Unwind - Neal Shusterman

Although he knew it was possible, Connor never believed his parents would make him an Unwind, until he found the paperwork. He plans to run - if he can survive until his eighteenth birthday he'll be safe.
Pianist Risa knew she'd blown her latest assessment; as a ward of the state she's only required to be supported as long as she's exceptional - now she's not, she's an Unwind.
Lev grew up knowing he was a Tithe, the tenth child of religious family who've chosen to give back to the community. All his life he's been prepared for the day after his thirteenth birthday when, after a tithing party to celebrate his joyous sacrifice, his body parts would be reallocated to worthy recipients, allowing him - in a way - to live forever.
A bloody Civil War between the Life Army and the Choice Brigade was resolved when a compromise was suggested - life is sacred from conception to age thirteen, but for the five years until children reaches adulthood their parents may retrospectively abort them, provided the child doesn't technically die. Known as Unwinding, the unwanted teen's organs are redistributed according to need and merit. Three youths of different backgrounds are thrown together by chance, and have the potential to make a difference.
Unwind has a fascinating premise (though the idea that either side would see this compromise as acceptable, this is acknowledged in the text), and a new twist on this months' inadvertent theme of teens in dystopia. There are some lovely moments, chief among which was the letter writing scene in the Unwind underground railway sequence.
There's also some imagining of the consequences of this policy: without termination an option for unwanted pregnancies, society has created 'storking' - leaving a baby on the doorstep of a stranger, who is then obliged to take it in, a practice that has its own consequences. There's a mythology around Humphrey Dunfee, whose distraught and repentant parents tried to reconstitute him post-Unwinding. And there's social commentary, including an observation that, were it not for Unwinds, science would be working on improving health instead of relying on quick patch-ups (with the assumption that immunosuppressent medications have been improved between now and then). Finally, opening each chapter is a news extract or factual nugget supporting the direction the narrative takes from that point. This last reminded me a little of Tepper's Gibbon's Decline and Fall.
It's a little distressing, then, that I found the whole delivered less than the promise of its parts. I think this may be because more attention was paid to the world-building than the characters - I just didn't warm to the central trio, and found reading the novel more an exercise of intellectual interest than engagement. - Alex

Matched - Ally Condle

Cassia has looked forward to being Matched for as long as she can remember - and that it's scheduled for her seventeenth birthday makes it even more special! She's picked the perfect dress for her Match's first vision of her, and though it will be returned after the Match Banquet she'll get to keep a sliver of the fabric.
Cassia's Match is even more special than she anticipated - in an amazingly rare happenstance, Cassia is Matched with someone she already knows, rather than a boy anywhere in the country. Xander's not only someone she knows, he's her best friend, and Cassia knows she truly fortunate. That is until she puts her microcard into the home port the next day, to look at Xander's picture in private. Instead of his face she sees another, and it's also a boy she knows - Ky, who lives down the street. And just like that, everything in Cassia's life begins to change.
Condle has created a well-crafted world that is reminiscent of a number of dystopian novels set in a totalitarian future (like This Perfect Day, Collin's Mockingjay trilogy and Westerfeld's Uglies triology, with elements of Logan's Run) while still being unique, engaging and entertaining. We learn about a way of life wholly unlike ours, as Cassia passes through what is utterly familiar to her, in a seamless example of show don't tell.
The flicker of Ky on her port viewer is a mistake, an Official tells Cassia, but Society does not make mistakes. She's not to talk of this error to anyone, and that alone triggers a shift in Cassia's outlook. And her increased awareness of Ky goes hand in hand with an increased awareness of problems in a Society that she's been trained to believe is perfect. As Cassie sees her world with new eyes, the reader uncovers layers of reduction, repression, manipulation, secrecy, injustice and cover-up.
Matched is a brilliant example of how perception and society shape reality, how restricting art (to the One Hundred Poems, for example) limits thought, how language frames ideology and the capacity for innovation, and how removing the ability to write has multiple repercussions. This is the kind of book I was hoping The Maze Runner would be - rich, textured, layered, grounded, unique, with a completed narrative arc that holds promise of a sequel. Just perfect. - Alex

