Customer Reviews

Direct Red: A Surgeon's View of Her Life-or-Death Profession

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My gold standard for books by surgeons about their profession is Richard Selzer's "Mortal Lessons: Notes on the Art of Surgery" which conveys a sense of the fragility of human life by simply looking at the physicalities of our bodies close up. Gabriel Weston's "Direct Red: A Surgeon's View of her Life or Death Profession," does not reach the poetic heights that Selzer's prose does, but it is a strong, well-written account of a surgeon's experience from her early days as a medical intern through her growing expertise as a practitioner. Because Weston is female, it has the added bonus of giving us some insight as to what it's like to be a woman in a mostly male profession. (clue: it ain't easy). And because she's British, it's a particularly timely look at how some aspects of the British Health Care system work, although that is largely a by-product and not a direct topic of her observations. What I like best about it, however, is her willingness to share her emotional life with us, reminding us that surgeons are not automated machines that slice and cut, but rather human beings like ourselves with sometimes very strong personal feelings about the situations they find themselves in. It's very much worth reading.

One expects of a surgeon that she will be completely confident, completely expert, and extremely precise --- she is cutting away at a living person's body and one wants not a single wasted stroke, not a single guess or uncertainty in that cutting. The prose of this book is just so --- precise, exact, succinct and minimalist; prose designed not to delight with prolixity but to describe as sparingly and exactly as possible just what doing surgery is like.
I deeply appreciated this narrow focused writing -- my young daughter, still in college and already an EMT, loves the thought of cutting em open and fixing em up --- so I wanted someone to tell me about this without long complicated attempts to be prosey.
Weston accomplishes this with admirable style. Her writing conveys in its topological tonality just what I wanted to know about a surgeon --- how she can cut into a living human being, how her emotions play in that moment, and what she is thinking as it happens.
I wont describe what she has already described, I can only recommend a night spent with this book as one that wont go away easily...the imagery sticks, particularly as I drive by a local hospital I used to totally ignore. This book in its accurate cuts seems so much more satisfying than all the dramatic overblown plot-driven drivel on television about doctors and surgeons, who must be emotionally wrought and yet resolve each dilemma in an hour with time out for commercials.
I thank Dr. Weston so much for her insights and sharing them in what must have been a difficult writing experience, one in which I suspect she had to pare much to get to the essence.

The beauty of internal organs sliced open, the obsession with neatness surrounding an operating room, and the hypnotic and amplified sounds of paramedics rushing into a hospital. These could be elements in a horror novel featuring a sadistic surgeon, or they could be Gabriel Weston's descriptions of her foray into the surgical world.

Weston is a British surgeon who now works part time as an ear, nose, and throat surgical specialist, and her book offers a fascinating look into a world seen by few. This is not a "tell all" book in which she destroys the reputations of fellow surgeons, in fact she beats herself up more than anyone else, but instead an honest look into the humanity behind the surgeons' masks. And humans are what we find. All intelligent, but some more skilled than others. There are the male chauvinists who chase young women, the older women who have passed on family life to focus on their career, and a range of young surgeons in training all trying to gain the confidence they seen in their older colleagues.

Weston is a gifted writer who actually studied literature before deciding on a medical career. The combination works as she breathes new life into the medical genre with her unique approach to what she learned. Of her time in the emergency room, she takes away more than medical knowledge. "I came to see the ER as a sort of departure lounge in which every patient had come to say goodbye to someone or something, often with no warning, usually with no time or peace or preparation."

The book is arranged by themes, including sections on death, voices, beauty, ambition, children, changes, and home. At times she is hilarious as in the section on sex where she describes her first unsuccessful attempt to put a catheter on a male while being watched by a number of operating room staff. But she balances the humor with a touching story of being attracted to one patient who eventually offered her to share his bed, a line she dared not crossed and which ended their mutual interest. It is dangerous for a doctor to admit they may have romantic feelings for a patient, but Weston is honest in facing her challenges as a young surgeon.

She even admits to a general distaste for the entire childbirth routine, but can wax eloquently about the beauty of a body as it is opened for surgery. In fact, her one failing in the book is the detail she gives to some of her surgical experiences. Her description of a tonsillectomy going wrong gets lost in details a fellow surgeon may appreciate, but are hard for the layman to follow. But these instances are rare and she does pause to explain medical terminology in a way most readers can understand.

