Critical moments when godlike doctors crack

Book review by Kevin Chong, National Post
January 21, 2006

n Bloodletting & Miraculous Cures, Vincent Lam's strong debut collection of short stories, doctors in emergency rooms are regarded as fallible deities, holding the godlike power to save lives but vulnerable to human error and doubt. For this reason, a physician must learn not only to practise medicine but how to appear and behave like a doctor. In one of Lam's stories, a young doctor reminds himself to sit with a patient to create the "perception of time"; in another story, a different doctor wonders whether he should maintain eye contact with the bereaved wife of a deceased patient to express his sympathy, or turn away to preserve her privacy. Lam, an emergency physician in Toronto, concentrates on those critical moments in which the studiously constructed personas of young doctors crack -- if only momentarily and minutely.

The first stories in Lam's linked collection focus on doctors-in-training. In How to Get into Medical School, Part I, an ambitious student, Ming, uses a rigorous study regimen to ace her exams while cautiously nurturing a romance with Fitzgerald, another aspiring doctor whose unfocused intellect hampers his prospects. The story hinges on a dark secret that also explains Ming's academic brilliance. Later, when Fitzgerald exploits this secret to his advantage, in How to Get into Medical School, Part II, the ruthlessness he displays is shown to be essential to his success as a doctor.

Conversely, in Take All of Murphy, a more sentimental medical student, Sri, struggles to preserve the dignity of a cadaver in an anatomy class when he refuses to slice through a tattoo on an arm.

Later stories in Bloodletting & Miraculous Cures describe the frantic pace of an emergency room. In Before Light, an emergency physician, Chen, spends a night shift treating patients, including a woman with hiccups and a man who refuses to believe he's had a heart attack: "It's not a heart attack. It's something else. I rollerblade like a fiend."

In one of the book's best stories, Eli, Fitzgerald (now a doctor) tries first to protect a man who's been roughed up by policemen but ultimately collaborates with the officers when the patient, refusing to co-operate, bites him. "Benevolence and cruelty are separated by a veneer of whim," Fitzgerald notes.

Fitzgerald shows benevolence in another excellent story, Night Flight. Now working for a flight company, the young doctor flies to Guatemala to retrieve a young Canadian man who suffered a stroke while on vacation. When the patient dies on the flight back to Toronto, Fitzgerald tells his wife a white lie: "I think that your husband got the crucial treatments he could have received at home."

Occasionally, the narratives veer away from doctors. In Winston, Lam writes ambitiously from the perspective of a mentally disturbed man who believes his upstairs neighbours are poisoning him. In Afterwards, a woman visits the massage parlour where her husband died of a heart attack.

The stories are told in clear, elegant sentences, and the descriptive metaphors used are well-chosen and judiciously deployed: A split forehead, for instance, bleeds like a "red curtain." The formal tone of the narrative, however, often shifts uneasily into interior monologue, which is awkwardly set off in italics. A bigger problem, though, is the flat dialogue, which is often stilted ("Why don't we get married?" "The circumstances are not ideal," she said. "But are they ever, for anyone?" said Fitzgerald), self-consciously demotic ("Fine bitch cop there, huh?") or larded with medical jargon ("Call anaesthesia, stat call, cord prolapse, get the section room ready"), forcing the reader to the glossary of medical terms provided at the end of the book.

Occasionally some of the pieces feel more like writing exercises than stories. In A Long Migration, a medical student cares for his ailing grandfather, whose fascinating life as a headmaster and compulsive gambler in Saigon appears in flashbacks. (Perhaps not incidentally, Lam's first novel, due next year, features a similar character.) But the story fizzles to an end without any crystallizing insight or reversal.

Nevertheless, Bloodletting & Miraculous Cures is a satisfying, engrossing read, partly because of the intrisically fascinating subject matter, but also because of Lam's patient characterizations and understanding of the human heart.

© National Post 2006