Dirty Work

Starred review from April 7, 2014
A physician in crisis is at the heart of this intense debut novel from doctor and memoirist Weston (Direct Red). Nancy Mullion is a talented obstetrician-gynecologist, who, as the novel opens, blunders during surgery, leaving her patient in a coma. As a result, Nancy faces suspension and an inquiry into the incident. She spends the following weeks in front of review boards and is subjected to psychological evaluations. Sheâs left fighting for her career and questioning her commitment to her work. As Nancy begins to crack under the pressure, she dwells on her memories of childhood, adolescence, and her student days. She has suppressed her deep outrage at the medical systemâs disregard for patientsâ feelings, but over time has also lost her sense of self. Weston writes harrowing medical scenes (lots of blood in these pages), and manages to nail Nancyâs psychological state in a series of small moments depicting her atrophied inner life. Nancy is both a sympathetic and a frustrating characterâa balance that becomes all the more precarious after certain details of her work are revealed. As Nancy observes: âI am a brute and I have the evidence. But I am compassionate, too.â While Westonâs ambitions for the book initially seem modest (i.e., plumbing the depths of a single surgical mistake and its aftermath), she raises profound questions by the conclusion. A medical and moral tour de force.

July 15, 2014
A London doctor is summoned beforean ethics board for allegedly botching an abortion in Weston's fiction debut. Dr. Nancy Mullion, a fledglinggynecologist, faces a potentially career-ending hearing before a hospital tribunal.Her patient, the subject of the inquiry, lies comatose in the ICU, connected toa ventilator. The hearing, which acts as a frame of sorts for the story,proceeds in increments, as Nancy, too frantic with guilt to focus on defendingherself, relives the childhood, young adulthood and professional life thatbrought her to this pass. Nothing in her relatively benign early life hasprepared her for this catastrophe. A brief and happy stint in America, someromantic disappointments and grueling surgical training have left her psychemostly unscathed. However, due to social anxiety and a self-confessed inabilityto say no, she's been steered into a specialty that her colleagues view asanathema: performing abortions. Nancy is steadfastly pro-choice, and has had anabortion herself, and she begins to see the hypocrisy of a medical system whichhas marginalized the practitioners who do this "dirty work." As she recognizesthat her unearned status as a pariah and scapegoat has compromised theimpartiality of the doctors who are judging her, she is finally able toconfront what actually happened in that particular operating theater and cometo terms with her conduct. Perhaps out of reluctance to bore or puzzle thelayperson, readers are not told in any detail what transpires at the hearings,and as a result, the question of Nancy's culpability is somewhat blurred. Herambivalence and her anguish over the impossible dilemmas visited upon bothherself and her patients are sharply delineated, however.A cautionary professionalcoming-of-age tale which faces the moral quandary posed by abortion head-on.

COPYRIGHT(2014) Kirkus Reviews, ALL RIGHTS RESERVED.

June 15, 2014

Nancy Mullion, a young and talented obstetrician-gynecologist, is in crisis. She has been suspended from her London hospital following the near death of a patient and awaits the outcome of a formal inquiry by a medical panel. The surgery in question was a abortion, and the charge is clinical negligence. Overcome by worry for her patient's survival and concern for her own career, Nancy searches for insight and reasons. She reflects on her life, the path that led her to medical school, and the personal and professional choices she made that brought her to this point. Over four weeks of intense scrutiny, she struggles to assess her own state of mind and to answer honestly the questions put to her by the board-appointed psychiatrist and other panelists. Through this intense introspection, Nancy comes to understand more deeply that there are no comfortable and uncomplicated answers. VERDICT Weston, a British physician and author of the award-winning medical memoir Direct Red, has written a courageous, incisive debut novel that offers a reflective and compassionate view of the medical work and human dimensions surrounding the surgery to end pregnancies. The author traces neutral ground between this subject's hard inflammatory factions and offers a sensitive view of abortion providers who may be themselves conflicted.--Sheila M. Riley, Smithsonian Inst. Libs., Washington, DC

Copyright 2014 Library Journal, LLC Used with permission.

June 1, 2014
Following a near-fatal operating-room mistake, OB/GYN fellow Nancy Mullio finds her life is on hold. While she waits to find out whether her patient will recover, she attends a month of meetings with the hospital committee that will decide the fate of her medical license. In the interim, she has a lot of time to rest, and she spends the days looking back on her life and thinking about her more recent role in the debate over abortion rights. Both as an individual and as a medical professional, she had long been pro-choice, but as her job became more about ending pregnancies, while her colleagues were working toward beginning and completing them, she became increasingly uncomfortable with her level of participation in the conflict, if not her overall position. Now she wonders what lies in her future. Nancy's struggle to reconcile her emotions with her scientific beliefs will resonate with many contemporary readers, and Weston writes with an ease that belies the complexity of the message within, without being overly preachy or political.(Reprinted with permission of Booklist, copyright 2014, American Library Association.)