Nor are the larger lessons in life missed during her time in the hospital. She reflects back on a visit to Ben, a quiet 10-year-old boy who dies of a rare brain tumor. She visited him earlier in the week because his headache was getting worse and she settled for prescribing more painkillers to get him through the night. Later, after the birth of her own children, Weston better understands what her role was as a doctor that night. "I know now that when a sick child cries in the night, medicine is the last thing on his or her mind, and that what Ben needed from me that night was to give him whatever small amount of my heart's warmth I could afford." It is this reflective side of Weston which gives the book its greatest strength as she does not shrink from an honest appraisal of what she could have done differently. "I still feel ashamed of how I behaved that night," she says, a startlingly honest admission from anyone.

In the end we see her decision to narrow her scope of work in order to become a part-time surgeon and spend more time with her children. She has a schedule which gets her home just before her children were off to bed, and she is content. But one minor encounter changes her direction. Visiting the children's intensive care unit she sees one baby curled up tight and small. "So compactly, completely sleeping that I had felt something deepen, as if a single thin note in me has warmed into a major chord...I had experienced that sharp parental craving for nearness with a child." And thus she beings her life beyond the hospital.

Weston gives us a touching, funny, and most importantly, human look at the world of surgery and the people who inhabit it. It is a story which impacts us all not just because most will eventually face a surgeon, but because we all constantly face life.

This book might appeal most to people in, or interested in, the medical field. The author has a blunt, honest, and entertaining writing style. The book is comprised of a collection of anecdotes about her experiences and some lesson that she took from it.

The book does not touch on non-medical aspects of her life; it is strictly about her residency and being a surgeon.

Weston takes an unusal approach in that much of the book is true to life recounts and other parts are fiction based on truth. Although she does preface this up front, I was a little put off by it. I prefer to read fact or fiction, yet Weston has added detail, situations which didn't necessarily occur or happen to her in some of this book

She is very graphic in her description of some surgical procedures, which didn't bother me, but other might not enjoy it.

An interesting tidbit is the reason for the title, although I won't spoil that here.

Overall, I found the book entertaining, although it isn't the type of book I couldn't put down or might pick up again.

I was expecting a memoir of a surgeon looking back at their 30 plus year career, but this book is slightly different. It takes the reader through viewpoints the author has as she progresses through medical school, internship, and residency. It poses the questions I'm sure every surgeon has to answer from the human aspect of dealing with life and death decisions. I had a relative who was a surgeon, I'm not sure he ever stopped to answer those questions.

There are a couple of things I would have liked to have seen in this book. First, why the author chose the course they did in becoming a surgeon. That would help to understand her viewpoints at certain points in the book. The second is what I said before, more experience to be drawn from.

As a patient on the other side of the knife, it is nice to know that surgeons have embraced the human side of their trade. We aren't just a piece of meat to them, and sometimes they do allow us to have a say in our treatment. Of course there are times they have to hurt us, or push us to our limits, in order to save a life. One story told in this book will settle with me for awhile, where she describes the seemingly barbaric treatment of a patient to attempt to save their life, without the chance for that patient to say their goodbyes to relatives.

For a first stab as an author, Gabriel Weston has done a good job portraying what it's like to be sometimes a "superhero" in the medical field. Based on what I gathered from the book, I can't see many more books like this coming from her.

This isn't the typical type of book I read but with some friends and relatives in med school and the medical profession, it seemed like it would be interesting to read about Gabriel Weston's journey to becoming a surgeon.

When you read this book, it takes a strong stomach. The accounts of the various situations and surgeries are so vivid you feel like you are right there watching things unfold, except you can't close your eyes to shut out the images. Nothing in here is sugar coated. The physical pain, the emotions, the sights and smells are all presented and described in graphic (and sometimes gory) detail to make the reader feel as if they are in the OR watching the events unfolding.

Throughout the book, Weston addresses the issues faced by doctors & residents from the lack of sleep to the politics of making the right decision for the patient vs. the right decision for political purposes and the conflicting emotions that may arise when a bond begins to build with a patient.

Overall, I thought the book was excellent and painted an extremely vivid and sometimes gruesome picture of what it is like to be a surgeon and that path it takes to get there. Most of all, it simply provided a perspective on a journey in life different from my own. It also makes you appreciate a little bit more how lucky many of us are as we remain healthy and do not have to endure the procedures, operations, and recovery times of those unfortunate souls who provided the material for the episodes recounted in the book.

