Bodies by Jed Mercurio

A sick doctor in the National Horror Service

If Bodies is anything to go by, patients stuck on NHS waiting lists can count themselves lucky. It's after admission that things get dangerous. "Don't you just love hospital?" asks Rich, a senior house officer in doctor-turned writer Jed Mercurio's first novel: "Come in to have your piss dipped or your shit sniffed and you wind up brain-dead on ITU." The Intensive Treatment Unit, as he loves to remind us, used to be Intensive Care – until it was discovered that nobody did.

It's the first of August, the start of the Killing Season. Troops of idealistic doctors fresh out of medical school take their first steps as professionals. Mercurio's unnamed narrator is one of them: a 23-year-old houseman, the most junior medical grade. His white coat, though "stiff like armour", is flimsy, useless as protection against the world he has entered. When his bleeper goes for the first time he fumbles to stop the piercing tone, but can't. With irritated heads turning, he stuffs it in his pocket and dials through to Accident and Emergency.

Once there, he fondles his first real patient's skull. The Young Headache Man, he finds, has meningitis. That much is clear. How to treat it is not. So, as if searching for instructions for a VCR, the houseman consults his trusty Oxford Handbook of Clinical Medicine. Take blood, it tells him. A simple enough procedure, but the patient and his mother endure four failed attempts before the syringe fills. Then the blood clots.

After a string of errors, the Young Headache Man survives. His hands, feet and genitals are removed after he develops gangrene, but he survives. "Poor bugger probably went to the pub like us," says Rich, the hardened senior, to his houseman over a pint. "Now he's fubarbundy." A footnote explains: fucked up beyond all recognition (but unfortunately not dead yet).

Which is more than can be said for the houseman's next patient, the Breathless Lady. She dies for the pleasure of his negligence. Rich goes on: "Don't be shy to paint it black... You think the job's going to be like TV. You think you'll be saving lives with the tail of your white coat flapping round your arse like it's Batman's fucking cape."

For Mercurio, creator of the TV series Cardiac Arrest, the power of television and its distortion of public perception is unsettling. Why, he seems to be asking, does our faith in medicine remain unshakeable when we read daily how the NHS fails us? Might TV have something to do with the way we look to the medical profession as saviours of humanity? TV doctors are handsome, intelligent, altruistic and ethical. We want desperately to believe in the romantic notion that, through them, our lives will be less painful.

Mercurio's young houseman would like to believe it, but is soon robbed of faith. His white coat stops flapping once he realises that failure and "buffing medical notes" are all part of the job. The stains of blood, shit and vomit don't wash out. His relationship with Rebecca, to whom he is engaged, declines. It becomes difficult to communicate with anyone outside his profession. Eczema details his internal decay.

He's trapped in a system of secrecy, at odds with the idealistic person he once was. Incompetence surrounds him, but speaking out may cost him his job. "I'm ashamed of medicine," confesses the young doctor, "the profession I once held above all others. Now I see it acts without discrimination between error and negligence. The code of silence is absolute."

Disillusioned and demoralised, he seeks comfort in sex. Both he and the student nurse Donna, so cold now through their profession, crave feeling, even physical pain. At one point, Mercurio has Donna demand, "Just fuck me. Just fucking rape me." With that line, the book's beguiling sickness becomes repulsive. Throughout Bodies, the drink, drugs, fear, aggression and sex lend themselves perfectly to the mass culture Mercurio so criticises.

Nonetheless, his debut novel is an astute page-turner, littered with crass medical wit. Each line will drag you screaming down the corridors of the young doctor's hospital hell. At times, you will feel that you're inhabiting his mind. At times, you'll wish you weren't.