Dr. Vincent Lam's literary debut delivers an unflinching portrait of his profession, following a group of four ambitious young doctors as they move from the pressures of medical school into the intense world of emergency medicine, evacuation missions, and terrifying new viruses.Subtitled Stories, this is a collection of interconnected short stories that combine to create a complex narrative whole greater than the sum of its parts. And the parts all sound completely up my alley - health care, the evolution of practitioners, exciting scenarios realistically portrayed, ethico-moral decision making, and even interaction with the dead (my current research focus).
Through the eyes of Fitz, Ming, Chen, and Sri, Lam finds conflict - and humanity - in the most surprising moments. Together these doctors test the bounds of intimacy as they cope with exam pressure, weigh moral dilemmas as they dissect cadavers, confront police who assault their patients, and treat schizophrenics with pathologies similar to their own.
Sadly, I was unable to enjoy the panoply of the whole, because I found the trek into Lam's literary debut entirely too arduous a journey to complete, stopping at page 69, roughly half way through the third story. I therefore can't render a review of the whole, but will quite happily discuss the parts I managed:
The first story, "How to Get into Medical School, part 1" is about Ming and Fitz. He's American, she's the daughter of Chinese migrants who have very traditional beliefs which don't include their daughter either distracting herself from her pre-med studies or her dating a white boy. Though Ming pretends to herself that she's only spending time with Fitz to improve her study, she's really attracted to him, and knows he is to her. what Fitz doesn't know - what nobody knows - is that Ming is dirty, and her academic success rides on the back of sexual abuse.
"Take All of Murphy" picks up when Ming, Chen and Sri are partnered together in the cadaver lab. They're cautioned to treat their cadaver, who they name Murphy, with respect; they're also expected to dissect him with care and according to the text book. But the text book doesn't include an ornate and clearly symbolically important tattoo right over an intended dissection site. The students have to decide whether respect for Murphy trumps their academic requirements.
"How to Get into Medical School, part 2" picks up Fitz's narrative - he didn't get into medical school with Ming, and since she started they barely speak. He feels as driven by his need to see her as by his desire to study medicine/be a doctor, until a chance accident gives him the first peace he's known in months. I have no idea how that ends or him, though, as I put Bloodletting & Miraculous Cures down at that point and just couldn't bring myself to pick it back up.
This was for two reasons. The first is that I didn't connect with any of the characters, and so I just didn't care at all what happened to them. I found Lam's creations self-oriented, relatively two-dimensional, with tragic histories included not as extra depth but in lieu of character development (Ming's aforementioned abuse, Fitz's motherlessness). This might have been alright if there was an emphasis on plot, but Bloodletting is Literature, so (at least in the part I read) plot isn't a huge narrative driver.
The second issue is that I was frequently snapped out of the book by the writing. Fitz in particular is overly analytical, self-conscious and introspective, his every move accompanied by an exploration of its deeper meaning and possible interpretations:
Fitz picked up a shrimp chip by its edge, dipped it in the peanut sauce with red pepper flakes, and crunched. His face became sweaty and bloomed red as he chewed, the n coughed. He grasped the water glass and took a quick gulp...A couple of page later, after Ming has gone and Fitz begins to drown his sorrows,
He coughed to his right side, and had difficulty stopping. He reminded himself to sit up straight while coughing, realized he wasn't covering his mouth, was embarrassed that his fair skin burned hot and red, wondered in a panicky blur if this redness would be seen to portray most keenly his injured emotional state, his physical vulnerability in choking, his Anglocentric intolerance to chili, his embarrassment at not initially covering his mouth, his obvious infatuation with Ming, or - worst of all - could be interpreted as a feeble attempt to mask or distract from his discomfort at her pre-emptive romantic rejection.
The pain of rejection was a significant shade different from the longing of desire, he noted, though drawn from the same palette. This somber phase could generally be gotten through withal few more, and therefore justified the third drink. A washroom break. With the third pint came the brink between anger and the careless release that could sometimes be attained and was the goal of the drinking. Fitz tired to will himself into this easy release, to tip over the meniscus of anger that grew like water perched higher than the rim of a glass, but it didn't work today.Really, a 'meniscus of anger'? I found the writing style pretentious, the characters flat, and felt that insufficient use was made out of potentially strong scenarios. Of course, this is a literary work, and these elements aren't exactly out of place in this genre.
It probably didn't help that my expectations going in were more in line with a House of God type work, perhaps without the awful first chapter of that classic work, and I anticipated the lucid writing of some of my favourite medical authors (like Gawande, Groopman or, if we're going for the purely literary fiction, Klass). This is my own fault, and not that of the author, for whom my expectations were raised by the reviews favourable and plentiful.
And I'm clearly in the minority - Bloodletting has not only been compared with medical television dramas like ER, Grey's Anatomy and House, it's been optioned as a similar series itself. With, I can only assume, significant changes. - Alex