Author Interviews
3:02 am
Sat August 9, 2014

In 'Dirty Work,' A Doctor Turns To Fiction To Talk About Abortion

Originally published on Sat August 9, 2014 9:40 am

All surgeons must pick the organ they'll spend their career protecting, Gabriel Weston writes in her new novel, Dirty Work. And as Nancy, the obstetrician-gynecologist at the center of the book, explains, "We gynecologists have the womb to look after. ... And whichever specialty we choose, each of us has to do something ruthless to keep our patient safe: We have to forget about the human significance of the organ we're operating on."

Nancy performs abortions, and at the beginning of the book you learn that she has botched a woman's termination, leaving the patient in a coma. Suddenly she is hurled into weeks of sessions with medical review boards and psychiatrist evaluations where she has to re-examine her life and what she does for a living.

Weston, who is also an ear, nose and throat surgeon, joins NPR's Lourdes Garcia-Navarro to discuss the book.


Interview Highlights

On how she came up with this character

The main starting point for writing this book — using abortion as the medical subject that I was looking at — was that as a novelist, I was very interested in interrogating what it is that all of us feel we can't say to people. And the idea that I came up with was that a young woman of reproductive age who was performing abortions for a living instead of having babies would be the most stigmatized and difficult story to tell that a woman could possibly tell. So, I actually came to the subject matter of abortion more from that point of view than because I had any particular ax to grind about abortion politically.

On black-and-white abortion rhetoric

I really found as I went into researching this subject that I couldn't find any writing or any voice anywhere within the abortion debate that didn't seem incredibly stark, either for or against abortion. People seem to feel that there's a great sort of burden upon them to have a very, very clear and formulated position on this very, very serious subject. I felt really that fiction was a perfect medium in which to examine the ambiguities of the subject. And I thought, if I could convincingly really place a high level of conflict within the consciousness of one person on this subject, it might encourage the reader to see that it is possible to have more than one feeling, and more than one thought, and more than one judgment on this very, very difficult subject.

On her detailed descriptions of the abortion procedure

It was probably the biggest challenge of the novel. In the end, I opted for changing the font when I come to describing the abortion procedure, in order ... to flag up for the reader that this is the part in the novel that they might not want to read. So I hope that I have given the reader an out if they need one. But I did feel that writing a novel on abortion wouldn't be complete without tackling, you know, what it actually is like to see that done, or in the case of this character ... I'm writing from her point of view, and she is doing the procedure.

On whether her own opinions of abortion changed as she wrote the novel

They evolved. I don't know if they changed. I mean what I found that really surprised me when I wrote this book was how I sympathized with the patients having the abortions and the doctors doing the abortions, but also, interestingly, I really sympathized with the people who were out there waving their banners and objecting.

I think that everyone who has a strong opinion on this subject is doing it from the best part of their heart. And that was something I don't think I realized before, and I think the more we can have an ambiguous, nuanced discussion about this subject in which people feel they're allowed to admit, perhaps, there are little contradictory feelings and thoughts that they have, the better.

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Transcript

LOURDES GARCIA-NAVARRO, HOST:

Gabriel Weston is an ear, nose and throat surgeon. But in her new book, she writes about a doctor, Nancy, who's focused on a different part of the body. And a note to our listeners, we'll be talking about a sensitive topic for the next few minutes.

GABRIEL WESTON: (Reading) Every surgeon picks the organ they will spend the whole of their career protecting. The neurosurgeon gets the brain, the coloproctologist, the bowel and we gynecologists have the womb to look after, a piece of tissue as small as a fist, but with the capacity to expand and fill the whole abdomen, an organ with great tensile strength, but delicate as paper and as easy to perforate. And whichever specialty we choose, each of us has to do something ruthless to keep our patients safe. We have to forget about the human significance of the organ we're operating on.

GARCIA-NAVARRO: That's Gabriel Weston reading from her new novel "Dirty Work." It follows Nancy, a talented obstetrician-gynecologist who performs abortions. At the beginning of the book, you learn that she's botched a woman's termination, leaving the patient in a coma. Suddenly, she's hurled into week of sessions with medical review boards and psychiatrist evaluations where she has to re-examine her life and what she does for a living. Gabriel Weston joins me now. Welcome.

WESTON: Hi, nice to be with you.

GARCIA-NAVARRO: I have to tell you, this was pretty dark, heavy stuff. Some of it was really hard to read. The character Nancy struggles with complicated feelings about the work she does. Is that something that resonated for you as a practicing physician?

WESTON: The main starting point for writing this book, using abortion as the medical subject that I looking at, was that as a novelist I was very interested in interrogating what it is that all of us feel we can't say to people. And the idea that I came up with was that a young woman of reproductive age, who was performing abortions for a living instead of having babies, would be the most stigmatized and difficult story to tell that a woman could possibly tell. So I actually came to the subject matter of abortion more from that point of view than because I had any particular ax to grind about abortion politically.

GARCIA-NAVARRO: Abortion is often talked about in black and white terms - you're either for it or against it. Why, you know, was it important for you to create such a complex character?

WESTON: I really found, as I went into researching this subject, that I couldn't find any writing or any voice anywhere within the abortion debate that didn't seem incredibly stark either for or against abortion. People seem to feel that there's a great sort of burden upon them to have a very, very clear and formulated position on this very, very serious subject. And I felt really that fiction was a perfect medium in which to examine the ambiguities of the subject. And I thought if I could convincingly really place a high level of conflict within the consciousness of one person on this subject, it might encourage the reader to see that it is possible to have more than one feeling and more than one thought and more than one judgment on this very, very difficult subject.

GARCIA-NAVARRO: In a lot of ways, you do write very clinically about the actual performance of an abortion. Were you worried that it might be too gruesome for people?

WESTON: It was probably the biggest challenge of the novel. In the end, I opted for changing the font when I come to describing the abortion procedure, in order, as it were, to flag-up for the reader that this is the part in the novel that they might not want to read. So I hope that I have given the reader an out if they need one, but I did feel that writing a novel on abortion wouldn't be complete without tackling, you know, what it actually is like to see that done, or in the case of this character of course, I'm writing from her point of view and she is doing the procedure.

GARCIA-NAVARRO: You still practice medicine.

WESTON: I do, absolutely, yes. I wouldn't give it up for the world.

GARCIA-NAVARRO: Did your opinions about abortion change or evolve as you wrote this novel?

WESTON: They evolved; I don't know if they changed. I mean, what I found that really surprised me when I wrote this book was how I sympathized with the patients having the abortions and the doctors doing the abortions, but also, interesting, I really sympathized with the people who were out there waving their banners and objecting. And I think that everyone who has a strong opinion on this subject is doing it from the best part of their heart and that was something I don't think I'd realize before. And I think the more we can have an ambiguous nuanced discussion about the subject in which people feel they're allowed to admit perhaps there are little contradictory feelings and thoughts that they have, the better.

GARCIA-NAVARRO: Gabriel Weston, her new book is "Dirty Work." Thank you very much.

WESTON: Thank you. Transcript provided by NPR, Copyright NPR.