I wasn't sure about Christie Watson's non-fiction account of her twenty years as a nurse, The Language of Kindness. The narrative voice felt complacent rather than thoughtful; it struck me that her depiction of the profession was a bit sugar-coated, whereas other medical professionals and hospital workers were either ignored or criticised. Happily, Watson is a much better fiction-writer: Moral Injuries is really, really good. Interestingly, this is actually Watson's second novel, but it's the first to draw closely on her experiences as a nurse, where she worked across a range of specialisms that included resuscitation, paediatrics and mental health. This breadth of knowledge is vital, making this story of three female doctors working, respectively, as a heart surgeon, an air ambulance doctor, and a GP, totally authentic and convincing. Watson doesn't overload us with unnecessary detail, but she brings to life these different medical environments with precision: 'Majors was always busy. Patients spilled out into the corridor and there was constant noise, alarms and shouting, the smell of urine or bleach or NHS egg sandwiches. The central station was like a hive for medics, all on the phone, permanently harassed, their dark blue scrubs as crumpled as their faces, lanyards swung over their shoulders, pens stuck into ponytails.'
Moral Injuries is pitched as a kind of thriller: these three friends, Olivia, Anjali and Laura, who met at medical school, are forced to confront a secret they are keeping after two of their teenage children witness a tragedy at a party. I suspect those who want a breathlessly fast-paced psychological thriller won't necessarily click with this. Despite a series of medical emergencies, it's much more character-driven, and doesn't rely on a shocking 'twist'. All the better, I say. This allows Watson to make her characters much more realistic, sympathetic and complex. I was especially drawn to Laura, who starts off as the stereotypical 'anxious perfectionist from a tough background' but become so much more than that. She's the most effortlessly competent of the three as an older adult, has plenty of casual sex, and is dealing with family trauma, not just growing up working-class on a council estate. Bisexual Anjali is also much more than a flaky risk-taker, and Olivia is hard to pigeonhole at all - she's ambitious, sure, as the blurb says, but she's also shaped by her privileged background and her relationship with husband Dele.
The title, if at first a little baffling, ends up being perfect for this novel, which is ultimately about moral choices, and the damage we cause to ourselves, and other people who witness our choices, when we make the wrong ones. All three of the characters are culpable to different degrees. Again, it's a dilemma Laura faces in the second half of the novel that I found most compelling, as medical ethics run up against old loyalties. Watson effectively creates a situation which is not ethically clear-cut, and yet we appreciate the enormity of what Laura chooses to do. My only criticism of this novel would be that the chapters rely too much on flash-forwards and flashbacks: a character often recalls a situation rather than it happening in real time, which was a bit confusing and unnecessary. But otherwise, a top-notch literary thriller. 4.5 stars.
I received a free proof copy of this novel from the publisher for review.