|Page 21||Book Reviews Non-Fiction||April 2009|
By AlidŽ Kohlhaas
Direct Red offers life in the raw as a surgeon presents a view of the life-or-death drama of her profession in an extra-ordinary book. Gabriel Weston is a British ear nose and throat (ENT) surgeon who has taken a look at her profession with uncanny frankness. She now works part time in her chosen field to allow her to spend more time with her two children, and it seems, to write books. Her exposť of the life of a medical student and later practicing surgeon is a book that should be a must-read by medical students and anyone aspiring to enter the medical profession. But it is also an important book for ordinary folk, because it makes us aware of the hardship and the dedication needed to be a medical practitioner, and the pitfalls the profession contains.
The title of her book comes from colorful dyes used in pathology to stain tissues for clearer microscopic viewing. In her case, she visualizes these colors during particularly long and stressful surgery, when she feels she may loose control, or faint from standing too long. She has developed a mantra of these colors until she finally reaches Direct Red, which generally brings her back to gaining control. It's her device of handling things, but as she admits, "What to do when you feel unwell in theatre is never discussed, but it is my private belief that all surgeons have these moments of incapacity, and that we each try to save ourselves differently."
While Weston admits to having taken some liberties by combining some events or personalities in her book, or incidents that happened or "that might have happened", she in no way sugarcoats or over-dramatizes her profession. As someone who grew up in a family with several of doctors, who was allowed to watched a number of operations as a youngster and later as part of a medical writing career, I found her account honest and illuminating. It must be said, however, that her slim volume is not for the squeamish at heart. There is a rawness to this life that is hidden to many who only see the glamour attached to the profession. Weston hides nothing, yet also infuses beauty into that rawness.
The author makes the reader aware of how important it is for doctors to counter their instinct for compassion with a distancing of emotions to survive what they have to face daily. It is not an easy lesson to learn, but most manage to do so. Some doctors, as she reveals, become rather arrogant or aloof as they move up the ladder and then fail to communicate well with their patients. This is something that Europeans accept more than North Americas. Canadians and Americans expect their doctors to have bedside manners, and are not easily impressed by the stature of a surgeon, or a specialist. At least that is my experience.
Each of the one-word titles of the 14 chapters in her book describe with accuracy those aspects that befall the life of a doctor, or in her case, that of a surgeon. Speed, as she tells us eloquently in her first chapter, is of the essence, and when it is absent, it has dire consequences. She is fascinated by the Beauty of surgery, but describes a situation in this chapter that is quite the opposite: a patient suddenly having to be moved into Resus and then into the surgical theater for an emergency operation that failed and that lacked any kind of beauty. "I still see the beauty in surgery all around me when I'm at work. In clear diagnosis. In methodical procedure. In the rudimentary environment of the operating theatre. In the rigorous magic performed by surgeons on patients, whose diseases are often cured by going under the knife," she writes.
"But even the most righteous surgery can be ugly. Even the most necessary operation, in the best hands, can fail. And in the process of acting on the patient's best surgical interests, we may sometimes make the final moments of their life more terrible than they would ever have been had we left them alone to say their farewells uninterfered with, more wholly and with grace."
There is an honesty in her writing that is hard to resist. It makes this book of a mere 180 pages such a gem of medical information, written in plain language that contains extraordinary poetry.
The book has, to me at least, one flaw. There is no glossary of British medical terminology attached to it. The publishers, having taken the stance that most Canadians are 'bilingual' in English, felt it unnecessary to include one. But, I feel that unless an ordinary reader has some familiarity with the British medical system, some acronyms will leave them puzzled, such as ITU or A&E. What to make of titles like 'registrar' or the acronym SHO? As for Weston's use of medical terms that may be unfamiliar to the ordinary reader, they soon fall into place, or can be looked up in most dictionaries. For my own satisfaction I am attaching a short glossary to this review. It is my hope it will help those who have been inspired by this review to obtain this book to read and gain insight.
Auto Da Fay - an autobiography has been moved to Archives