I don't really think of this book as a memoir because the author tells right up front that the events are a mixture of what happened and what might have happened and that events are disguised. Also, she didn't share enough of herself and her personal life to make it a memoir. The book read more like a series of very interesting essays about the training and the work of a surgeon in the U.K.

I liked the way Ms. Weston set the chapters off into categories: Ambition, Children, Territory, etc. I feel this helped to give the book focus. For the most part the descriptions were very exact and fit with the author's spare style. The places where the writing suddenly became overly florid and convoluted were few and not enough to detract from the reading experience. The medically graphic parts didn't bother me, but they might not appeal to the squeamish. Overall an interesting read.

Gabriel Weston's writing style seems fitting for a surgeon. The writing is to the point, and almost coldly clinical, even in its candor. For this alone, I found it to be an interesting read.

For some readers, the short sentences read as "choppy" and the cool tone turns them off. Others wonder what the point of the book is, and another reviewer is dismayed at the idea of a medical student feeling uncomfortable touching a patient's penis. It seems to me that many wish the surgeon/writer to be a person much larger than life. The fact that Gabriel Weston presents herself and her subject matter as a series of simple quiet vignettes, exposes her weaknesses plainly and with little apology, to me, it's quite refreshing. Medical students are young people, and Weston's reflections about that fact are not ground breaking, but personal and honest. How many surgeons would admit to feeling attracted to patients, feeling nauseated or bored during surgery, unmoved by birth, confused when diagnosing, or feeling relief when a patient dies after a long operation?

We learn little about Weston's life outside the hospital or her motivations for choosing her specialty. Given the tone of the book, this would have seemed out of place. The 14 chapters, all with simple names such as "Speed" and "Beauty" feel quiet and reflective, as if they were meant to serve more as meditations on the subject at hand than a memoir. Indeed, the author prefaces the book by stating clearly that the "stories" are not, as Weston puts it, "in the strictest sense, true."

This, too, is part of this book's appeal for me. One would expect a book about surgery, with sometimes gruelingly bloody scenes of emergency surgery, would read at an exciting clip. Even when reflecting on her own sense of excitement, Weston writes in this quiet manner. I found this almost fascinating. While personal facts are missing, we do get to know this doctor in a most intimate way through this unique voice.

This book is not for everyone, nor is Weston's style. One criticism I have is that there is much medical jargon that goes unexplained. I understand the language and found that it fit the writing style, but for the uninitiated, it certainly could be an obstacle to enjoying this book.

I enjoyed the quite British "Direct Red", though I do recommend it with some reservations.

I think many of people's heroic and majestic attributes ascribed to doctors, and especially to surgeons, are influenced by the numerous hospital television programs. In Direct Red, Dr. Gabriel Weston tempers those attributes with her descriptions of long, exhausting and ultimately mundane stints in the operating room and in her medical training. There is often little glamor in her descriptions. However, it is in these descriptions that I found Dr. Weston writing at her best. Her writing made me feel as though I was at her side and privy to a normally closed world.

I enjoyed the organization of Direct Red. Its chapters are organized by themes rather than a chronological telling of Dr. Weston's medical training. For example, one chapter is titled "Territory" and in it she addresses hierarchies of doctors and the dichotomy of being both a fallible human and an infallible doctor. Each chapter usually describes her experiences with two patients and what she learned by delivering care to them. Some other chapter titles are "Speed", "Death", "Emergencies" and "Ambition".

In spite of my interest in Dr. Weston's themes, I found several stylistic annoyances with her writing:
* she tends to use overly florid phrasing in some of her descriptions, medical and otherwise;
* the book has numerous sentence fragments;
* there are long passages of procedures that overuse medical terminology without purpose to non-medical personnel;
* there are many references to British-specific events, people and culture that might be lost on a non-British reader.

Overall, I enjoyed Direct Red which gave me insight into a surgeon's life and training. While I was distracted by Dr. Weston's writing style, this was a satisfying read for someone interested in the medical profession.

This book recounts the trial and tribulations of a woman training for surgery in England. The book is well-written, personal and honest. Her career and the challenges she faces are ordinary for someone in medicine. Readers with a medical background will be able to immediately relate, but may find some of the "dramatic" events described as mundane. Readers without a medical background may find the perspective of the author novel, but the debunking of the stereotype of the surgeon as superhuman and devoid of indecision or doubt has been before, in literature, television, and movies. There is little new here, but this book may be of interest to individuals seeking to learn more about the subjective experience of medical education.