“The Cut” is the fictional story of a present-day emergency physician (Harvey Pearce) in Sydney, who is both a newly-discovered lifestyle podcaster and an animated protagonist for patient safety and welfare in health care.
Harvey is a clinician and academic, and a respected and successful leader. He works in the Emergency Department of a major hospital and lives a healthy though tastefully indulgent aesthetic life as a single 50-something man.
The story focusses on a critical period of several weeks in Harvey’s life, beginning at an international conference in Brussels. As the plot unfolds, the reader will search for explanation and meaning in a profound tragedy. In those weeks, Harvey navigates failings in the emergency, ambulance and hospital systems, including illicit drug use and the implementation of practices which compromise patient care. He uncovers serious weakness in management behaviours amongst executives and staff who have responsibility for reporting, investigation and rectification of health system failures. Together with close friends Rob and Jess, who share similar experiences, Harvey begins to piece together an understanding of the underlying issues.
Five of Harvey’s podcast scripts are presented throughout the book as he develops them – they support the philosophical background of the plot and provide a voice for the author, having relevance beyond clinical medicine to a broad and general international audience. The podcasts as the title of the work suggests, propose a pragmatic approach. They offer a view that much of life’s distress, could be managed with a closer focus on truth, simplicity, challenge, sufficiency and integrity. Each podcast is around fifteen minutes in length, and they are presented by an international production company, ‘Loquitur’.
In parallel, the story follows Harvey’s struggles with the health system which is under pressure, and in which numerous episodes of patient harm and several preventable deaths occur. Harvey drives to investigate these events, whilst the health system resists his efforts. As he discovers more about the underlying motivations for the resistance that he encounters, and as a result of more sinister political interference, pressure mounts on Harvey and others. The system and its executives continue to tolerate its catastrophes.
Harvey is increasingly frustrated and angered by this situation. An unexplained leak of material to the press creates a predictable furore and results in a backlash from management, health department, and government – and Harvey is wrongly blamed. The political and criminal fallout from the revelations is potentially enormous.
The story becomes more complicated and Harvey is impacted. The investigation that is subsequently triggered leads to a full understanding of the complexity of the scenario and a revelation of the motives and perverse mechanisms of the system failures.
Later, we learn more about the circumstance and fallout from Harvey’s story and the associated political mayhem and unhealthy connections. The system resets, and we are left with some hope for a brighter future.