By Rebecca Abrams
Macmillan, £12.99

The author of When Parents Die blends history and fiction in the story of a doctor battling 18th-century medical mores

That naches follows new birth is our 21st-century norm. Not so in 1790 Aberdeen, where delivery led to a shattering succession of maternal deaths.

Rebecca Abrams’s first novel puts fictionalised flesh on the real-life records of that puerperal fever epidemic and its unsung physician hero Alec Gordon who, way ahead of his time, fathomed its cause and likely cure.

Abrams is best known for her book and broadsheet reflections on contemporary childhood issues: children whose parents die, children caught up in war, and the unacknowledged tribulations of second pregnancies. But Abrams’s mother survived puerperal fever as late as 1959, and she herself experienced the close collision of birth and death during a tricky labour. 

Picking up a rare obstetric history (The Tragedy of Childbed Fever by Dr Irvine Loudon), Abrams was sufficiently hooked by Alec Gordon’s impassioned efforts at saving maternal lives to spend the next five years in his figurative company. Her research delivers an accomplished evocation of place and period, and a medical mystery that grows more compelling by the page.

The story is set at a juncture in world history when revolution rumbles and enlightenment is just around the corner. But science and psychology have yet to yield their secrets: Gordon’s wife (soon pregnant with her second child) may not too vigorously protest as he puts his patients first. Of her inner terrors inherited from a girlhood in slave-trade, wild-forested Antigua, Gordon knows nothing until too late. Nor can he credit the self-interest among colleagues who would suppress his meticulously gathered findings.

The tension Abrams draws between husband and wife, doctor and midwife, truth and professional reputation, mounts like fever. A backdrop of natural history — well-tended Scottish gardens, shrouding fogs, and the wild lushness of the West Indies, mirrors Alec Gordon’s alternating moods  — precise patient care followed by confusion and despair as yet another woman suffers and succumbs.

This is partly a tale of enslavement — to the female condition, to ideas, to reputation and to memories. It is also about the limitations of education and enquiry, and the small, intuitive spark that makes all the difference. It is, after all, through his small daughter at play that Alec Gordon finally perceives how and why the fever takes hold. 

But Touching Distance is also, and most movingly, a novel about the dangerous game of striving for truth, and the sometimes hollow triumph of achieving answers. Alas for mothers, and Alec Gordon, all’s not always well that ends well. A century-and-a-half after Aberdeen’s tragic time, antibiotics were born; yet, every year, 250,000 women still die of puerperal fever.