truth and lies, memoir and fiction simply don’t matter. It’s an approach that has not won Higgins a mass readership, and without risk-taking publishers such as Calder and the Dalkey Archive his books would never have been published at all. I suppose he can take some consolation in the fact that having fewer readers makes it less likely that he’ll be sued by an irate literalist.