Carl Shuker’s sixth novel The Royal Free is expansive, wry and, at its close, moving; a book that feels quite different in length and scope than his last work, the taut, visceral A Mistake. 

Everything is on fire. It’s 2011 and a rioting, looted London is burning. Copy editor and bereaved father James Ballard is caring for his baby daughter, suppressing grief with gin, distance running, and paid sex with his daughter’s babysitter. He’s also being haunted and hunted by a group of vicious local teens. At work things are on fire too, more or less. A process review is underway at the Royal London Journal of Medicine, which is publishing its last ever print edition and moving to digital only.

Informed by Shuker’s own time as an editor at the British Medical Journal, The Royal Free is, among other things, an office comedy. James’ story and point of view are central but there are multiple point-of-view characters, most from the Royal London Journal of Medicine’s editorial ranks, all contributing to the book’s expansive feel, and to its detail. On writing, editing, and office dynamics it’s laugh-out-loud funny, though like a decent copy editor the reader needs to pay attention. 

Absurdly, believably (all workplaces are a little absurd) despite the actual calamities, the riots, the burnt out buildings and smashed infrastructure making it difficult to get to the office, and despite their own personal difficulties (James’ loss, fellow tech editor Kristian’s diminishing sight) he and his colleagues continue to prioritise work, to care deeply about syntax and the rulings of the journal’s hefty style guide. 

The Royal Free (the title is also the name of the hospital in Hampstead where James’ daughter is born) might be about grief and copy-editing but it’s also who we are, and aren’t, in the places we spend most of our waking hours. James’ colleagues do not know his wife has died. At the journal, office culture seems to dictate that employees conduct their private lives privately. 

‘The journal is bigger than us,’ says editor-in-chief Dr Claudia ‘The Goddess’ Godwit. But is it? Dr Ibrahim al-Rayess, Syrian surgeon, a bereaved father too, bends the journal’s position on retractions (no deletions) to his own protest. He knows first-hand the poor medical conditions in Syrian refugee camps on the Turkish border and he posts a blog to the journal’s website calling out the WHO and IMF authors of an earlier article on the Turkish public healthcare system. And it is James’ keeping of the journal’s style guide that gives the reader (and perhaps, later, his colleagues) moments of insight into his wife’s death. He has weighted the style guide with terms on pregnancy and birth and begun to collect additional observations there. A colleague searching for the journal's style guide at the book’s close says ‘but it’s not it … There’s all kinds of stuff in there.’ 

Shuker captures the boredom, weight and sheer exhaustion of parenting in chapters following James at home caring for six-month-old Fiona. There is a nice observation about swaddling—the baby can’t sleep if she’s free. It parallels James’ grief: he’s bound too. 

Inexplicable things occur, beyond wayward spelling. Water and leaves mysteriously flood Fiona’s bedroom. She goes missing, taken by the local boys tormenting James and is discovered unharmed, protected by the boys’ Rhodesian Ridgeback. It’s not the first time James has found this dog looking over his daughter. Leaves and nursemaid dogs? Is it a nod to J.M Barrie? Maybe. There are many literary breadcrumbs: I can only imagine how many. The repetition in baby Fiona’s perspective (yes, there is a chapter from the baby’s perspective and it’s great), from an Anthony Browne picture book put me on notice, making me realise how much had likely flown well over my head.

Missing for me through the wit and watercooler moments, through James’ ordeals with the teenagers, was an emotional connection with his grief. There are hints, a glimpse brought towards the surface at work (nothing like a visceral medical article to make you look at your own trauma). But information which felt urgent from the first page is withheld. What has happened to his wife (she is unnamed throughout) is largely absent. James is numb: believable, but difficult for a reader.

Finally, in fragments, in the last pages we see more: an ambulance ride, the hiss of a ‘pale midwife’ and James’ grief punctuating the journal’s style guide. When it comes, this detail is needed. It’s also quiet and razor sharp. In the guide, he has recorded Fiona’s birth, and a copy error first laid out in the book’s opening pages: ‘burned to aches around me’.  It is this error, first wry then wounding, that gives the most lingering, powerful sense of The Royal Free.

Reviewed by Kirsteen Ure