Book review - Direct Red: A Surgeon's Story

by Gabriel Weston. Jonathan Cape 2009; £16.99

Review by Joanne Curran, associate editor

SO YOU’VE GRADUATED FROM medical school and you sweep into the hospital ward on your first day with your brand new stethoscope and an overwhelming sense of purpose. You’re ready to start saving lives and lay your healing hands on the needy hordes. For trainee surgeon Gabriel Weston, this idealistic start to her medical career quickly gives way to an alarming reality where her caring response to patients’ needs is tempered by the need to make her mark in a predominantly male world, focused more on cure than compassion.

Now a part-time ENT surgeon in London, Weston recalls her first faltering steps in medicine with brutal honesty in a compelling memoir that is as beautifully written as it is gruesomely described. She strips away any preconceptions of all surgeons as selfless heroes whose only motivations are to save lives. At worst they are arrogant, lazy and incompetent with virtually no interest in communicating with patients. Often their medical decisions seem based as much on suiting their own needs as those of their patients.

There must be few places where a doctor so openly describes the shame of praying her patient is seriously ill, if only to justify a decision to operate to her superiors. Weston never flinches from discussing her true feelings, no matter how distasteful, when faced with an array of patient complaints and emergencies.

In one particularly painful encounter as a junior doctor, Weston is called at 3 am to a lonely and distressed 10-year-old boy named Ben who was admitted for investigation of headaches. Exhausted and unsure of how to speak to children, she doubles his pain medication, pats him on the shoulder and tells him things will be right by morning. He dies later that week from a sudden complication of an unsuspected brain tumour. She admits: “I still feel ashamed of how I behaved. I know now that what Ben needed from me that night was to give him whatever small amount of my heart’s warmth I could afford. Without a parent nearby…Ben sought the nearness of another person. And he was unable to find this comfort in me.”

Direct Red is a serious contender for a spot on all trainee doctors’ required reading lists. It offers a fascinating insight into the closed world of surgery as well as tips and observations on a wide range of topics from coping with operating room nausea to sawing cadavers in half and surviving the unpredictable and emotionally charged world of medicine.