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This is a rather odd review to be writing, because the subject of this book is my step-great-great-grandfather, and its author is my mother. But, then again, I did finish reading it two nights ago, and I am blogging all my leisure reading again this year. So I guess I kind of have to, really!

Of course, the book itself, now that it has finally emerged into the world, is only the culmination of a project which I've been intimately aware of for many years. It all begins, really, with a lady named Margery - a characterful and forthright individual, whom I only ever knew as an elderly (but indomitable!) woman, but of course was young and beautiful once, too:

Constance Margery Fryer (née West), 1904-1991

Margery entered into our family's history when she became my mother's father's second wife in 1961. This means, of course, that she was no blood relation to me - but she was effectively my step-grandmother, and we visited her regularly throughout my childhood, even after my actual grandfather died when I was four. She used to play Mastermind with me, and was amazed and entranced by modern innovations which I brought into her house, such as felt-tip pens. Margery had always talked about her own family, and we certainly knew about 'Grandfather West' and various of his children - her aunts and uncles. It was clear that they'd been a well-to-do family, and that Margery herself had been brought up in fairly privileged circumstances.

It wasn't until after she died, though, that we began to realise just how interesting her family history really was. Mum was named as one of her executors in her will, and inherited from her a chest full of family documents and photographs, which included not only things like wills, property deeds and so forth, but also much more personal material such as theatre programmes, newspaper clippings, and of course Grandfather West's last diary. From this, we found out that West had in fact been a prominent surgeon in one of Birmingham's major hospitals, practising medicine at an incredibly exciting time when the profession was really entering into the modern age, and had besides enjoyed a busy social life, belonged to countless local groups and societies, been father to eight children, and gone on regular foreign holidays in Europe. This was not just some long-dead guy, but a fascinating exemplar of the Victorian age.

Around the same time, Mum decided to leave her career in teaching, and re-enter education herself. She began by doing a part-time MA course in local history at the University of Birmingham. And when she had finished that, she knew that her next project should be making the most of the fascinating archive she had inherited from Margery. She became an active member of the University of Birmingham Society for the History of Medicine, and began giving papers at their meetings, other local history societies and conferences. Meanwhile, she began serious work on examining the family archive, researching the background to West's life and career, and writing her findings up into this book.

I am so thrilled for her that it is finally in print. She's worked steadily away at it for about seven years now, I think, visiting archives, combing census records, tracking down photographs and identifying properties which the family had once owned. Now, at last, all this labour has blossomed and fruited into a very thoroughly-researched and beautifully-presented book:

Of course, for me, the experience of reading it is rather different from how it will be for anyone outside our family. A lot of the content I already knew from conversations with my mother over the years. Reading the full details in the book, then, was rather more like adding in the finishing pieces to a jigsaw than a raw journey of discovery for me. I also found the 'Epilogue' at the end particularly affecting in a way that most people wouldn't. This was about what had happened to West's family after his death at the early age of 49 in 1883. It is, of course, the point in the narrative where West's life story stretches out and meets mine, since it traces the lives of his eight children, one of whom was Margery's father. But it is also, alas, a rather tragic tale.

It begins with a widow left to bring up eight children, whose ages ranged from two to seventeen years old at the time. Of those eight, three then went on to die within four months and a day of one another in 1895 - the first certainly from suicide, and the third possibly so. It must have seemed to West's widow as though the family was under a curse. By the time she died in 1911, things probably seemed rather happier. Two grandchildren had been born (Margery and a cousin, Joyce). But three of West's surviving children chose never to marry, the grandchildren both remained the sole offspring of their respective parents, and neither of them went on to have children of their own. So within two generations, the family had died out completely - which is of course why the family archive ended up passing to us, rather than to any blood descendants. There just aren't any. After reading all this, I went to sleep thinking about the contents of the archive, and these thoughts apparently then proceeded to get all mixed up in my head into a dream where I was unearthing not the papers and documents of the archive itself, but the actual corpses of West's family, wrapped in blankets and plastic sheeting and actually stored in the roof of a church, rather than buried as such. My mother was in the dream, assisting with the process, and based on fragments of dialogue which I can remember passing between us I can report that the corpses were "in remarkably good nick" considering how old they were, and smelt kind of "musty". So, yes. I really hope no-one else would have that kind of reaction to this book, anyway!

