06 June 2011


I've just read Ian McEwan's novel Saturday. The hero is a neurosurgeon, and the book follows one day in his life. To me, the story felt just a little too contrived, too improbable. Yes, I know it’s a novel, it’s about themes and all that, yet it didn’t feel right. And too much as if the author was reciting all the neurosurgery he had learned for the purpose of reciting it. It takes around 10 — 15 years as a student and junior doctor to become a specialist, an ‘expert’ — another example of the necessary 10,000 hours of study and practice. Neither a novelist nor a lawyer can really expect to get this depth of learning from observation and reading. They may be able to recite things parrot-fashion, but they don’t give the impression that they understand, that they know.

Neurosurgery isn’t what people seem to think it is. It’s not about operations on the mind, it’s as much about ‘non-brain’ things that go wrong inside the cranium as the ‘brain’ itself. It’s no different from things going wrong in the chest or belly except that access is more often limited. There are plenty of non-neurosurgical operations that can be technically much more difficult. Curiously, the most common problem for neurosurgeons — head injuries — is the one they are happiest to leave to others to sort out, the one area that, in general, they don’t really want to know about. Yet neurosurgery attracts an aura that other branches of surgery don’t; it’s no coincidence that neurosurgeons hold themselves in very high regard.

In Saturday there are descriptions of multiple neurosurgical operations at the start, and a further, different one at the end. All the operations are  depicted in considerable detail — and the details checked by experts —  yet somehow it doesn’t seem quite right to me. There isn’t enough information to enable you to do the operation, yet more than I would have thought necessary in a novel. I didn’t really see the point of these extensive discourses. There’s nothing technically wrong with them, but the combinations that are described don’t seem to go together; it’s like describing an author as a (superb) poet, novelist and biographer simultaneously. No one person is likely to be expert in these three fields, yet that is what is being suggested. The non-surgical reader wouldn’t see this, or would perhaps suggest that it was ‘poetic licence’.

Without spoiling the denouement, the final operation does merit some description, if only to indicate the time that it takes to do — but yet, it’s not such a common procedure, it’s the sort of thing associated with bleeding of nightmarish proportions, though as said of another operation, more ink has been spilt in its description than blood has been lost during its performance.

Saturday was generally well received; reviewers were taken with the themes, and not apparently distracted by the extensive descriptions, so perhaps it’s just me. Then again, perhaps it’s what a novelist would write, for operations are a very significant part of the story. Still, I preferred Direct Red by Gabriel Weston as an author’s view of surgery: she knows about surgery and writing.

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