Take four, one at a time, for life

Reviewed by Roger Cox Scotsman
March 22, 2008

OU HAVE TO FEEL SORRY FOR North Americans sometimes – the crosses they have to bear. At the back of Bloodletting and Miraculous Cures, the book's author, Vincent Lam, has added a helpful "Glossary of Terms". Lam is a Canadian doctor-turned-novelist. His book is about the lives of four fictional doctors and therefore it contains a fair bit of technical jargon. Under the circumstances, the presence of a glossary shouldn't really need any justification. Because the Canadians and their American neighbours just love to sue, however, this section is prefaced as follows:

"These explanations are provided for the purpose of clarifying the narrative in this work of fiction. While they are believed to be accurate, this is not a medical dictionary. The glossary is not intended to explain medical conditions in any therapeutic way, and does not replace an explanation of any of these terms by a medical professional if they are relevant to your personal health."

I kid you not. It really says that. I'm not sure why Fourth Estate left that bit in for the UK edition of the book, other than to give readers over here a good laugh. It's not as if anyone in this country is going to read Lam's two-line description of hepatitis, get it, and then take him to court for not properly appraising them of the risks. But leave it in they did.

I highlight this a) because I'm a pedant and I think it's funny and b) because it's the only part of this book where something seems to have been lost in cultural translation. Otherwise, there's no reason why Bloodletting shouldn't become as big a hit in this country as it has been in Canada.

And let's not beat about the operating table: this book was a really big hit over there. First published in 2005, it quickly went on to become a number one best-seller. Luminaries including Margaret Atwood and Alice Munro have praised it to the hilt, and it picked up the prestigious Giller Prize for fiction. Success in Canada doesn't necessarily equate to success in the UK, and Lam's debut is very Canadian in many respects, yet it is black enough in its wit and universal enough in its themes to appeal to readers here.

A case in point is the opening chapter, which deploys the same brand of toe-curling humour that seems to be so popular on British TV at the moment, only with more subtlety. Two young students, Fitz and Ming, are trying to get into medical school. Fitz is a thinker, whereas Ming is a lean, mean exam-acing machine. Complicated scientific concepts are fascinating riddles to Fitz, but to Ming they are simply a means to an end. Fitz is passionate and impulsive; Ming pragmatic and coldly rational.

We first meet them in a restaurant after an exam, where Ming is trying to give Fitz the brush-off because she doesn't want romantic complications to stand in the way of her career. They are both in love, but both spectacularly unable to articulate their feelings, and what happens next will make you smile to yourself and squirm in your seat in equal measure. It's a masterly beginning – the only drawback is that nothing else in the book is quite as good.

It's hard to know whether to describe Bloodletting... as a novel or as a collection of short stories. All the chapters feature either Fitz, Ming, Ming's other love interest, Chen, or their mutual friend, Sri, as the four of them progress through their medical careers, yet they function almost entirely independently of one another. There is an overarching narrative of sorts, but it's so thinly sketched that you hardly notice it until the end. Each character has huge gaps in their story that are never filled in, and if you read the chapters in a random order you could still make sense of the whole.

This set-up could prove frustrating, were it not for the fact that Lam provides us with just enough information to guess at the blanks. In the end, it's up to the reader: play the detective if you like, and try to create complete narratives for these characters based on the information you're given, or simply sit back, relax and enjoy the effortless charm of Lam's storytelling.

© Scotsman 2008