Monday 20 November 2017

'Other people walk the dog or do yoga before work. I write books' - oncologist Austin Duffy

Oncologist Austin Duffy is the new star on the Irish literary scene. As his debut novel hits shops, our reporter asks him how he combines medicine, writing and being a dad

Dedication: Dr Austin Duffy splits his time between his oncology work, his writing job, and his wife and two children. Photo: Doug O'Connor
Dedication: Dr Austin Duffy splits his time between his oncology work, his writing job, and his wife and two children. Photo: Doug O'Connor
Andrea Smith

Andrea Smith

In Celtic mythology, Brigid was the goddess of poets, smiths and healers, and physicians have a long history, dating back to Greek medicine, of literary activities. Even so, most people would consider the worlds of medicine and literature to be poles apart, and indeed writer Oliver Goldsmith and poet John Keats both left their careers in medicine behind after being bitten by the writing bug.

Why healing and writing though? Well, aren't doctors in a uniquely privileged position to observe and create the stories that make us human, given they are witnesses to some of the most intimate and intense experiences, including birth, illness and death?

The arrival of US-based Irish oncologist Austin Duffy onto the literary scene at the age of 41 has caused a stir in publishing circles. His debut novel, This Living and Immortal Thing, was released this week and has been roundly praised for its freshness and originality. Critics noted his mastery of dialogue and humane humour, which sees him gleaning poignant yet amusing anecdotes from the most tragic situations.

Austin agrees that there are many similarities between the two disciplines he straddles. "I think that with medicine, you are looking to establish scientific truths that are objective and reproducible," he says. "It is broadly similar for writing, in that you are looking to express truths that are verifiable for people when they read them, if it rings true to them."

Austin began work on This Living and Immortal Thing in 2008. He was living in New York at the time in very basic hospital accommodation with no television or internet, and decided to enrol in creative writing classes at a writers' studio in Manhattan as he had always fancied the idea or being a novelist.

"I signed up for classes with no great expectation, but I just really loved it," he says. "It got me out of my own head, and the story emerged partially out of an exercise I was doing within the classes.

"The book was accepted for publication six years later in 2014, but I was also writing a lot of short stories and entering competitions, so I was developing the craft, which took a lot longer than I thought it would."

In 2011, Austin was awarded RTÉ's Francis MacManus award for his short story Orca, which was a great confidence boost. When you meet him, he exudes the calmness and gravitas of a doctor, and indeed he is a highly skilled consultant oncologist in Washington in the area of gastrointestinal cancer, with a further speciality in the pancreas and liver areas.

He didn't have a burning ambition to become a doctor growing up in Dundalk, Co Louth, and was happy to discover after he qualified that he had made the right decision. This was fortunate, he admits, as a lot of people in his position subsequently find they regret their choices.

Austin travelled to Australia and New Zealand doing a lot of medical work, mostly in emergency rooms, but when he worked at an oncology job in Wellington hospital, he liked it so much he decided that it would become his speciality.

He came home to Dublin, and embarked on a four-year training scheme with the Royal College of Physicians, working in different hospitals. He then won a €200,000 pharma-funded award to enrol in a training programme at the Memorial Sloan Kettering Cancer Center in New York's upper east side in 2006.

He had mixed feelings leaving, as although he was excited about living in New York, he also loved Dublin and was leaving his parents and siblings behind. He keeps in close contact, and tries to make it home with his family twice a year.

Apart from developing his career further, Austin also met his wife Naomi Taitz in New York in 2007. She comes from the Bronx and is an artist, and has had a residency at the Mart in Rathmines for the past month. Austin and Naomi were married in New York five years ago, and now have two children, Theo (3), and Vera, (nine-months-old). They live in Washington where Austin works with the NIH (National Institutes of Health.)

Combining writing with medicine and family life can be tricky, but Austin writes in the morning and even on the train to work, although there are distractions, of course. "Sometimes I don't get to write for as long as I would like because my son tends to get up early these days and wants his porridge," he laughs.

"Becoming a dad was great, although it was hectic with a lot of sleepless nights, but I really enjoy it.

"I love writing in the morning, as it sets me up for the day, just as other people would do yoga in the morning or take the dog out. And once I go into the hospital, it's like a switch is flicked and I have my game face on."

The area Austin works in is highly pressurised because he is dealing with experimental treatments. The sort of patients he sees have already had the standard treatments somewhere else in America, and they either haven't worked or else worked for a while and then stopped.

"They are challenging cancers to be looking after, and I basically design the clinical trials and then look after the patients while they are taking part in them," he explains.

"There is a huge pressure there, as issues arise both relating to their illness and the treatments that you are giving them. Designing the studies and treatments is very rewarding on different levels though.

"Yes, there are moments of sadness and difficulty, and unfortunately it happens quite a lot in my job because we are dealing with treatments that aren't proven or established," he says.

"On the other hand, there is a huge excitement about immune-based treatments in cancer at the moment, which is getting the immune system to fight against the cancer. We are seeing some really extraordinary stuff, and the logic is that your immune system is much more sophisticated and intelligent than any drug that we could come up with, so we use medicine to manipulate it in a certain way.

"The ones that are getting attention at the moment are the drugs that take the brakes off the immune system and let it get at the cancer. It's a totally different concept, as with chemotherapy or radiotherapy you are directly treating the cancer, but we are treating the immune cells and not the cancer."

There have been a lot of high-profile deaths from pancreatic cancer, including Alan Rickman, Steve Jobs and Patrick Swayze, and it's a cancer that has a low survival rate (5-6pc after five years is the official rate for Ireland) and a reputation for being difficult.

Austin has had extensive experience in this area, and he says that the difficulty in detection and survival relates to a combination of things.

"It depends on where the tumour is situated in the pancreas, and also the pancreas is located in a delicate position, next to the stomach and small bowel," he says.

"The main reason it's difficult is related to the biology of the tumour itself, as there are certain biological characteristics that make it very hard to treat.

"There is one study we have just opened in cancer of the pancreas, which took a lot of work to get off the ground, and if we got any sort of breakthrough, it would just be fantastic. I am very optimistic, as it is not all hype around these immune-based treatments, and some of the results have been amazing."

They say you should write about what you know, and for Austin's debut novel, the protagonist is an Irish oncologist searching for a scientific breakthrough in the lab of a New York hospital, while struggling with his failing marriage and growing alienation within the city's urban spaces.

It's a gripping tale, and the finished product took six years to get from inception to publication. He got an agent, Faith O'Grady, when the book was pretty much written and then Granta Books published it. Did he always have faith that this would happen?

"In hindsight, I was kind of naive, as I always hoped or assumed it would be published, which seems totally crazy, but the battle for me was just to finish it," says Austin, who is now working on his second novel.

While Austin has now been catapulted into the spotlight, he is modest and unassuming and seems to prefer a life lived under the radar. Being hailed at 'one to watch' seems to come as a genuine surprise to the Louth man.

He has no website, Twitter or Facebook fan page. He seems genuinely astonished at the notion that anyone would be interested in following his life or literary adventures.

"It's kind of bizarre and a little bit daunting doing publicity, but I want to try and enjoy it as well because even if there is another book, there won't be another first book.

"The book I'm currently writing isn't medical so it's totally different. I did that deliberately as I don't want to be restricted to just being a doctor writer or a cancer writer."

'This Living and Immortal Thing' by Austin Duffy is out now. (€17.99, Granta Books)

Irish Independent

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