On a less bizarrely personal level, though, I certainly learnt a great deal about Victorian medical practices and life in Birmingham in West's day by reading this book. The value of West's life, really, is not that he was exceptional, but that he was solid - one of many energetic and well-educated men of his day, busily engaged in careers and hobbies that would lead the world smoothly into the 20th century. To tell his story is to tell the story of the society he belonged to, and of many similar men whose life histories have not been so well preserved. It's about social mobility, and education, and medical advances, and experimentation, and discovery, and the thirst for knowledge, and institutional corruption, and philanthropy, and social networks, and the acquisition and display of status - in short, everything that characterised the Victorian period.

This was an era which allowed West to rise from humble beginnings in Southwark as the illegitimate son of a leather dresser's daughter by a noted magazine editor, to a privileged end as a respected medic living in a large house in the best district of Birmingham. The passport, of course, was that essentially Victorian invention: a good education, possibly provided for by his otherwise absent father, but in any case somehow arranged by his mother. After that, it was down to diligence, ability and an energy which West clearly possessed in droves. He spent his career actively learning new techniques, applying them in his own work, and sharing his own observations and discoveries with others in turn. It was a world of experimentation and debate, and West played his role by writing papers for the Lancet, exhibiting diseased body-parts at local medical societies and undertaking difficult and dangerous operations like the removal of ovarian cysts. Meanwhile, he built up valuable friendships, threw himself enthusiastically into musical and literary life, and proudly raised his family. But there was drama, too - especially in 1857, when a massive dispute blew up over his election to the post of full surgeon at Queen's Hospital, which raged for six months in the local papers, and very nearly came to personal confrontation. Basically, it boiled down to power-struggles between the hospital's chief medics and its lay council, and I'm happy to say that West eventually emerged from it all with dignity and the post he had applied for in the first place. But the whole event reveals a great deal about just how passionate people were prepared to get about how a hospital should be run at the time.

I was struck at several point by how very similar some of the key issues in West's professional life were to the ones which come up today. In the course of his hospital work, for example, he was continually dealing with issues such as pressure on beds, complaints about food and hospital-acquired infections - though the common infections of the day were erysipelas, pyaemia, gangrene and septicaemia rather than MRSA and C-Difficile. A great deal of effort, too, went into the identification and treatment of cancer, although the consensus of the day was that it could be considered 'cured' once all visible tumours were removed. West even got involved in some early ventures into plastic surgery, when attempting to 'reconstruct' body parts which had been partially removed as a result of cancer treatments.

But there was a lot that was very different, too. For one thing, surgeons like West did not specialise, as surgeons today tend to. Rather, he would simply turn his hand to whatever cases were presented to him. Mortality rates as a result of surgery were also vastly higher than they are today, although they were falling all the time thanks to the innovations of people such as Joseph Lister. And I was astonished to learn that West's post as surgeon at Queen's, despite all the fuss made over his appointment, was actually completely unpaid! The system was that it was a charitable hospital, and its medical staff were expected to contribute their time and expertise for free. But, from their point of view, the hospital posts gave them access to resources and, more importantly, contacts, which would allow them to flourish as private practitioners - the real source of their income. This is, of course, an entirely different world from the medical profession of today, and one which reflects very strongly the hierarchical and nepotistic character of the society in which it was based. In fact, in many ways it reminded me of the Romans, with their highly formalised and complex systems of patronage. In particular, even though Queen's hospital was a charitable institution, people were only admitted to it if they were in possession of a 'ticket'. These were distributed to wealthy and powerful subscribers on the basis of how much money they donated to the hospital each year, so that they could then be passed on via a 'trickle-down' system to the poor and needy who would actually use them - very much the same sort of system that was used in the Roman world to distribute tickets for public shows.

Naturally, I'm bound to conclude by saying that this book was brilliant, and that everyone should rush out and buy a copy. ;-) But I really did get a lot out of it, and not solely because it concerned a (step-)ancestor, or allowed me to get closer to the subject my mother has been working on for so many years. West's life gives us a genuine window into the world of a typical Victorian medic - and in this book I think my mother has done a great job of helping us to see through it. I'm deeply, fiercely proud of her achievement.

Meanwhile, in a brilliant stroke of timing, this seems like the perfect opportunity to plug once more the serialisation of West's last diary which I am undertaking to celebrate the publication of this book over at jamesfraserwest. The first entry will in fact appear on Friday, since West for some reason did not start writing in his 1883 diary until January 11th (more details here). I know a lot of you have friended the diary already - but if you kind of meant to take a look last time I mentioned it and never quite got round to it, or thought you'd wait until it started up properly, now is the time to get over there and hit that add button! It's very much worth reading, and since it runs out in April when West enters his final illness, it really is a case of add now or miss out. Hope to see you there! :-)

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