Tag Archives: Dirty Work

This Living and Immortal Thing by Austin Duffy: Of mice and men

Cover imageHospital dramas abound on TV – Holby City, Gray’s Anatomy, ER, House – they’re not quite as ubiquitous as crime but it seems odd that they’re notable by their absence from fiction given their enduring popularity. Its setting was partly what attracted me to Austin Duffy’s novel; that and the fact that he’s a practising oncologist. I was hoping for something along the lines of Gabrielle Weston’s quietly elegant Dirty Work with its compassionate story of a gynaecologist who performs abortions. Rather a lot to expect but Duffy’s novel doesn’t fall too short of that with its clear-eyed but humane story of a clinical researcher brought uncomfortably face-to-face with the disease he’s studying.

Our unnamed narrator has been working in his New York hospital for a couple of years having left Ireland shortly after his marriage ended. He spends his days tucked away in a lab monitoring cancerous mice injected with either the current drug under observation or a placebo. Not, as he muses, that mice are likely to experience a placebo effect. Sitting outside on the smokers’ bench one day, he meets a young Russian woman who introduces herself as a translator, a volunteer who helps the many Russians who find themselves in the hospital unable to understand what’s happening to them. Soon she’s popping up all over the place in her canary yellow sweater, making notes at lectures, attaching herself to rounds and translating oncologists’ prognostications, often choosing to soften them. Our narrator has his own preoccupations – it seems that his estranged wife is pregnant, possibly with one of the embryos they left frozen – but he can’t help but be interested in this attractive young woman given to wry pronouncements about doctors and their well-meaning uselessness. It seems their friendship might become something else until the real reason for Marya’s presence in the hospital becomes apparent.

There’s a welcome vein of quietly dark humour running through Duffy’s novel. Marya has a nice line in dismissive comments about doctors and their inability to help their patients. Our narrator is a man well-suited to the forensic observation needed for his work yet compassionate enough to have sought research as a retreat from clinical practise after Mrs X collapsed and died within minutes of him declaring her clear of cancer. His cool, slightly melancholic tone fits the novel beautifully. Duffy is very good at showing us what it’s like to be a doctor, unable not to assess everyone in terms of the symptoms they display: ‘If possible I would like to lose that skill’. His descriptions are striking if sometimes disquieting: an autopsy is often ‘like coming across a burnt village in the middle of nowhere, every inhabitant and piece of Baileys Prize 2016wood charred black. All you can say for certain is that there has been a fire or some other cataclysmic event’ while Mrs X’s liver has ‘”a large tumour burden” as if it were a working animal, unable to support the weight of disease’. It’s an unusual novel, a story well told in a setting unfamiliar to the fortunate among us and it does that thing that good fiction so often does – educates us and helps us understand what it’s like for others. I’ll look forward to Duffy’s next novel, if he has time to write one.

And for anyone interested in how my wishes scored with the Baileys Prize judges, I managed three which gives me lots to explore on the longlist. Naomi and her team will be valiantly shadowing the panel, working their way through the ones they’ve not yet read and reporting back. I’ll be cheering from the sidelines.

Aren’t We Sisters?: A lesson in not judging a book by its cover

Cover imageAren’t We Sisters? put me in a bit of a quandary. The author contacted me asking if I would review her novel, not an unusual experience as I’m sure fellow book bloggers know only too well. Usually, I politely decline but she’d heard of me through a mutual acquaintance whose opinion I trust and I’d enjoyed her Orange Prize longlisted Peripheral Vision, still on my shelves which says a great deal given the overcrowding issue. So I said ‘yes’ then looked it up and saw the cover. Not my style, I thought, and after long years of reading unappealing books for work I’d vowed not to do that with this blog. What to do? Well, read it for a start and I wouldn’t have written this post if I hadn’t enjoyed it enough to recommend it to you. Phew!

