Beyond the miracle cures of primetime television

Book review by Paul Gessell, The Ottawa Citizen
February 4, 2006

hould a doctor try to resuscitate a heart attack victim even when the situation is totally hopeless?

Does it matter if a medical student mutilates an unusual, and surely a beloved, tattoo on a corpse being carved up in anatomy class?

Should a physician try to ease the guilt and pain of a grieving widow by telling a white lie about the not so excellent care she arranged for her recently deceased husband?

These are the kinds of moral dilemmas faced by doctors every day. These are the kinds of dilemmas contained in the short stories that comprise a most unusual new book of fiction, Bloodletting and Miraculous Cures (Doubleday Canada), by Vincent Lam, a Toronto-based emergency room doctor originally from Ottawa. (You may remember the much younger Lam during his high school days, long before medical school, marriage and fatherhood, busking in the Byward Market with a violin and an upturned hat.)

Lam's stories are linked. We meet the same characters, Ming, Chen, Karl, Fitzgerald and others, again and again as we follow them from their frantic days dissecting and romancing at medical school into their careers and their lives outside the operating room.

Their stories are not the usual medical dramas we tend to see on primetime television or splashed across the front pages of newspapers. There is no Herculean effort to separate conjoined twins. No disfigured woman gets a face transplant.

Perhaps that is because Lam, a very literary doctor, owns no television and is more attuned to reality than to the more sensationalized medicine pictured in popular culture and the news media. And so, we get far more ordinary bloodletting and few miraculous cures but all performed by superbly crafted, compelling, compassionate and complex characters long remembered after the book is read.

Bloodletting is just the beginning for Lam, the writer. He has a non-fiction book coming out later this year on influenza and, next year, is scheduled to publish his first novel, a story inspired by the life of his own grandfather, a school teacher in Vietnam. We get to meet grandpa, sort of, in one of the Bloodletting stories.

Basically, Bloodletting is about the doctor next door, the man or woman who mows the lawn, coaches hockey and, at the office, tries to meet the expectations of patients believing in the infallibility of modern medicine.

But doctors are fallible, inside and outside hospitals. The physicians constantly encounter moral dilemmas in their professional and personal lives that come with no clear answers and no permanent cures. The rightness of their choices is often debatable.

Day-to-day medical practices save many lives with procedures we take for granted, such as pap smears and x-rays. These are the "cures" we no longer consider miraculous, Lam says. The separation of conjoined twins and unusual body part transplants are far more problematic and more fatal, he says.

"The more dramatic it gets, the less good the results are. There are really tons of things we do that are fantastic but we could never write a short story about because there's no drama. It's hard to write a story about getting someone's blood pressure checked because it's not that exciting."

Well, actually, Lam is wrong. He takes rather ordinary heart attacks, anatomy classes, medical evacuation flights and turns them into literary marvels with a plethora of moral dilemmas, rivalries between doctors, patient-doctor tensions, lives affected long after surgery. Who would have thought checking your blood pressure could be so dramatic?

Human emotions, not medical science, dominate the stories of Bloodletting. Lam has, in effect, put humanity back into medicine. That's a relief after this country has just passed through yet one more election campaign where medicine was all politics, balance sheets, waiting lists and endless pain.

© The Ottawa Citizen 2006