A compassionate brute

Dirty Work by Gabriel Weston tells the story of Nancy (who is never addressed by her full name), a doctor who specialises in gynaecology and obstetrics. While performing an abortion, she freezes at a crucial moment, with her patient almost haemorrhaging to death. Nancy is brought before a panel of health professionals who will determine her competency and ultimately decide her future.

In Nancy we have a character who has a complex and conflicted relationship with the abortion services she provides. On the one hand, she believes intrinsically in a woman’s right to choose and is highly sensitive to the needs of those under her care. She observes other doctors and their brusque bedside manner and vows never to disengage from her patients. Nancy does not believe that performing abortions is morally or ethically wrong – quite the opposite.

It is compassion that motivates Nancy, in contrast to popular misconceptions of abortion providers as faceless, emotionless butchers

However, although her pro-choice stance is firm and sincere, even Nancy’s professional expertise does not shield her from the emotional fall-out that pre-empts her incident in the operating theatre. The physical nature of the procedure itself has left Nancy scarred; during a psychological assessment following her suspension, she admits to having terrible dreams about dead foetuses. Nancy often wonders who in their right mind would perform abortions. She chides herself constantly, “I am a brute, but I am compassionate.” It is compassion that motivates Nancy, in contrast to popular misconceptions of abortion providers as faceless, emotionless butchers.

Unlike her male colleagues, some of whom are widely admired for their work with IVF, Nancy’s work is the unspoken ‘other’. She wryly observes that while both disciplines exist to give bodily autonomy to women, performing abortions is seen as strictly bottom-of-the-ladder stuff by other health care professionals.

As readers (or listeners of the audiobook, in my case) we are privy to flashbacks and insights into Nancy’s life leading up to her moment of professional crisis. She rakes through the past in an effort to understand her current situation: from an incident of childhood sexual abuse, a family move to America (where Nancy discovers that she wants to be a doctor after tending to a friend’s cut foot), a dreamy night camping under the stars with a boy, her first sexual experience on prom night, her own abortion… the old adage “Physician, heal thyself” certainly springs to mind as Nancy attempts to counsel herself.

What makes Nancy such an interesting character is her determination to treat her patients as though they are indeed people: “no patient of mine would ever feel like they’d been treated like meat in my care.” In her own way, Nancy is returning voices to women denied their political and social agency by honouring their choices and not condemning them for it. Nancy does not conform to the old stereotype of doctors not thinking about their patient’s feelings. She does care and goes to great lengths to provide a service essential to women’s lives at what is, arguably, great personal cost. Often the fact of women actually being people gets lost in talk of abortion statistics and other abstract concerns. To me, this is the one of the novel’s subtle criticisms of the anti-choice lobby – those who are so anxious to preserve a foetus at any cost to the woman’s emotional or physical well-being. We just have to look at the Savita Halappanavar case for proof of that.

Nancy’s is a seemingly untellable tale, but she reflects upon her circumstances with dignity and professionalism

One thing that struck me almost immediately about Dirty Work was its vivid description of colour: the claret tones of blood, the sensual red-pink of a Maraschino cherry, the green and brown forest hues of a psychologist’s jumper. Reviewing this book in audio format certainly made me appreciate some of the finer detail a little more than a quick skim would have allowed.

Nancy’s is a seemingly untellable tale, but she reflects upon her circumstances with dignity and professionalism. It is evident that perhaps Nancy is possessed of an exhaustive obsessive nature: the minutiae of her everyday life is scrutinised with as much zeal as the major events leading up to her breakdown. She is calm, respectful and yet somewhat detached from her story, despite the reader being in no doubt of her commitment to women and her work, as if she is an outsider looking in and examining critical evidence. After all, she is under investigation by the General Medical Counsel and she would rather any character assassination be by her own hand than someone else’s. Lending her voice to a debate that rages on, Nancy’s is a calm one, and the tone of Dirty Work reflects this in its measured and thoughtful prose.

Overall, Dirty Work is a sensitive, elegant novel that deals with a timely and hugely contentious issue. The novel does not descend into direct pro-choice-versus-anti-choice rhetoric, but presents the complex circumstances of one individual. Nancy’s dissection of her own life and motivations is painful to observe at times, but, most importantly, we can empathise and identify with her situation and analyse what it is that makes us human.

Dirty Work by Gabriel Weston is available as an audio download from Audible.co.uk.

Image shows the cover of Dirty Work by Gabriel Weston.

Katherine is a knitter, feminist, bookworm, lover of tea and horror novels and co-founder of Swansea Feminist Network. She blogs at booksandting.wordpress.com and can be found on Twitter (@polygluttony).