Set not long after the First World War, it opens with Lettie Quick. Proud proselytiser of contraception, she’s a nurse working for Marie Stopes whose work is widely regarded as that of the devil. Lettie is smart, sharp and likes the good things in life but her judgement in men is poor. She knows it’s time to ditch her latest and when she spots a photograph of her childhood home town she decides to set up shop there. She’s soon ensconced with Norah – genteelly poor, virginal and completely ignorant of anything remotely sexual despite her thirty-six years – and not long afterwards has found herself another unsuitable man: Dr Philip Hayward, married, comfortably confident in his entitlement, ‘good at a party, good in a shipwreck’. Lettie has a sideline in discreetly delivering the children of expectant mothers who find themselves in embarrassing situations. Soon she has a rather inconvenient customer in Rae, a movie starlet installed in a crumbling old mansion, once an orphanage. Rae’s story intertwines with Lettie’s and Norah’s in what soon becomes a novel full of secrets and lies.

It took me a little while to get into this book, not because it has a slow start but because it’s busy with storylines running through its often very short chapters. Once I’d got those straight I found it quite gripping, and all the more so as the tension ratchets up. Wrapped up in what becomes a page-turning thriller is a deep concern about women’s reproductive health and sexual ignorance. For Lettie, who knows from bitter experience that it’s so rarely the case, every child should be a planned child. For Norah, even the basic mechanics of sex are a mystery. And for Rae, childbirth and how it can possibly work, is not something to be thought about no matter how imminent the birth of her baby. It’s very much about women – male characters are thin on the ground and, with two honourable exceptions, nasty or clueless. This may sound a little worthy but Ferguson’s skill and clever plotting is such that her novel is completely absorbing. Not a great cover – at least for me – but a brilliant title which proves to have a multitude of interpretations and answers.Those of you alreadyCover image acquainted with Silkhampton will know that this is a sequel to The Midwife’s Daughter but although there are clearly many references to characters in the first novel they’re handled so deftly that you don’t need to have read it to enjoy this one. If Aren’t We Sisters? is anything to go by, adapted for TV they’d both fill the Sunday night drama slot beautifully.

There’s particular scene in Aren’t We Sisters? that brought to mind Gabriel Weston’s Dirty Work, a fine novel much overlooked last year. It explores a very different present day dilemma through the experiences of an obstetrician who performs abortions – legally, of course. I’m sure Lettie would have approved despite the ethical questions it poses. How far things have progressed in the years since Marie Stopes was roundly abused on the streets of London.

Baileys anyone?

The winner of the Women’s Prize for Fiction will be announced tonight. I’m hoping for a Kate Atkinson victory but still reeling a little from the thought that I’ll soon have to refer to it as the Baileys Prize. Perhaps I’m being snobby. Let’s be honest – I am being snobby. But it’s hard to equate a thick, sweet liqueur with the very best fiction by women, even if I have enjoyed the odd tipple of it myself many years ago.

Cover imageIt’s been a pretty sobering week’s reading so far with the excellent Meet Me in Gaza on Monday followed by Gabriel Weston’s powerful first novel, Dirty Work. Direct Red was Weston’s remarkably honest and compassionate account of her training in a large London teaching hospital written in elegant clear-eyed yet sometimes poetically beautiful prose. Dirty Work is written in the same quietly striking style. It follows Nancy Mullion, an obstetrician and gynaecologist, as she awaits a tribunal’s verdict on whether she is fit to continue practising surgery after her patient suffers a catastrophic haemorrhage. Nancy’s work is her life. Not much room for anything else when you’ve spent seven years studying intensively, then working all hours and must not only continue to maintain your knowledge but publish new research if you’re to get on. Her suspension gives her the time to reflect that she does not otherwise have. Weston interweaves Nancy’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 Nancy 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. She lives on her own and has few friends. Gradually we learn that Nancy performs abortions.

In 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 Nancy’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. After giving her readers the opportunity to skip ahead, Weston refuses to spare those who continue 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 really 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 sides of the debate but it is one that brings you face to face with harsh realities.

Somehow it’s hard to envision the Bailey’s tag attached to a book like Dirty Work even though it’s just the sort of novel that would qualify for the prize. Still, as H said to me this morning – rather tartly, I thought – I should be glad that anyone has stepped into the Orange breach given our current straitened times.