A surgical dissection of bloody work

Gabriel Weston, the surgeon who received acclaim for Direct Red, a memoir about life as a junior doctor, now turns her hand to fiction to examine the dilemmas and difficulties facing doctors who perform abortions. Rosamund Urwin is hooked.
13 June 2013

Dirty Work
by Gabriel Weston
(Cape, £14.99)

Nancy is a good doctor. Assiduous, sympathetic and determined never to treat patients “like meat”. An introverted and obsessional young woman, for her the hospital is a sanctuary where she finds purpose in “coming to the rescue”. But she isn’t just a life-saver: Nancy is a gynaecologist who performs abortions. Such work means even some colleagues can’t meet her eye, and twist their mouths when they discuss it. One day, Nancy freezes at the operating table, leaving the woman whose pregnancy she is terminating bleeding to death.

Gabriel Weston’s debut novel follows Nancy during the resulting General Medical Council tribunal, interweaving her interrogation by a panel with flashbacks of her childhood and training. Weston, a surgeon who specialises in skin cancer, previously wrote Direct Red, a lauded memoir about life as a junior doctor. Choosing abortion as the subject of her first, well-researched work of fiction seems a brave move but it pays off — forcing readers to confront not just the usual pro-choice/ pro-life debate but the toll that delivering such care can take on abortion providers (the term “abortionist” is now deemed too harsh, to carry with it too much moral judgment).

While Nancy fervently believes in a woman’s right to choose — “something that saves a woman’s freedom” — her body, overcome by the pent-up horror of her job, puts up a protest in theatre. “Lady Macbeth-style” foetus dreams follow the botched operation.

Weston is careful to keep the novel balanced, though: while Nancy wonders “What kind of human being performs abortions for a living?” she also asks: “What would happen without people like me? What path,

I wonder, apart from celibacy, is a girl meant to tread, if she is to avoid catastrophe?”

Despite this neutral approach, Weston refuses to skim over the gruesome. Interestingly, in a recent interview, she argued that the pro-life lobby — brandishing their posters of aborted foetuses outside clinics — has gained traction by acknowledging the gory nature of late-term abortions, and she believes its power to shock would be reduced if the pro-choice camp admitted it too. Bloody and brutal doesn’t always mean morally unjustifiable.

Unsurprisingly then, the squeamish will struggle with Dirty Work. Beyond the harrowing subject, it is sometimes scatological and often bleak. Much like medicine, in fact. As Nancy notes: “Doctors’ lives are full of disgusting things ... Dealing with the sick and dying. Performing horrible procedures on people ... Spending two years cutting up dead people before tea isn’t exactly genteel.”

Weston is clearly still enamoured of her profession, calling the operating theatre a “perfect universe, all action, no need for talking” and writing fondly of its inhabitants.

Even when passages are peppered with medical jargon, she is an elegant, often poetic writer, with a talent for vivid description. Dirty Work is short, powerful and brutal. If you can stomach the gore, it is hard to put down.

Go to standard.co.uk/booksdirect to buy this book for £11.99, or phone 0843 060 0029, free UK p&p

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