Under the Knife by Dr Liz O’Riordan review – cancer from both sides | Autobiography and memoir

Liz O’Riordan is a consultant breast surgeon who was forced to retire from practice six years ago after her own breast cancer diagnosis. Like many, I knew her story, having followed her on social media since my own sister passed away from breast cancer. Online, she comes across as both candid and joyful, sharing adventures, advice and pictures of her bright handmade dresses.

I had assumed her memoir would be the straightforward tale of a doctor turned patient. However, the experiences of illness, both depression and cancer, actually come in the final act of this revealing and ultimately hopeful book. The first two acts comprise a frank account of her long apprenticeship in medicine and surgery. She sets out in meticulous detail the complexities and demands of this process, which involves a new rotation every four months, in a different specialty where you effectively begin from zero, sometimes in a different hospital or a different town.

O’Riordan also documents casual sexism from male colleagues, the responsibility and risk of the on-call shifts, and how she had to spend the first year of her marriage living away from her husband in order to pursue the specialism she wanted. The bookends of her clinical journey are significant: that first appendicectomy, which left her buzzing, marred by the creepy surgical registrar whispering “But are you a real surgeon? Did you get an erection?”. And the last surgery, where she is the consultant, digging out a difficult breast cancer the day before her own results are due, snapping at her locum, fearful that she hasn’t done a decent job. In between, there are moments of doubt and dusted-off exit plans, thoughts about what she would do if she left surgery, or left medicine altogether. Instead, she perseveres. And then comes the deterioration in her already fragile mental health, and a diagnosis of cancer.

She tells us what happened, how she felt, what she did. She is open about her fears, and her late-night tears. She praises her competent colleagues and her supportive husband. She finally acknowledges – after having to retire due to post-operative pain and lack of movement in her arm – that it is OK for her to be “just Liz”, as opposed to being defined by her title, her status as surgeon. I wasn’t quite convinced by the resolution of this trauma, in these neat and short chapters. One can’t help wondering if there is more to say, but perhaps this requires greater distance from the events. And perhaps she is already sharing it in different places, in her podcast, blogs, and talks.

What stays with me is O’Riordan’s compelling description of training, which doctors will recognise as a sort of Hunger Games with the post of consultant as a prize, though with no guarantee that you will be left happy or healthy enough to enjoy the role. At a time when so many of my junior doctor colleagues are talking about leaving the profession, and the vast majority are striking, this book feels sharply relevant. The author succeeds not only in telling us how she learned to love her life after cancer, but how a life after medicine can offer fulfilment too.

Liz O’Riordan is a consultant breast surgeon who was forced to retire from practice six years ago after her own breast cancer diagnosis. Like many, I knew her story, having followed her on social media since my own sister passed away from breast cancer. Online, she comes across as both candid and joyful, sharing adventures, advice and pictures of her bright handmade dresses.

I had assumed her memoir would be the straightforward tale of a doctor turned patient. However, the experiences of illness, both depression and cancer, actually come in the final act of this revealing and ultimately hopeful book. The first two acts comprise a frank account of her long apprenticeship in medicine and surgery. She sets out in meticulous detail the complexities and demands of this process, which involves a new rotation every four months, in a different specialty where you effectively begin from zero, sometimes in a different hospital or a different town.

O’Riordan also documents casual sexism from male colleagues, the responsibility and risk of the on-call shifts, and how she had to spend the first year of her marriage living away from her husband in order to pursue the specialism she wanted. The bookends of her clinical journey are significant: that first appendicectomy, which left her buzzing, marred by the creepy surgical registrar whispering “But are you a real surgeon? Did you get an erection?”. And the last surgery, where she is the consultant, digging out a difficult breast cancer the day before her own results are due, snapping at her locum, fearful that she hasn’t done a decent job. In between, there are moments of doubt and dusted-off exit plans, thoughts about what she would do if she left surgery, or left medicine altogether. Instead, she perseveres. And then comes the deterioration in her already fragile mental health, and a diagnosis of cancer.

She tells us what happened, how she felt, what she did. She is open about her fears, and her late-night tears. She praises her competent colleagues and her supportive husband. She finally acknowledges – after having to retire due to post-operative pain and lack of movement in her arm – that it is OK for her to be “just Liz”, as opposed to being defined by her title, her status as surgeon. I wasn’t quite convinced by the resolution of this trauma, in these neat and short chapters. One can’t help wondering if there is more to say, but perhaps this requires greater distance from the events. And perhaps she is already sharing it in different places, in her podcast, blogs, and talks.

What stays with me is O’Riordan’s compelling description of training, which doctors will recognise as a sort of Hunger Games with the post of consultant as a prize, though with no guarantee that you will be left happy or healthy enough to enjoy the role. At a time when so many of my junior doctor colleagues are talking about leaving the profession, and the vast majority are striking, this book feels sharply relevant. The author succeeds not only in telling us how she learned to love her life after cancer, but how a life after medicine can offer fulfilment too.