The Mystery of Breathing - Perri Klass

Neonatologist Maggie Claymore is devoted to her career, to the saving of the youngest and most innocent of lives. Her life is orderly and controlled - she rotates between the clinical service and research, her marriage (to Dan, a doctor she met when they were both medical students) is sound despite their inability to conceive, and they share their home with her best friend Sarah (a medical school drop out) and her two-year-old daughter Penelope.
Maggie likes her life, a far cry from her impoverished childhood to single mother Annalisa. When she receives an anonymous letter that breathlessly accuses her of falsifying information and being dangerous, it comes out of left field. Unable to dismiss it but equally unable to report it, Maggie begins to suspect those around her. As the harassment escalates the author takes up more and more of her time, affecting the way she speaks to people and her concern about the way she's perceived. Then posters start to go up, and the hospital hires an investigator, but the campaign is beginning to affect Maggie in ways neither she nor her nemesis could have predicted.
This could have been a taut, Joy-Fieldesque suspense novel, but Klass (a pediatrician and medical writer) has gone a more literary route. The text combines flash-backs to Maggie's childhood, the occasional flash-forward of (presumably) Maggie's future, and from about two thirds in, scenes from her harasser's perspective, including his/her underlying motivation (very little of which has anything to do with Maggie herself and much to do with what she represents).
The medical details are strong and decisive, even to someone with a health care background, with enough detail to convince without belabouring the point; they're so well integrated that it's clear this is the environment of the author rather than information researched for verisimilitude. The contrast in learning interest between medical students (will this be on the exam?) and interns (will this be something that could help me save a patient's life?) is one such example, and she accurately recreates an insider's perspective of hospital life.
Klass has a sure and decisive writing style that suits her protagonist, and which reminded me somewhat of Chris Bohjalian, though some of that may be the female-medical-provider-under-pressure context.
There are odd light moments from time to time (like the aside that, though Sarah dropped out, their medical school "

sticking by its unofficial motto, Hard to Get In, Impossible to Get Out, did not let her go; they told her that she was on an extended leave of absence, and when the time was right, she could of course come back and finish.

Klass has all too clearly attended mandatory team building workshops where creating Necklaces of Need and Stockings of Support have robbed her of time better spent doing actually useful work - having been there, too, I was impatient as Maggie for those scenes to be over!
Mostly, though, The Mystery of Breathing is humourless and literary. This is not to say that it wasn't compelling or interesting, and I found her analyses of hospital politics, particularly neonatal conflicts (and rules, like the inevitable failure to thrive of multimillion dollar IVF babies versus the irrepressible survival of the unwanted products of casual flings by drug-using minors) were enlightening.
The Mystery of Breathing is a gendered novel - it's no coincidence that both the protagonist and the investigator are women, and the reader is left wondering how the hospital administration would have reacted to a male doctor being similarly harassed. Though, as the perpetrator shies away from acknowledging (but Klass draws out), the preoccupation of women with how they're perceived, of needing to be liked and seen as nice, plays a significant role:

[her tormentor] wouldn't bother sending [ male doctor] the messages that [s/he] was quite sure had helped unhinge Maggie.. would not have been able to explain [the] sense that [he] would be at most mildly perturbed by letters telling him everyone hated him and no one trusted him as a doctor. [He] might be irritated, but on some very profound level, would not give a real big flying fuck

(I apologise for the bracketing, but on the off-chance you read it, the slow reveal of the identity of the poison pen writer significantly ads to the suspense).
I was both involved in, and felt separate from The Mystery of Breathing, and am not sure whether or not I like it, which is always an annoying position in which to find oneself. I certainly found the ending unsatisfying, unsatisfactory and a little disjointed, but that's how you know it's literature. I have another of Klass's novels at home, and though I'll wait a while before tackling the next there's no question that I'll do so before it's due back at the library. - Alex