Doctors and Nurses Lucy Ellmann Bloomsbury, 209pp, £12 ISBN 0747580073

The outrageously fat heroine of Lucy Ellmann's fifth novel likes to RANDOMLY CAPITALISE OCCASIONAL WORDS. Such attention-seeking is understandable, given the cruel conditions in which she lives. Nurse Jen is unloved, unloving and EXTREMELY OVERWEIGHT. She has recently had to move to a RURAL BACKWATER to work in a lacklustre GP practice. The patients are annoying, the receptionist vicious. And Dr Roger, the dishy object of her desire, barely seems to realise she EXISTS. He is too busy misdiagnosing his patients and craving the things that every doctor craves, which are "EXCITEMENT, rescue missions, bad accidents on the highway, pain, death, gore, and looking DOWN on people".

Yet despite the obstacles, love manages to flower. Nurse Jen and Dr Roger come together, and then apart, in an atmosphere of maximum vulgarity. Dr Roger lowers the tone - a tricky feat - by molesting Jen's collection of handbags. A bigamous marriage is forestalled. Murder is committed. The naked hiker makes a brief appearance.

This is farce as pure anarchy, plot as an excuse for more comic monologue. As a novel, it has all the narrative coherence of a pensive Eddie Izzard. Flying doc-tors, cafes that refuse to serve respectable portions of cake, the beauty industry, wedding buffets, the British railway network - no aspect of contemporary life is immune to hysterical venting.

The tone upholds the mayhem. Not since John Irving had Owen Meany deliver his thoughts ENTIRELY IN CAPITALS has an author made so free with the shouting case. But then Ellmann is a pretty liberal stylist altogether. Exclamation marks: what the heck! Bad puns: why not! Arbitrary lists: bring 'em on! Why not fill 12 pages with the names of a hundred random diseases? (The result reads like a medical student's actual nightmare: dysarthria! psittacosis! PAPILLOEDEMA!) There are even a couple of blurry photographs imported randomly into the text a la W G Sebald, if Sebald had ever decided to embellish his essays on vanished East Anglian landscapes with a smudgy monochrome image of a naked crotch.

It really is very very BAD: in fact, it's so bad that, bizarrely, it's pretty GOOD, if only as a virtuoso display of absolute chutzpah. Ellmann takes various innocent expectations about fiction (that it might contain plausible characters, or a believable plot, or some stylistic control) and does as much violence to these bourgeois fantasies as she can, given the relatively limited forum offered by a 200-page pastiche of romantic potboilers.

The effect, overall, is at once hilarious and exhausting. Ellmann is nearly always funny, whether she's pondering the vital role of "A NICE CUP OF TEA" in medical practice or discussing the difficulties faced by hospital romances: "These doctor-nurse things are always complicated because your lovemaking can be so easily interrupted by PATIENTS and their frequent need to DIE or have BABIES or a STROKE." But the deeper themes of her book - which is, after all, a novel rather than a late-night set at the Edinburgh Fringe - are not well served by her lack of ability to simmer down.

Wisecracks aside, Ellmann has interesting things to say about women and their bodies. The Mills and Boon setting is, it turns out, a sort of genteel cover for The Vagina Monologues: what Ellmann is really curious about is the FEMALE SEX ORGAN and all its implications. She's interested in Jen's ambivalent relation-ship with hers and society's ambivalent relationship with Jen's and the weird and frequently not-so-great things that medicine has to say on the topic. She has clever thoughts to share about how science deals with the sheer untidiness of female sexuality. But she cannot stop trumping sensitivity with crudity, insight with excess.

In other words, she cannot resist the temptation to engage in just a tiny bit more SHOWING OFF. And the problem with showing off - as every show-off knows - is that, in the end, someone will always plead ENOUGH ALREADY before finally begging you to STOP.

Sophie Harrison, a former deputy editor of Granta, is training to be a doctor

Post your comment

Please note: you will need to login or register before you can comment on the website