Barbara Erskine: Daughters of Fire

From the back of the book
The Romans are landing in Britannia... Cartimandua, the young woman destined to rule the great tribe of the Brigantes, watches the invaders come ever closer. From the start her world is a maelstrom of love and conflict, revenge and retribution. Cartimandua's life becomes more turbulent and complicated as her power grows, and her political skills are threatened by her personal choices. She has formidable enemies on all sides as she faces a decision which will change the future of all around her.
In the present day, historian Viv Lloyd Rees has immersed herself in the legends surrounding the Celtic queen. Viv struggle to hide her visions of Cartimandua and her conviction that they are real. But her obsession becomes ever more persistent as she takes possession of an ancient brooch that carries a curse. Bitter rivalries and overwhelming passions are reawakened as past envelops present and Viv finds herself in the greatest danger of her life.
I have long been a fan of Barbara Erskine. I particularly like her intertwined past/present story lines. But to be honest, this isn't one of her best.
The historical aspect is brilliant: well researched and rich with detail, she brings Celtic Britain to life. The past characters are vibrant, complex and wonderfully drawn. The past story line is gripping and intense.
Sadly, the present day portions of the story are not a shadow of their past counterparts and let the whole down. The present day characters are flat and so inconsistent in behaviour as to be completely unbelievable (even for people possessed). I simply didn't care what became of any of them. The modern story line felt forced and contrived. The pacing was painfully slow and the delightfully eerie mood that Erskine usually does so well was completely missing.
This is a great historical novel ruined by an overlay of deathly dull present day patina. A hard slog even for a long time fan.-Lynn

Call Me Irresistible - Susan Elizabeth Phillips

Meg Koranda has a lot in common with her best friend, Lucy Jorick - both the daughters of famous parents, they have reacted quite differently to being brought up in the spotlight. For while Lucy is sensible, mature and always considers the needs of others, Meg is almost thirty, dependent on her parents, and drifting. She is, however, not only loyal but able to see what nobody else has - though her groom-to-be seems perfect in every way, Lucy doesn't love him, and from what Meg can see, Ted doesn't love her, either. Which is why, even though she only arrived in Wynette, Texas, the day before the wedding, Meg feels comfortable telling Lucy that it's time to live her own life. And, in an upset reported by media worldwide, the daughter of America's first female President leaves the son of golf's finest star at the altar.
Call me Irresistible weaves together multiple characters from previous Phillips novels - we met Lucy in First Lady, jilted fiance Teddy's parents' story was told in Fancy Pants and we met them again in Lady Be Good, while Meg guest starred in What I Did For Love (a small part that didn't appear in my review) and is the product of the couple whose story's told in Glitter Baby.
This is something I've quite enjoyed in other series, particularly Brockmann's SEAL Team series. For some reason, though, I found the constant allusions to previous plot lines really irritating, perhaps in part because I haven't read Glitter Baby. I suspect, though, that it's more likely because in Brockmann's series the characters are all present in one another's stories, with different protagonists in the spotlight from book to book; Phillips' characters, however, have inhabited separate universes until now, so keeping their stories straight and present is harder work.
For me this overshadowed what was otherwise a very good romance - though the pie-eyed esteem of the locals toward Ted was a little hard to swallow, I found the central premises of Call Me Irresistible believable within the confines of the genre, the plot hurdles were plausible, I really liked the central characters, and I particularly enjoyed the way Meg pushed Ted past his own people pleasing, as she did Lucy. Phillips also adroitly handled the potential squick factor of a heroine moving in on her best friend's ex.
It's been a while since I read a good romance, and I'm a little disappointed that I found the references to previous narrative threads getting in the way of my enjoyment. Readers less distractable than I, or with a better grasp on Phillips' oeuvre, may not find this to be an issue. - Alex

Craig Harper: Your Perfect Body-A State of Mind

From the back of the book-

Most weight-loss books advocate that creating your best body is all about diet and exercise. Exercise scientist and personal trainer Craig Harper says that for most people it is more about having the right attitude than it is about choosing the right nutritional philosophy or exercise program.While many books focus on food, Harper teachers that creating life-long change is more about the dieter than the actual diet.
"Once we fix the psychology, then we can address the physiology," he says.
Australia is a country which now offers more weight-loss options than ever before, yet as a society continues to get fatter by the year. More experts, more information, more gyms, more health retreats, more dietary options, more media hysteria and more fat Australians.
This book is written for those people who have a history of almost getting in shape.

