Stories examine doctors' doubts and aspirations
Book review by Joel Yanofsky, Montreal Gazette
January 21, 2006
ere's hoping Anton Chekhov, the immortal Russian writer who was also a practicing doctor, had a lousy bedside manner. For those of us struggling with one career, it's always unsettling to learn about someone who has found the talent, and time, to master two.
Vincent Lam is a Toronto emergency room physician, and while it may be premature to compare him to more famous literary doctors like Chekhov, or even Michael Crichton, Lam's debut collection of linked short stories, Bloodletting & Miraculous Cures, proves one thing: moonlighting has its advantages.
There's no information like inside information, and Lam puts his to good use.
Night Flight takes readers along with its hero, a dissolute young doctor named Fitz, on a harrowingly authentic trip to Guatemala for a medical evacuation. In Take All of Murphy, the insights are more intimate: three ambitious med students, Ming, Sri and Chen, are knocked unexpectedly off their career path as each forms a curious attachment to the cadaver they're assigned to dissect.
The lurid title notwithstanding, there's a minimum of gore and heroic measures in Bloodletting & Miraculous Cures. Instead, Lam's fiction strikes a balance between clinical and emotional detail. There's a glossary of medical terms at the back of the book, but Lam is at his best when he explores more recondite territory: the private doubts and aspirations of his cast of four young, mainly inexperienced doctors. Mistakes and misjudgments are as routine as rounds - a fact of life, and death.
In Afterwards, Sri deals efficiently with a patient's sudden death and less efficiently with the stunned reactions of the patient's family: "Relatives asked things (Sri) had no idea about - whether the car would be towed, or which hairdresser had given the last trim. Why did they care, now that these things were in the past?"
The tables are turned in Contact Tracing, with Fitz and Chen quarantined during the early days of the SARS outbreak. That "the overwhelming majority of (SARS) cases occur in health care workers" isn't a surprise. The surprise is how well Lam humanizes this fact. Here's his description of the lottery employed to choose nurses - yellow tags are exempt; red tags are not - for the SARS unit:
"Those who had been selected ... only met the eyes of others who held the same colour tag. Some cried openly, or left the room to do so. One woman with a yellow tag offered it to her friend who had a red one, and who was just back from her honeymoon, but the trade was refused. Grief and trauma counsellors were available in the next room, said the union rep over the murmur."
The linked story collection is a staple of recent Canadian fiction, especially with first books and, often, the form feels forced, more like a chopped-up novel than a self-contained work. But Bloodletting & Miraculous Cures gets it just about right. The two-part How to Get into Medical School, for instance, is an engaging romance as well as an unsentimental look at the demands of med school, an environment so stressful, so competitive that even the most promising relationship doesn't stand a chance.
Each of Lam's recurring characters trade off cameo and featured roles. They interact, but also have their own problems. In A Long Migration, Chen cares for his dying grandfather. The result is a poignant and complicated look at the burden placed on a young man who has, by virtue of studying to be a doctor, become the standard-bearer for his family and his community.
Compassion may be the hardest and most important lesson med students and young doctors have to learn. That's why in the story titled Eli, Fitz relies on his training and fakes it: "Always sit down with the patient, I was taught. ... It makes it seem like you've spent more time and that you care. ... If you give this impression then the patients will do what you say and leave quickly."
Compassion is a requirement for writers, too, except the first-time author of Bloodletting & Miraculous Cures doesn't have to fake it. In this impressive first book, by all appearances, Lam's concern for his flawed characters and their difficult choices comes naturally.
Joel Yanofsky is a Montreal writer.
© Montreal Gazette 2006