Reviewed by Susan Osborne

Gabriel Weston’s first book, Direct Red, was an account of her time as young surgeon training in a large London teaching hospital. It was remarkable for its honesty and compassion but most arresting was the elegant, clear-eyed yet sometimes poetically beautiful prose with which she described her work. This quietly striking style also characterises her first novel, Dirty Work, which follows four weeks in which Alice Mullion, an obstetrician and gynaecologist, must await a tribunal’s verdict on whether she is fit to continue practising surgery after her patient suffers a catastrophic haemorrhage.

Alice’s work is her life. Not much room for anything else when you’ve spent seven years intensively studying, then working all hours and must not only continue to maintain your knowledge but publish new research if you are to get on. The enforced hiatus gives her the time for reflection that she does not otherwise have. Weston interweaves Alice’s thoughts about her childhood, her relationships and her career with her fears about the tribunal’s investigation and her part in its procedures. In vivid vignettes we learn that Alice was a studious little girl whose happiest time was the years she spent in the States. She is a little obsessive harbouring a yearning for Tom with whom she shared a night of adolescent kissing until her disappointing encounter with him in adulthood. She has a loving and supportive sister who insists that she comes to stay weekends during the limbo of her suspension. She lives on her own and has few friends. Gradually we learn that Alice performs abortions.

On the book’s press release, Lionel Shriver is quoted as describing Dirty Work as a ‘brave book’. Indeed it is, and a very necessary one. Readers will no doubt have strong views about abortion but whatever your standpoint, Dirty Work will make you think about it again, perhaps in ways you don’t expect. By taking us through Alice’s thought processes, Weston forces her readers to think not just about the women who undergo abortion, or about the foetuses aborted, but also about the effects upon the doctors who perform the procedure and how the issue is talked about, or perhaps not talked about, by the profession. While giving her readers the opportunity to skip ahead, Weston refuses to spare them the physical details of an abortion, both the actual process and what has to be done to ensure that it has been entirely successful. And we shouldn’t look away. Those of us who are pro-choice should understand what we expect of those who carry out our wishes and the toll it takes on them. Dirty Work is not a polemical book for either the pro-choice or anti-choice side of the debate but it is one that will brings you face to face with harsh realities.

Weston is a surgeon who specialises in skin cancer. She clearly has a brilliant writing career ahead of her but let’s hope she continues her medical practice. We need thoughtful and humane doctors like her.

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Susan Osborne

Susan Osborne has spent the last 25 years thoroughly immersed in the book world, first as a bookseller, then as a freelance writer and book reviews editor for Waterstones Books Quarterly and We Love This Book magazines. She is the author of the Bloomsbury Essential Guide for Reading Groups and has written reading group guides for several publishers including Bloomsbury, Faber and Orion. She reads widely but particularly enjoys literary fiction and searching out interesting debuts. Her favourite authors range from Siri Hustvedt, Helen Dunmore and Kate Atkinson to Haruki Murakami, Kent Haruf and Colm Tóibin.

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Jonathan Cape

Jonathan Cape Ltd was founded in 1921 by Jonathan Cape and Wren Howard.  The firm quickly established itself as one of the leading literary publishers in London, publishing T.E. Lawrence’s The Seven Pillars of Wisdom, Ernest Hemingway, Arthur Ransome’s Swallows and Amazons (all the books in the series are still in print today in the original editions) and, in 1953, Ian Fleming’s Casino Royale, the first of the James Bond books. Today, Cape is still one of the most exciting fiction publishers in Britain today with authors ranging from Thomas Pynchon, Tom Wolfe, Philip Roth, Kurt Vonnegut, Martin Amis, Ian McEwan, Shena Mackay, Salman Rushdie, Julian Barnes, Roddy Doyle, A.L. Kennedy, Irvine Welsh, Audrey Niffenegger, Alan Warner, Chuck Palahniuk, Iain Pears, Anne Enright, Howard Jacobson and Adam Thorpe.

Cape’s non-fiction authors include Jung Chang, Stephen Jay Gould, Alison Weir, Piers Brendon, Julia Blackburn, Sara Wheeler, Mark Kurlansky, Frank McLynn, John Richardson, Ann Wroe, Bettany Hughes, Adrian Tinniswood and James Wood.

Cape also has a thriving poetry list (authors include John Burnside, Sharon Olds, Mark Doty, Michael Longley and Michael Symmons Roberts), the best graphic novels list in Britain (Chris Ware, Dan Clowes, Marjane Satrapi, Posy Simmonds, Raymond Briggs, Joe Sacco, Igort, Bryan Talbot, Charles Burns, David B.), and a list of photographic and art books (Richard Avedon, Robert Mapplethorpe, Don McCullin, Annie Leibovitz and Lucian Freud).

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