The main thrust of this book reinforces a message that I have lately come to myself, losing weight and getting fit is more about habit and consistency than motivation, so naturally I thought it was good.
I quite liked that the perfect body of the title is not measured by some external standard but is a reference to whatever the reader is wanting to achieve.
The author delivers a kind of tough love telling the reader that the results they get are entirely dependent on the effort they make. But unlike many other diet books he doesn't 'blame the victim' if they don't achieve the results they were promised by a particular program. He, rather sensibly I feel, points out that not all programs will work for all people. If you have honestly stuck with a program, followed it to the letter, and not got the results you want, then maybe it is time to reassess what you're doing and try something else.
Your Perfect Body is a no-nonsense book that tells it like it is, unapologetically stating that attaining your perfect body and keeping it is hard work but achievable for anybody if it's what they really, really want.-Lynn

The Maze Runner - James Dashner

The first thing Thomas is aware of is the noise - a boom, then a horrible crushing, grinding, scraping sound that reverberated through his body. That was frightening enough, but when Thomas realised that the sounds were not only the first thing he was aware of but also the only things he remembered, he became terrified. He knew facts, but all he knew of himself was his name and his gender - not where he came from, who his family were, or where he was. When the shuddering, shaking container he awoke in finally opened, Thomas was confronted with a confusing world where nobody would explain the arcane and clearly important rules. Run by boys apparently aged around twelve to eighteen, each has a defined role, all of which support the Runners - they race around the maze that surrounds the Glade, frantically mapping the stone walls' twists and turns, avoiding the deathly Grievers and racing back to the safety of the Glade before the massive stone Doors slide closed. Though he knows nothing of this, Thomas senses that he's meant to be a Runner, too. The Maze Runner has a Hunger Games-like potential. Certainly the elements are there, but somehow they just didn't come together for me. A significant part of that is because Thomas was too much of a cipher, but far more was because not nearly enough the world-building was revealed, even in an oblique way that would allow the reader but not the protagonist to guess at a reason for the maze. All the boys come to the Glade like Thomas did - with no memory of anything personal, but a broad general knowledge. Some of them have been there for two years, and all have learned the value of routine and discipline, But Thomas' arrival triggers something new, including the arrival of the only girl ever sent. She carries a note saying she's the last, and something about her is familiar to Thomas; odd in a world where nothing is familiar. But although Thomas and Theresa can communicate psychically, we're never given an indication of why they're so different, or what that means. I was disappointed but not surprised to find that The Maze Runner is the first in a series, most likely a trilogy. I have no problem with trilogies, provided at least part of a story arc's completed at the end of each section. I had the same reaction to that discovery as I did last year when Skin Hunger abruptly concluded with "end of book one" - the pay off wasn't worth the effort,. Though it means I'll never know what happened to Thomas, nor why he means anything, I'll not lie awake at night wondering. - Alex

Those Faraday Girls – Monica McInerney

Juliet was fifteen, Clementine just eight, and their three sisters Miranda, Eliza and Sadie strung like beads between them, when Tessa died unexpectedly from a post-operative complication. Her widower, Leo, did everything in his power to keep her memory alive and his family together – eight years on everything seemed fine, until Clementine announced first that she was pregnant and second that she had no intention of marrying the father. Maggie would instead be raised at home, with input from her aunts and her adoring grandpa, Tadpole.
Twenty-seven years later Maggie has moved from London, her post-Australia base, to New York. A combination of distressing events has forced a reevaluation of her life, and though she's concentrating on her career and how she could have managed to be living a life so incompatible with her beliefs, she also explores her history, which is inevitably entangled with that of her very close family, and discovers secrets including why her aunt Sadie vanished when Maggie was only six.
Those Faraday Girls unfolds more chronologically than my synopsis; though there are occasional flashbacks, for the most part it runs from the morning in 1979 when Clementine breaks the news to her disbelieving father through to the present day (or at least the present day of its 2007 publication), with almost half the novel taking place between 1979 and 1985, before taking a leap to the twenty-first century.
The themes of the book, in common with McInerney's other works, cluster around family - illustrated by the epigraph

No family can hang out the sign: 'Nothing the matter here' -Chinese proverb

They include: interconnectedness, love, forgiveness, dishonesty, brutal truths, unacknowledged hurts, deception, and the mistaken belief that we know our relatives better than we do. We're most often unkindest to those we're closest to, and this truism is clearly illustrated by McInerney, whose sisters are carelessly oblivious to each others' pain.

Anyone who decided there weren't favourites between sisters didn't have sisters, Miranda decided. Of course there were. The truth of it was, though, that the favourites changed constantly, the alliances shifting back and forth in some unspoken parody of a folk dance, two of them close for a time until a change in tempo forced them to break up and turn to different partners.

