Loved this book!! It is a fast paced medical thriller that feels like a mix of what a medical memoir feels like to read with a thriller aspect added. Four our of five stars.

I am sorry to say I couldn't enjoy the beginning of this one as I was expecting it to be more medical induced but I did like the middle and the ending was amazing. A great debut by Susan White.

“Cut” is an apt title for this book that incisively dissects the male dominated culture in the surgery unit of a large public hospital. Set in Melbourne, the story follows Carla, a surgical registrar, who is competing for a highly coveted position as a consultant. At the outset, we see Carla navigating the governing workplace patriarchy by following the dictum “if you can’t beat ‘em join ‘em”.

A number of scenes in the early part of the book show her striving to be “one of the boys”. For example, while she often finds the banter of her male colleagues “puerile” and “boring”, she laughs along because “this was my tribe …I wanted to belong”. This is not so much the desire of the outsider to belong, as survival tactics in an environment where she knows not belonging could cost her the career she longs for. That towards the end of the book she looks back and thinks “how strongly I had believed that they were my clan, my surgical brothers” is an indication of the extent to which she deluded herself in blind pursuit of success.

The plot is a development of Carla’s gradual journey from self-delusion through realisation that the only way to confront institutionalised sexism and misogyny is to call it out. That doing so can have drastic results brings her to the final recognition that the only way to beat the system is to step away, regroup and re-engage, accepting that justice on a greater scale than individual career advancement is worth far more and will, in the end, be more rewarding.

Things that detract from an otherwise strong story include unconvincing characters in some cases. Toby, Carla’s boyfriend, for example is painted as utterly obnoxious. It’s hard to understand why an intelligent, reasonably astute woman would be interested in him, despite “the curl of his biceps” or her desire to “smell the money in his aftershave”. Presumably the author wants to show the intensity of Carla’s attraction to him, but the fact that (pre-enlightenment) she goes weak at the knees at his every appearance and engages in behaviour that blatantly jeopardises her career, tends to weaken the case that women don’t engage in the same sexist behaviour as men. Also, Tess of the bouncing curls who tends to “squeal” and clap her hands together at the least provocation comes across as too girlish and silly, even given her relative youth and junior status.

Another shortcoming is the regular use of clunky similes, such as “humiliation chafed like sand in my bathers”, “panic falling away like a shed snakeskin”, “a breeze rustled through the plane trees like a stranger making their way through a crowd”. Sometimes the striving for originality can be counter-productive.

It’s easy to interpret this book as solely an indictment of the misuse of male power in the workplace, but it’s just as much about the unwitting compliance of women in permitting sexual privileges in return for material rewards, (be they jobs or diamond necklaces) especially when it seems blatantly obvious that characters such as Toby, the wandering-handed Benson and the smarmy “silver fox” Geoffrey will rarely behave with any kind of integrity. I’d have liked to see a bit more complexity to Carla, to whom, given her education and profession, the outcomes shouldn’t have come as such a surprise.

But the premise is a compelling one and certainly topical. Female oppression, sexual abuse and rape are plot devices that have been heavily employed in literature, movies and television in recent years, given further impetus by the Harvey Weinstein scandal and the #metoo movement it precipitated. There are some parallels with novels like “Anatomy of a Scandal” by Sarah Vaughan and “Apple Tree Yard” by Louise Doughty, although these stories benefit from more nuanced character development.

This is the author’s first adult novel. It’s an impressive debut and reflects the fact that Susan White is herself a doctor (a clinical geneticist) and has had twenty years first-hand experience of working in the hospital system where she had to navigate a similar workplace culture as her protagonist. Taking a surgical unit as the setting enriches the drama of the story, not just because of the heightened life and death context that accompanies operating theatre narratives (as evidenced by many popular television series such as ER, House, Grey’s Anatomy and so on) but because the field of surgery is, more than many specialties, emblematic of privilege, tradition, elitism and other trappings that characterise it as a uniquely male hierarchy.

The strength of this book is that unlike many narratives that explore gender prejudice and bias, this one is unapologetically about women and their particular strengths and weaknesses in working within a system that’s stacked against them. That in this story they ultimately succeed while maintaining their own integrity provides a triumphant ending.

Thank you to Affirm Press for providing me with an advance review copy of the book.