“The only thing worth writing about is the human heart in conflict with itself,” wrote American novelist William Faulkner (1897–1962). But neurologist and novelist Liam Durcan’s abiding concern is the human brain in conflict with itself. He calls this the neurologic narrative and says it’s “almost a new subgenre.” The Curious Incident of the Dog in the NightTime, by Mark Haddon, is an extraordinarily apt example, Durcan remarks. “I’m always interested in reading books like that, to see to what degree the author is successful in trying to depict neurological problems and how that relates to a narrative style and how that adds to the book.”
This is the rich territory he most recently mined in his award-winning novel The Measure of Darkness (Bellevue Literary Press, 2016). The protagonist, an aging architect named Martin, has neglect syndrome following right hemispheric brain injury, which means he does not perceive anything on his left side. On top of which, neglect can bring anosognosia, so Martin does not understand that he is ill. The result is that he blames everything and everyone else for his situation, sees conspiracy swirling everywhere and believes he is still competent at his work.
“Neglect syndrome is the ultimate nightmare,” says Durcan, who works mostly at McGill University Health Centre in Montréal.
In fictional terms, the syndrome results in an unreliable, unlikeable protagonist — seemingly a formula for disappointing literature, unless we factor in Durcan’s unique understanding.
He was initially drawn to neuroanatomy because it helped explain things about perception, and led to bigger questions of consciousness and memory “and to some degree, narrative. It’s really a fruitful subspecialty in that way. You get to think about things in a way that I don’t know you would have otherwise.
“For me that affects writing in two ways. One, I’m always interested in how something is affecting me, psychologically or neurobiologically; I view those things in very similar ways. The other thing is I’m drawn to stories that are particular to patients with neurologic problems. I don’t crib stories from case files, but I think there are some situations that haven’t really been explored in literature. … Sometimes the problems of memory or problems of perception or other neurological problems can create a situation that results in an unreliable narrator. I thought that was interesting, and I thought that hadn’t been explored.”

Image courtesy of Niall Durcan
That exploration took The Measure of Darkness in new directions. In an ironic twist, neglect syndrome gives Martin a second chance to understand the relationships he has neglected: those with his two wives, two daughters, business partners, brother and even himself. The title of the book is a paraphrase of Jung’s teaching that you can only find joy in life by understanding the measure of darkness, the things you do not normally attend to.
“It’s about all the things we choose not to see,” says Durcan. “Estrangement is extraordinarily compelling. I see the costs of estrangement all around me.”
So, does Martin find a resolution? Well, let’s just say he achieves a modicum of self-awareness, at least concerning the extent of his loss. Durcan says he favours an ambiguous ending. Others seem to share that view. The Measure of Darkness won the 2016 Paragraphe Hugh MacLennan Prize for Fiction from the Quebec Writers’ Federation.
It is not Durcan’s only prestigious prize. His first novel, much to his surprise, won the Arthur Ellis Award for Best First Novel in 2008. “I didn’t set out to write a mystery,” says Durcan. In Garcia’s Heart (McClelland & Stewart, 2007), the protagonist is a neurologist who comes to the defence of his mentor, a Honduran doctor being tried in The Hague for war crimes. Never one to dodge contentious issues, Durcan delves into terrorism and bioethics, alongside classic literary dilemmas of loyalty and betrayal.
His first book was a collection of short fiction, A Short Journey by Car (Esplanade Books/Véhicule Press, 2004), a Globe and Mail top 100 book for that year. There is nary a doctor nor patient in sight.
Durcan says he will not write about his own patients, although he sometimes borrows narratives from his wife’s patients. “Of course, she is a veterinarian,” he quips. “I would never base things on a particular patient. I see quite a few of these [neglect] cases. I never want my patients to feel constrained, to feel I was mining them. Temperamentally, I’ve always liked people. I’ve liked listening to them. There’s a level of intimacy that confidentiality gives you. That’s a privilege. I deliberately try not to use their stories. I don’t feel comfortable doing it and I want the freedom to have [the fictional] story go where it goes.”
With Martin, for example, “I had to create a compelling story with mystery, estrangement, his brother. All that makes up for loss of attraction [to the protagonist] because there’s no sympathy.”
Durcan’s love for narrative began when he was growing up in Winnipeg, but he quickly realized it would be difficult to make a living from it. Besides, he also loved biology and wanted to help people. “That meant a lot to me,” he says. His father, an electrician, was a politically active, progressive person, as was his mom, a nurse.
Durcan put creative writing aside for university and did not pick it up again until he had finished his residency in 1999. “I felt I was highly trained but didn’t have sophisticated understanding of a lot of things.” He toyed with the idea of returning to school, which understandably alarmed his wife. Instead he decided to learn to write and attended a workshop once a week for eight weeks. “It’s how I learned to read and edit my work, and understand editing suggestion as something other than a broad attack on my sensibility!” At the end of the course, the instructor suggested he submit a story to a journal. His stories began getting published.
These days he prefers novels to short fiction and considers the latter a sort of exercise to see if a story works structurally and interests him. Currently, he is reworking and expanding his story “Flash forward,” about a woman training to be a restaurant food inspector, that he wrote in 2006 and could not forget. That 8000-word story has now grown to more than 40 000 words; he hopes to have a good draft by Canada Day. “My wife was happy it’s a sympathetic character. She was worried because I always write about damaged characters.”
“Short stories are about that glance, that ellipsis, where the reader creates part of the story. With a novel you can go a bit deeper. Sometimes that’s a real relief; there’s more psychological complexity. You can pursue ambiguity. Now I do like longer forms.”
Those longer pieces are written in 45-minute periods, twice a day during his train ride to downtown Montréal from his West Island home in Baie D’Urfé, where he lives with his wife and three children.
“I have 90 minutes to write 500 words. That’s my goal every day. It solves a lot of problems. I’m disciplined. I’m always ready to write. I never think about it during the day, but it’s always a pleasure to go back to it.”
Is he torn between the two? “Not torn in the least. I’m happily compartmentalized. If you gave me two weeks to write, I’d go on a train.”
Footnotes
This article has been peer reviewed.