FictionOne of Litt's previous books - Finding Myself- was a pastiche of the chick-lit genre, and it is also tempting to see Hospitalas a parody of what, for want of a better term, we could call medical romance.
This novel, opening as a man and a boy are rushed to an unspecified A&E, occasioned a strong sense of déjà vu for me. Two years ago I was taken to the Middlesex Hospital, London, in similar circumstances. There I spent three weeks, chock-full of morphine which made me paranoid and caused hallucinations. The strange events that took place in my psyche at that time - including uncovering a plot by Maltese fascists to seize control of the EU - made Litt's Hospital an all too credible read.
No plot summary of this book is possible - the narrative inflates exponentially. From the moment the boy, left alone while the staff deal with the comatose man, sets out through the corridors in a quest for clothes to hide his nakedness and finds himself involved in an almost Manichean conflict between the forces of good and evil, the bizarre normality of a modern hospital is interrogated in grotesque detail. Litt asks us to consider a place where all the illnesses, abnormalities and deformities of life are placed in close proximity to, and often alongside, the twin certainties of birth and death - and to laugh at it. This is reality as we would prefer to ignore it, King Lear's walking holiday on the storm-battered heath as a universal truth.
The Hospital - it is never named - is very much a metaphor for a world where life is considered perfectible by science, where what used to be called sorrow is an object of therapy or counselling, and death is attended by the most terrible precursory invasions and indignities in the name of the ethical injunction to save life. A key passage comes, near the middle of the book, when the boy finds himself walking down a seemingly infinite corridor lined with doctors offices; the name-plates on the doors never repeat, and include famous specialists such as Dr No, Dr Who and Dr De'ath.
The doctors are all masterly and brilliant. Nurse Swallow, the heroine is kind, a little dim and quietly attractive. Sir Reginald Saint-Hellier is described as a "brilliant, kind, emergency medicine specialist", but in the first major ratcheting of the plot Saint-Hellier turns out to be the high priest of a secret Satanic cult involving half the medical and security staff (but not the porters, who prefer voodoo). Mr John Steele, the brilliant young surgeon - Sir Reginald is his mentor - is a strong, dark-haired, champion skier. His glance at Nurse Swallow "deeply affects her heart". When Swallow discovers two decapitated bodies in the hospital chapel her instinct is to admire the neatness of the incision and to "form a theory as to which highly-skilled pair of hands had done the cutting". Later "all her tenderly loving emotions" come back and sweep over her "like the seventh wave of the sea".
This flat, cliche-ridden language emerges at times of suspense, shock or emotion to emasculate the reader's sympathy and to inject ironic detachment.
Litt's best trick is to turn the nature of hospitalisation on its head. Although we fondly think of them as places where the sick are made whole, in fact, as a doctor once said to me, hospitals are places where people congregate to die - increasingly of something they didn't have when they checked in. But in Litt's Hospital the halt and the lame are cured and we are surprised and more than a little incredulous reading about it. Litt cannot leave well enough alone, of course, and, hilariously, no once-living thing is safe from this unexpected restoration.
This is a sad and funny book, an antidote to the pretended omniscience of science, a reminder of the shambles that awaits us all, and an edge-of-the-seat ride through a bizarrely imagined Armageddon National Health Service. Every medical school should have Hospital in its library.
William Wall's most recent book is a collection of stories, No Paradiso, published by Brandon last year
HospitalBy Toby Litt Hamish Hamilton, 511pp. £14.99