Trapped in roles both self- and family-created, another theme is transformation as a result of examining how true and applicable these constructs are. While Maggie is the focus in this regard, long-absent Sadie has recreated herself in a way unimaginable had she remained part of her family, but at a cost.
The sad and powerful legacy of sibling rivalry is echoed gnererationally - while the ostensibly focus of this is the repositioning of the sisters, the subtle driving of a lot of the narrative arc is Leo's relationship with his brother Bill. Tied with that is the invisibility of Sadie in her family, a person none of her siblings is rivals with.
The distortion, manipulation and fracture of truth runs through the novel - Leo lies to his daughters about Tessa, in large part out of fear he'll otherwise discover a truth to painful to contemplate; Sadie lies about her past, backing herself into a corner she can't possibly avoid; Miranda and Eliza lie to their families about their relationships and their secret lives; and Juliet lies by omission to her husband, wrapping herself ever more heavily in pain in the process.
Motherhood is heavily present throughout the text, both in its presence and in its absence - though long dead, Tessa is as influential a character as any of the others, while the inability to be a mother (through infertility or circumstance) is a burden and a blessing depending on the character.
All of this sounds as though the novel must be depressing and wearisomely heavy, but Those Faraday Girls is triumphant, accessible, and deeply satisfying. McInerney manages to avoid any number of cliches, and though the ending is somewhat bitter-sweet, it's all the more satisfying for the triumph of reality over neatly bowed plot ribbons. I've enjoyed all of McInerney's novels (and reviewed two thus far); perhaps it's because it's still fresh in my mind, or perhaps because it's more recent and therefore more accomplished, I think Those Faraday Girls is my favourite. McInerney does a beautiful job of recreating the complexity of relationships, particularly those of larger families.
Though in many ways very different from the Faraday's, some of my friends have expressed bewilderment at the closeness of my siblings and parents in my life, and mine in theirs, while I'm surprised by their ability to maintain distance. I think it's echoes of this in the lovingly claustrophobic, inextricably intertwined relationships of McInerney's characters that particularly resonates with me. You need not have this in your life to enjoy Those Faraday Girls, however - the character development, plot, dialogue and writing are brilliant whatever your viewpoint. - Alex

Fiona Mountain: Pale as the Dead

From the back of the book-

Natasha Blake is a detective with a difference. She's an ancestor detective, an ambitious young genealogist with a passion for history, whose choice of career is partly driven by the mystery of her own roots. Natasha's investigations involve family secrets, forgotten tragedies and buried crimes and her clients are anyone for whom the past affects the present-the haunted, the hopeful or the just plain curious.
Natasha is contacted by Bethany, a troubled young woman who is strangely reticent about her past-and then she disappears. As Natasha investigates, she uncovers a connection between Bethany and Lizzie Siddal, the haunting, ethereal Pre-Raphaelite model and artist, whose life was cut short by an overdose of laudanum. Was it accident or suicide? And why is Bethany so obsessed with her, and at the same time so determined to put herself beyond the reach of her lover, Adam?

This book presented an interesting spin on the usual detective story. It was a little difficult to believe that somebody would go to a geneologist to find a modern day missing person rather than, I don't know, the police or a detective, but once you get over that hurdle the past and present mysteries intertwine, making it impossible to unravel one without solving the other. And I didn't see the final twist coming too far out.
The characters, particularly the main character, had some substance to them, however I had trouble connecting with any of them. At least I didn't care enough to follow up with the next book in the series.
Not that this was a bad book, far from it. It just didn't pull me in.-Lynn

