There are several dilemmas at the heart of Abrams' gripping and beautifully constructed novel...
Ostensibly the very personal story of a young doctor battling a devastating epidemic of 'childbed fever' in Aberdeen in 1790, it is also a fascinating exploration of the dawn of the Enlightenment.
At the heart of the book is physician Alexander Gordon, a real-life unsung hero whose tireless efforts to fathom the cause of puerperal fever, an excrutiatingly painful post-natal septicaemia, have never been fully recognised.
Abrams' own mother survived the illness in 1959 and Touching Distance is her tribute to the little-known doctor who sacrificed his personal life to to fathom its cause and help discover a cure.
The story opens as Aberdeen is on the cusp of a prolonged outbreak of the disease which in fact saw 28 of 77 affected women endure an excrutiatingly painful and distressing death.
As the medical mystery grows, we learn little by little about the threads which have drawn together Alec and his reclusive wife Elizabeth who is reliving terrifying childhood memories of the slave trade in Antigua.
Through a series of flashbacks, we learn that Alec is a man obsessed with progress. Elizabeth recognises this early on in their relationship. 'He spoke of progress as if it were an exquisite jewel,' she recalls.
But it soon begins to dawn on her that 'progress, far from bringing her closer to him, might simply take him beyond her reach.'
For Alec, a man so assured and competent in the medical world, his wife proves more baffling to him than 'a thousand illnesses together.'
But their marital discord is only one element of this complex and intelligent story. Tensions also arise between ideas old and new, professional doctors and superstitious midwives, uncomfortable truths and endangered reputations.
Alec is not only fighting a baffling illness but also a whole army of people who cling to their customs and prefer to 'stumble in the dark ages of fear' rather than 'walk the new pathways.'
When Alec does chance upon a possible breatkthrough in the cause and treatment of the disease, he meets only a wall of hostility from a medical establishment who see the jumped-up farmer's son as a threat to their reputations.
And when Elizabeth becomes pregnant, Alec knows that she could fall prey to an illness more deadly than the plague...
Abram's book provides a moving and startlingly detailed window onto a world in which enormous change was creating clashes between knowledge and tradition, religion and science and convention and progress.
Her writing is poetically fluent, the plot is beautifully crafted and the theme provides a chilling reminder of the inherent and continuing dangers of childbirth.
A final sobering thought is that, despite the adavantages of modern medicine, puerperal fever still kills 250,000 women every year.
(Macmillan, hardback, 12.99)