Rare female surgeon's account slices descriptively beneath the skin


BOOK OF THE DAY: DAVIS COAKLEYreviews Direct Red: A Surgeon’s StoryBy Gabriel Weston Jonathan Cape 192pp, £16.99

JOHN AUBREY (1626-1697) in his Brief Livesmentions a “rare shee surgeon”, who successfully treated King Charles II for an injury to his hand. This was achieved “to the great griefe of all the surgeons, who envy and hate her”. For many years it was almost impossible for a woman to acquire any medical training unless she was prepared to masquerade as a man.

The most famous woman to pursue this strategy was Margaret Bulkley, a niece of the painter James Barry, who was born in Cork and who graduated as James Barry at Edinburgh in 1812. She managed to pursue a very successful career as a military surgeon in the British army. Eventually prejudice waned and, by the end of the 20th century, women were well-represented in most of the medical specialities.

However, surgery remains the most difficult of the career pathways for women. In 1996, though 50 per cent of medical students in the UK were female, women made up less than 1 per cent of consultants in general surgery.

Over the last decade, major efforts have been made, with some success, to encourage women to take up surgery.

Although the numbers are still modest, women are playing an increasingly influential role.

In 2010, Eilis McGovern, cardiac surgeon at St James’s Hospital, will become the first woman president of the Royal College of Surgeons in Ireland since its foundation in 1784.

Gabriel Weston, author of Direct Red, is also one of the new generation of women to enter surgery. Her book is a welcome addition to a number of others by female surgeons which record their experiences in the surgical world. Weston is an excellent narrator and her descriptions of the drama of emergency surgery are spellbinding. Her account of her first complicated tonsillectomy will bring the reader to the edge of their chair.

However, her syntax can be challenging at times and her repeated use of sentences without verbs becomes unnerving. These are matters which should have been addressed by editing.

The book is organised into 14 chapters, each of which deals with a separate theme such as sex, death, beauty, hierarchy, territory and ambition.

Weston became fascinated with surgery as a medical student and she found the speciality “not just practical but beautiful”. She admired the “almost military adherence” of surgery to the principle of order. She describes the layout and choreography of the operating theatre as another would describe a Georgian interior.

She was enthralled by the way the doors of the anaesthetic room opened into the operating theatre to “deliver a bedded, tubed patient at the same time as the scrub nurse appeared with her trolley, like a hostess bringing out a science-fiction tea. And how the surgeon would enter centre stage, arms held aloft, gown billowing like a gust-filled kite.” Weston was soon to see the other side of surgery when a patient she was speaking to suddenly developed excruciating abdominal pain due to rupture of his aorta, the largest artery. He was rushed into theatre where the surgeons worked for hours in a vain and very bloody attempt to save his life.

The author gives a sensitive and honest account of her experiences, both personal and surgical, as she proceeds along the pathway of surgical training.

The book ends as Weston struggles, like many women surgeons, to balance a busy life as a wife, mother and surgeon.

Davis Coakley is professor of medical gerontology at Trinity College Dublin. He has published a number of books on Irish medical history including Robert Graves: Evangelist of Clinical Medicine

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