Derek Emerson's Reviews > Direct Red: A Surgeon's View of Her Life-or-Death Profession

Direct Red by Gabriel Weston
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Sep 06, 09

bookshelves: 2009-books-read
Read in September, 2009

The beauty of internal organs sliced open, the obsession with neatness surrounding an operating room, and the hypnotic and amplified sounds of paramedics rushing into a hospital. These could be elements in a horror novel featuring a sadistic surgeon, or they could be Gabriel Weston's descriptions of her foray into the surgical world.

Weston is a British surgeon who now works part time as an ear, nose, and throat surgical specialist, and her book offers a fascinating look into a world seen by few. This is not a "tell all" book in which she destroys the reputations of fellow surgeons, in fact she beats herself up more than anyone else, but instead an honest look into the humanity behind the surgeons' masks. And humans are what we find. All intelligent, but some more skilled than others. There are the male chauvinists who chase young women, the older women who have passed on family life to focus on their career, and a range of young surgeons in training all trying to gain the confidence they seen in their older colleagues.

Weston is a gifted writer who actually studied literature before deciding on a medical career. The combination works as she breathes new life into the medical genre with her unique approach to what she learned. Of her time in the emergency room, she takes away more than medical knowledge. "I came to see the ER as a sort of departure lounge in which every patient had come to say goodbye to someone or something, often with no warning, usually with no time or peace or preparation."

The book is arranged by themes, including sections on death, voices, beauty, ambition, children, changes, and home. At times she is hilarious as in the section on sex where she describes her first unsuccessful attempt to put a catheter on a male while being watched by a number of operating room staff. But she balances the humor with a touching story of being attracted to one patient who eventually offered her to share his bed, a line she dared not crossed and which ended their mutual interest. It is dangerous for a doctor to admit they may have romantic feelings for a patient, but Weston is honest in facing her challenges as a young surgeon.

She even admits to a general distaste for the entire childbirth routine, but can wax eloquently about the beauty of a body as it is opened for surgery. In fact, her one failing in the book is the detail she gives to some of her surgical experiences. Her description of a tonsillectomy going wrong gets lost in details a fellow surgeon may appreciate, but are hard for the layman to follow. But these instances are rare and she does pause to explain medical terminology in a way most readers can understand.

Nor are the larger lessons in life missed during her time in the hospital. She reflects back on a visit to Ben, a quiet 10-year-old boy who dies of a rare brain tumor. She visited him earlier in the week because his headache was getting worse and she settled for prescribing more painkillers to get him through the night. Later, after the birth of her own children, Weston better understands what her role was as a doctor that night. "I know now that when a sick child cries in the night, medicine is the last thing on his or her mind, and that what Ben needed from me that night was to give him whatever small amount of my heart's warmth I could afford." It is this reflective side of Weston which gives the book its greatest strength as she does not shrink from an honest appraisal of what she could have done differently. "I still feel ashamed of how I behaved that night," she says, a startlingly honest admission from anyone.

In the end we see her decision to narrow her scope of work in order to become a part-time surgeon and spend more time with her children. She has a schedule which gets her home just before her children were off to bed, and she is content. But one minor encounter changes her direction. Visiting the children's intensive care unit she sees one baby curled up tight and small. "So compactly, completely sleeping that I had felt something deepen, as if a single thin note in me has warmed into a major chord...I had experienced that sharp parental craving for nearness with a child." And thus she beings her life beyond the hospital.

Weston gives us a touching, funny, and most importantly, human look at the world of surgery and the people who inhabit it. It is a story which impacts us all not just because most will eventually face a surgeon, but because we all constantly face life.


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