Dirty Work: A Novel

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An informed and arresting debut novel about a young surgeon in crisis, by a writer whose "exactitude of expression is rare and uncanny." (Rachel Cusk)

Nancy Mullion, an obstetrician-gynecologist whose botched surgery has put a patient in a life-threatening coma, must face a medical tribunal to determine if she can continue to practice medicine. Nancy's fears about both her patient's chances for survival and whether she will be "undoctored" are made palpable to the reader. ...

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Dirty Work: A Novel

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An informed and arresting debut novel about a young surgeon in crisis, by a writer whose "exactitude of expression is rare and uncanny." (Rachel Cusk)

Nancy Mullion, an obstetrician-gynecologist whose botched surgery has put a patient in a life-threatening coma, must face a medical tribunal to determine if she can continue to practice medicine. Nancy's fears about both her patient's chances for survival and whether she will be "undoctored" are made palpable to the reader. Throughout four weeks of intense questioning and accusations, this physician directly confronts for the first time her work as an abortion provider—how it helps the lives of others but takes a heavy toll on her own.

Interweaving memories of Nancy's English and American childhood and adolescence, Dirty Work creates an emotionally charged portrait of one woman's life; the telling of seemingly untellable stories sets her free, as it can all women. Gabriel Weston has given us a truly original, courageous, and meaningful novel.

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Editorial Reviews

From the Publisher
Praise for Dirty Work:
"A lot of books are called 'brave,' and they aren't. Dirty Work is."—Lionel Shriver, author of We Need to Talk About Kevin

"Weston has an unwavering passion for the truth as well as the courage to tell it."—The Telegraph (UK)

"Perfectly measured doses of compassion, respect for human dignity and straight-talking attention to detail....A gripping read."—Observer (UK)

"Making Nancy self-aware allows Weston to explore a doctor's feelings in a way that is nuanced and affecting."—Times (UK)

"In Dirty Work, the weave of past and present, strength of characterization and storytelling, captured my attention and masterfully pulled me through the ethical challenges at the heart of the book. I learned so much about abortion generally, about my own feelings on the subject, and about the complexities of medicine-particularly in those areas where doing the right thing is unimaginably hard."—Louise Aronson, author of A History of the Present Illness and associate professor of medicine at the University of California, San Francisco

"A medical and moral tour de force."—Publishers Weekly (starred review)

Kirkus Reviews
A London doctor is summoned beforean ethics board for allegedly botching an abortion in Weston's fiction debut. Dr. Nancy Mullion, a fledglinggynecologist, faces a potentially career-ending hearing before a hospital tribunal.Her patient, the subject of the inquiry, lies comatose in the ICU, connected toa ventilator. The hearing, which acts as a frame of sorts for the story,proceeds in increments, as Nancy, too frantic with guilt to focus on defendingherself, relives the childhood, young adulthood and professional life thatbrought her to this pass. Nothing in her relatively benign early life hasprepared her for this catastrophe. A brief and happy stint in America, someromantic disappointments and grueling surgical training have left her psychemostly unscathed. However, due to social anxiety and a self-confessed inabilityto say no, she's been steered into a specialty that her colleagues view asanathema: performing abortions. Nancy is steadfastly pro-choice, and has had anabortion herself, and she begins to see the hypocrisy of a medical system whichhas marginalized the practitioners who do this "dirty work." As she recognizesthat her unearned status as a pariah and scapegoat has compromised theimpartiality of the doctors who are judging her, she is finally able toconfront what actually happened in that particular operating theater and cometo terms with her conduct. Perhaps out of reluctance to bore or puzzle thelayperson, readers are not told in any detail what transpires at the hearings,and as a result, the question of Nancy's culpability is somewhat blurred. Herambivalence and her anguish over the impossible dilemmas visited upon bothherself and her patients are sharply delineated, however.A cautionary professionalcoming-of-age tale which faces the moral quandary posed by abortion head-on.
Library Journal
Nancy Mullion, a young and talented obstetrician-gynecologist, is in crisis. She has been suspended from her London hospital following the near death of a patient and awaits the outcome of a formal inquiry by a medical panel. The surgery in question was a abortion, and the charge is clinical negligence. Overcome by worry for her patient's survival and concern for her own career, Nancy searches for insight and reasons. She reflects on her life, the path that led her to medical school, and the personal and professional choices she made that brought her to this point. Over four weeks of intense scrutiny, she struggles to assess her own state of mind and to answer honestly the questions put to her by the board-appointed psychiatrist and other panelists. Through this intense introspection, Nancy comes to understand more deeply that there are no comfortable and uncomplicated answers. VERDICT Weston, a British physician and author of the award-winning medical memoir Direct Red, has written a courageous, incisive debut novel that offers a reflective and compassionate view of the medical work and human dimensions surrounding the surgery to end pregnancies. The author traces neutral ground between this subject's hard inflammatory factions and offers a sensitive view of abortion providers who may be themselves conflicted.—Sheila M. Riley, Smithsonian Inst. Libs., Washington, DC
The Barnes & Noble Review

