Assisted dying: the novel
Tiffany Matsis reviews Dr Eileen Merriman's latest gripping medical drama
Jake Heremaia knows he has a high likelihood of having inherited a fatal illness. Huntington’s disease killed his mother and has plagued his extended family. Double Helix, the latest novel by best-selling New Zealand author, Eileen Merriman, asks us to consider: how do you learn to live with the knowledge that your genetics may be a ticking time bomb? How do you plan for the future, build a relationship, and think about having a family, with a genetic sword of Damocles forever dangling above your head?
After three years away, Jake has recently returned to Dunedin to start his second year at medical school. Dunedin, the city where his mother died horribly and tortuously from Huntington’s disease just three years ago. Dunedin, the city where Emily lives. More than Jake fears Huntington’s, Jake loves Emily. Emily is the literal girl-next door and a fourth-year medical student. She knows all too well what Jake’s “maggoty genes” could mean for his future – and hers. Can she let herself fall in love with someone who might break her heart by leaving too soon?
It's a timely novel - assisted dying becomes legal in New Zealand in a mere few months - and raises, in fictional form, the difficult ethical conundrums facing doctors, patients, and families. If you enjoy playing hypothetical “what would I do if…” mind games, then this is the book for you. It's an emotional rollercoaster, with Jodi Picoult-esque twists and turns in the plot that I didn’t see coming – and some I did but was still winded by. Have a box of tissues on hand.
I work as a lawyer. When I'm reading courtroom thrillers, I'm much more comfortable with those that are written by authors with some legal experience. It usually saves me from throwing the book at the wall in exasperation and screaming, “That'd never happen in real life!" Eileen Merriman is both a medical doctor and a PhD doctor, as well as being a fabulous author of adult and young adult fiction. (A bit of an over-achiever really, with the greatest of respect.) Her books ring with authenticity. This is someone who knows what it was like to be a young med school graduate starting out in a busy hospital.
Merriman writes medical dramas extremely convincingly. Double Helix is the second of her novels that I've read with young medical professionals as the central characters. I read The Silence of Snow last year and was incredibly moved. It was a novel that haunted me long after I finished it. She paints the medical profession as so very complex, problematic, and emotionally challenging. I confess I wouldn't be encouraging my children towards medical school on the basis of her novels. I have so much respect for the doctors and nurses who deal with literal life and death questions every day, knowing full well I could not do it.
As well as being a gripping medical drama, Double Helix is a very New Zealand story: Jake and Emily forage for tuatua in Northland, surf at St Clair, and look up restaurant deals in the Entertainment Book. The sprinkling of te reo throughout the book is a delight. It firmly anchors the story in Aotearoa, even when the characters make side trips across the Tasman (international travel, remember that?). It feels genuine and not at all gratuitous. It's fantastic to see New Zealand fiction maturing in this way. More, please.
I'm aware that some consider the phrase “trigger warning” to be censorship in woke-ist clothing. But I do feel compelled to say that for those who are personally affected, directly or indirectly, by Huntington’s disease or other genetic illnesses, this may not be the book for you. It is in parts a very sobering and challenging read and may be too close to home for some readers. Please be careful.
All other readers are urged to be prepared to engage in a lot of soul-searching afterwards about advance directives, powers of attorney, and really difficult discussions with whānau. This is a powerful book on many different levels – an entertaining and quite adorable love story, a riveting medical drama, and a thought-provoking dive into contemporary ethical issues.
The Double Helix by Eileen Merriman (Penguin, $36) is available from bookstores operating in level 2, which is to say ABA (Anywhere But Auckland)