You need toughness to be a cutter …

Direct Red: A Surgeon’s Story by Gabriel Weston

This slim book about becoming a surgeon is one of the best medical books I’ve ever read.  Some days as an interested bystander, I secretly wish I’d become a doctor – even a surgeon, but then seeing programmes on telly or reading books like this, I know I’d be very inadequate and remain in awe of them.

For Weston, being a woman in a man’s world adds another layer to penetrate, although it’s clear that things are changing there.  But I must tell you a bit more about the book first…

Weston tells the story of her medical career in chapters each concentrating on one aspect of a life in medicine including speed, hierarchy, beauty, ambition, children.  Each chapter then contains vignettes from her days as a student, registrar and junior surgeon. In the chapter entitled ‘Ambition’, she tells of how as a new surgical registrar she is to assist in a complex operation to remove cancerous lymph nodes from a lady’s neck …

The operation will take most of the day. My own role is likely to be ancilliary: holding retractors to give my consultants a good view, cauterising small bleeding vessels with a little soldering iron, known as diathermy, sewing up the wound at the end if I am lucky. I have been training for eleven years but am accustomed to the painstakingly slow acquisition of operative experience; the joke goes that the hard-earned MRCS does not only denote Member of the Royal College of Surgeons but – more aptly – Maybe Ready to Close Skin.

Although it must be terribly frustrating at times for the aspiring surgeon, this slowness gives a potential patient much confidence. Not only should your surgeon’s skills be finely honed by the time they are ready to cut you open, but they should also have developed the toughness needed in the operating theatre to make the right decisions quickly. In particular, Weston writes brilliantly about communication – from reading the body language of a ill child, to talking to patients, and equally as important – how to talk to your colleagues…

Poor communication, not clinical error, is the main reason why doctors end up getting sued. Because of this, we are increasingly taught, as surgeons, how better to relate to our patients. This is of course a good thing and we all need help here. By contrast, interacting with colleagues should be the easy bit, but occasionally is bedevilled by factors which are hard to pinpoint. Sex, power, competitiveness, enmity. And sometimes, even when we think we are communicating most clearly, we may be asking for the wrong thing. And the right answer to our question may be the one we least expect.

This book was truly fascinating. She writes with great elegance and clarity about the path to becoming a surgeon with all the associated pitfalls and problems.  I’ve read several other doctor’s memoirs, but this was the first surgical one, and once finished I wanted more.  (9/10).

P.S. Dovegreyreader has also written a wonderful pair of pieces relating to this book – click here …



Source: Own copy

Gabriel Weston, Direct Red (Vintage, 2009) paperback, 192 pages.

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