Touching Distance, By Rebecca Abrams

"He spoke of progress as if it were a marvellous journey. He spoke of knowledge as if it were an exquisite jewel."

Aberdeen, 1790. Alec Gordon, recently qualified as a doctor and both blessed and cursed with a questing intellect and strong sense of purpose, has returned to his home town to become a physician. A man for all seasons, put on earth to make a difference, is always a fine start for a novel and here, in her first work of fiction, Rebecca Abrams has taken a true story and woven it into a compelling, thought-provoking book.

The Age of Enlightenment was dawning with a fog of resistance in Scotland, and if ever there was a time and a place not to be having a baby, it was there and then, as over and over women delivered of healthy infants died in agony of the mysterious childbed fever. Gordon struggles to terms with his inability to save so many of these vulnerable wives and mothers, while attempting to separate cause and effect in a battle against established traditions and an implacable wall of ignorant resistance.

Gordon's mission first to discover and then to prove that the disease is spread by nothing more sinister than the imperative requirement of hygiene in birth attendants, runs in parallel with his wife Elizabeth's mental breakdown. Neglected by her husband, Elizabeth begins self-medicating to suppress the childhood demons within her and descends unnoticed into her own hell. Gordon, wrapped up in his work and blamed for his patients' deaths by everyone from medical authorities and midwives to the families he is treating, makes the classic error of missing what is under his nose. His personal drama collides poignantly with his professional crisis at the novel's denouement.

Touching Distance is a vivid and moving window on a time when, like now, the world was spinning through enormous change. Gordon's frustrating battle to be taken seriously is at the heart of Abrams' first novel, and her accomplished handling of the clash of knowledge and progress with tradition and fear is a great achievement.

Throughout the book, small touches of the personal emerge: Gordon's assistant secretly finds a recently dead mother for Gordon to cut open and learn from; she is his former sweetheart. Mary, Gordon's young daughter, is found mewing like a kitten under the kitchen table while her mother lies upstairs in a drug-induced trance.

These details and the agonies of the women in childbirth are skilfully written. The plot is more complicated than it needs to be for a book with such a plausible narrative, but as a whole Touching Distance is often gruesome but truly enjoyable.

But a word of warning: do not read it if you are pregnant.