Book Review: Dirty Work

by Dr Gabriel Weston

Jonathan Cape; £14.99 hardback

THERE are few taboos left in modern medicine, or in society generally, but this bold new book from surgeon Gabriel Weston confronts one head-on.

Dirty Work plays out over four weeks in the life of gynaecologist Nancy, an “abortion provider” whose inability to complete a procedure leaves her patient in intensive care and her facing an investigatory panel of the General Medical Council.

As she is called to explain her actions, Nancy is forced to consider the brutality of the dirty work she must perform, as a doctor whose purpose is to end lives as much as save them.

Each of the four chapters covers one week in Nancy’s life as she struggles to answer her investigators’ questions. This is interspersed with flashbacks to her past, describing the events and experiences that have made her the person she is now.

What kind of person, or indeed doctor, is Nancy and is she guilty of some kind of wrongdoing? These questions are carefully and skilfully explored by Weston whose beautifully descriptive writing is both harsh and poignant.

Weston has talked of her interest in exploring the idea of women’s silence in this novel, of how they are often unable to describe their experiences as freely and brutally as men do.

It is partly Nancy’s struggle to find her voice, to tell her story, that results in her potentially fatal surgical error. She remains virtually mute throughout the initial GMC interviews, afterwards explaining to her sister: “I had so much that I wanted to say. But I just... I just didn’t say it. Or I didn’t say it right. I didn’t say enough of it right.” A sentiment that any doctor who has ever been called to justify their professional behaviour will no doubt understand.

The novel follows Weston’s award-winning first book Direct Red which laid bare her experiences as a trainee surgeon and offered a fascinating insight into the closed world of surgery. Dirty Work is a brave and complex work that examines the conflict between a doctor’s belief in the right to abortion and the difficult reality of carrying out such procedures. It is a compelling read that never flinches from some of the less palatable issues that doctors must face.

Review by Joanne Curran, associate editor of publications, MDDUS