What Gabriel Weston attempts to capture in her slim first novel, Dirty Work, is nothing less than the truth — of how it is to be a doctor, a human being, and a human body. "Every surgeon picks the organ they will spend the whole of their career protecting," Weston writes. "Gynecologists have the womb to look after. A piece of tissue as small as a fist. . . . And each of us has to do something ruthless to keep our patients safe." The novel's nightmarish prologue, however, shows the narrator, Dr. Nancy Mullion, failing spectacularly. "I have never seen so much blood," she reports of the moment when she freezes up during a routine operation. "My eyes can't take in the redness to start with." Another surgeon rushes in to save the patient's life, but weeks later the woman remains in a coma, and Nancy faces a medical tribunal that will decide whether she will be "undoctored" or allowed to continue to practice.

"The room is perfectly square and family-planning-clinic beige," she notes as the panel chairwoman enters. "I see tiny holes in the pile where her suede aubergine heels wound the carpet." The forensic sharpness of Weston's descriptions produces a jittery sensation of anxiety and hyper-awareness; each detail is so keenly noted that the pages hum with tension. Some scenes, in addition, are not for the fainthearted: the tumor operation, for example, or the bowel excavation. A surgeon herself in London, Weston shuttles the reader between her clinical terrain of blood, feces, bone, and tissue and an everyday world made strange and oddly precious by the contrast.

"[T]he day arrives like a watercolor as I cycle so that by the time I arrive at the hospital the sky is not quite black but bluish at the edges," Nancy observes before entering "the dark of the ward, where the night-time smells of those sleeping around her still cluster, not yet blown through by the doors that will soon be opening and closing to bring ward rounds, groups of doctors who will swirl this air away, replacing it with their own scent of showers and adrenaline."

Over the course of a month, while she anticipates and endures the interviews that will decide her future, Nancy excavates memories of her childhood in the U.S. and England, of love and disappointment, of becoming a physician. Her trainee self imagines "driving through the brilliant empty night to my hospital where I would sweep sick patients for surgery, ease tricky babies out of their mothers, rescue women from ectopic pregnancies. I thought of the operating theater, that green heaven in which I would clear and console and sort." Which she does, in addition to terminating pregnancies at varying stages of development, a specialization that eventually causes "perpetration-induced traumatic stress" and immobilizing panic: ". . . do not read these next words if you don't want to understand my reality," Nancy warns before describing, in minute detail and over almost six pages, both early and late terminations. "Can I not be allowed to tell this truth, so that it is not only in the wrong hands?" she asks in a bludgeoning conclusion that splinters the crystalline glaze of this beautiful, disturbing novel.

Anna Mundow, a longtime contributor to The Irish Times and The Boston Globe, has written for The Guardian, The Washington Post, and The New York Times, among other publications.

Reviewer: Anna Mundow

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Product Details

  • ISBN-13: 9780316235624
  • Publisher: Little, Brown and Company
  • Publication date: 8/12/2014
  • Pages: 192
  • Sales rank: 954,687
  • Product dimensions: 5.50 (w) x 8.30 (h) x 0.90 (d)

Meet the Author

Gabriel Weston is an ear, nose, and throat surgical specialist. Her memoir, Direct Red: A Surgeon's View of Her Life-or-Death Profession, was named a Best Book of the Year in 2009 by The Economist and The Telegraph, long-listed for the Guardian First Book Award, and received the PEN/Ackerley Prize for Autobiography. She lives in London with her physician husband and their children.

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Customer Reviews

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Sort by: Showing 1 Customer Reviews
  • Posted September 6, 2014

    Much too short, at 133 pages,for the $13 I paid for the Nook ver

    Much too short, at 133 pages,for the $13 I paid for the Nook version. It felt like the story was just getting goid when it ended abruptly. I would have liked to see this fleshed out to a full novel.

    1 out of 1 people found this review helpful.

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