Review: Surgical fiction in 'Bloodletting & Miraculous Cures'

Terry Hong, San Francisco Chronicle
September 1, 2007

incent Lam's first book of fiction, "Bloodletting & Miraculous Cures," comes to the United State an already proven deal. The story collection won Canada's prestigious Giller Prize in 2006, the first time a premiere work ever had the honor, and "Bloodletting" was a best-seller in that country. Weinstein Books was so sure about the book that the new publishing house not only made "Bloodletting" its first acquisition but also will publish Lam's forthcoming first novel.

"Bloodletting" is worthy of all that attention.

An emergency physician in Toronto, Lam writes from experience, and with accuracy and confidence. He even includes an 11-page medical glossary. The loosely connected, layered stories of "Bloodletting" follow four young doctors-in-training into their medical careers - two successful, one not and one prematurely stunted.

The book opens with a tentative courtship between Ming and Fitz, two undergraduates in Ottawa hoping to get into medical school. Ming, unable to escape the unbending expectations of her disapproving immigrant parents, insists that their relationship remain secret. After she gets into medical school, she moves to Toronto, leaving Fitz behind. In her first year, she meets two fellow students, Chen and Sri, with whom she spends a semester dissecting a cadaver - Murphy, as Sri calls him.

By the time Fitz follows Ming to Toronto and medical school a year later, their lives have shifted in ways both expected and surprising. Ming, Fitz, Chen and Sri quickly graduate from cadavers to living individuals, although death is always a looming, sometimes unavoidable outcome. Bloodletting - whether from injury or in an attempt to heal - is constant, miraculous cures happen rarely if ever, and calling the time of death is all too frequent.

As the most ambitious of the foursome, Ming seems to have the most balanced life, sleeping and waking at regular hours, bringing new lives into the world even as others depart too quickly. Like the rigid study plan that originally got her into medical school, her life remains well ordered and predictable, and she moves through it with even, if detached, determination.

In sharp contrast, Fitz is out of control, forced out of his hospital career with barely his credentials, much less his dignity, intact. On call as the attending physician for emergency air evacuations, he never knows where he might be each day, crisscrossing the world, chasing the next desperate call for help, never finding his own salvation.

Back at the Toronto hospital, Chen's career eventually settles into a sleep-deprived existence in the emergency room, where he works long hours in the middle of the night. While most people slumber peacefully - including his doctor wife - Chen dazedly tries to save the medically needy while dealing with the emotionally desperate.

Sri, a vulnerable loner hoping to make human connections, goes beyond his resident-on-call duties to seek out a psychotic patient at his home, arriving just in time to keep the patient alive and prevent injury to others. Sri also attends to the surviving family of a man brought in DOA whose demise presents questions to which the man's wife and son must seek out the final sordid answers.

With four distinct narrative threads that mingle, diverge and ultimately come together, "Bloodletting" is a swift, dynamic read. From story to story, Lam unveils his characters' lives in careful ellipses, leaving clues like puzzle pieces to twist this way and that, each detail eventually dovetailing to form a picture.

Lam's characters are flawed, and while they sometimes have the ability to save, they are hardly miracle workers. They get frustrated and tired, they aren't always sure of their choices, they don't always like what they're doing or the patient they're treating. And, in case they get too convinced of their power to heal, they learn that in the blink of an eye a doctor can become a patient.

What makes "Bloodletting" so remarkable is its depth. The stories are entertaining on their own, but if you delve more deeply, you'll find human lessons sketched out with subtlety.

From interracial and generational relationships to sexual abuse to medical school admissions ethics to the failure of the medical insurance system (yes, even in Canada!), it's all here, and so much more.

Lam entertains and educates with fluidity and style, and that just might be a miraculous cure of the literary kind.

© San Francisco Chronicle 2007