All Together Now - Monica McInerney

This collection of short fiction covers a range of topics but has several universal themes, chief of which is female relationships; this is unsurprising, as these connections also form the mainstay of McInerney's novels. There are also varyingly successful attempts to twist the tale in the last paragraph or two. In the introduction she briefly discusses the origins of each story, where her observations of events around her sparked creatively.
"Hippy Hippy Shake" is the shortest piece, at just over three pages; it describes a brief interaction between adult sisters, one of whom is going through yet another phase. The twist ending wasn't quite as dramatic as I suspect the author intended but it was fairly effective and a nice introduction to the collection.
Sisters also appear in "Spellbound" - Jill's attempts to bolster Lucy's spirits after yet another bad date pay off unexpectedly after she finds an old love spell int he bottom of a trunk: could magic be real?
In "Just Desserts" caterer Libby has rebuilt her career in Melbourne, after being betrayed by her business partner. When the opportunity for payback unexpectedly appears, Libby takes the higher ground; her younger sister Sasha, however, feels less constrained.
"Sweet Charity" revisits eccentric Lola; the interfering and well-meaning grandmother from The Alphabet Sisters sees the chance to turn the tables on a careless, self-important teenage boy more interested in being the centre of attention than in the feelings of those around him.
"The Long Way Home" tells the story of Shelley, who decided that the best way to recover from a secret tragedy and the end of her marriage was to join and 18-35 European tour group; the respite from her life gives her opportunity for reflection, and a chance encounter at an Edinburgh shopping centre helps her realise what's important.
"The Role Model" is the only non-family-centred story in the collection, and also the second-longest; it opens with four old friends who are relatively happy with their country town lives but tired of their frequent, fruitless attempts to lose weight. When the arrival of a new doctor and his much younger, very glamorous wife coincide with a new weight loss method the four women discover a very uncomfortable kind of success, that comes at a price too high for all of them to keep paying.
Jeannie took up cleaning to pay her way through school; she never expected that working for sisters Kate and Amanda would bring up issues so relevant to her own life, where family disharmony had also been the result of "Wedding Fever."
"Odd One Out" is a novella, previously published as a stand alone title and reviewed here.
The collection is light, though it deals with topics as serious as humiliation, judgment, death, divorce, and self-discovery. Though this is good if the aim is holiday reading, I felt as though the two most weighty contributions ("The Long Way Home" and "The Role Model") fell a little short of their potential. In the first I didn't connect with Shelley, which is always difficult in a story this short any way, and so her situation didn't resonate deeply enough with me to feel a connection with her; in the second both the diet instructors' approach and the total lack of empathy of the friends for someone outside their circle distanced me from the narrative, even though I recognised that was supposed to be the point. I was very pleased to revisit Sylvie Devereaux by rereading "Odd One Out" and quite look forward to reading more of McInerney's novels, which I think are stronger than her shorter fiction. - Alex

Amanda Quick: Don't Look Back

From the back of the book-

As if a head for business and a nose for trouble aren't enough to distinguish Lavinia Lake from other women, Lavinia is also well versed in the practice of mesmerism. Nobody knows this better than Tobias March, who has fallen hopelessly under her spell. But Lavinia has retired her powers in favor of their partnership-providing "discreet private inquiries for individuals of quality." But when Celeste Hudson, the wife of a family friend and fellow mesmerist, is found murdered, with a gentleman's cravat wound around her lovely neck, Lake and March get on the trail of the killer. Any number of ruthless types-which may include the grieving husband-are after Celeste's priceless bracelet, said to possess legendary powers. And soon they will be after Tobias and Lavinia too, as the investigation leads them from the glittering ballrooms of the ton to the darkest reaches of men's psyches.

I've always enjoyed Quick's work in the past and this was no exception. Humour, intrigue and romance are beautifully blended together and presented against a well researched historical background.
However, having said that, there were a couple of blinding linguistic anomalies that pulled me out of the story with a jerk. How the reference to biscuits for breakfast (I'm sure she meant scones-dietary habits couldn't have changed that much) slipped through to the keeper I don't know but it was the presence of a trash basket (not waste paper basket or rubbish bin) that I found intolerable.
Apart from these minor, though irritating, slips, the story lived up to expectations. Enjoyable historical romance.-Lynn

Lady Be Good - Susan Elizabeth Phillips

Lady Emma Wells-Finch is on a mission – ostensibly in Texas to research one of St Gert’s Old Girls, in truth she has a far more important aim: to discourage the martrimonial interests of the Duke of Beddington an unpleasant man looking for his third wife and the mother of his heir. Sadly his few requirements are neatly met by Emma – well-born, comely, thirty or under, spotless of reputation, and virginal. Emma must somehow manage to disqualify herself, without allowing him to realise this is her intent, for if she refuses him outright, the Duke has unambiguously threatened to sell St Gertrude’s, the only place that was ever home to her, and where she is now a beloved principal.
Emma has a number of options – she’s considered getting a tattoo, or being seen drunk in public, but losing her virginity will be a move the Duke can’t possibly overlook. The mildly subnormal man her friend Francesca has arranged to escort her in Texas looks as though he’ll do nicely – virile, rugged, but a little slow on the uptake. When she discovers Kenny’s only chauffeuring her around as a favour to Francesca, and is really a golf pro on hiatus after being suspended by the PGA commisioner, Emma is taken back but not dissuaded – he’s still no intellectual giant. But all is not as it seems.
Lady Be Good returns us to Wynette, Texas, home of previous SEP couple Francesca and Dallie Beaudine from FancyPants. Despite the romance novel trope of a heroine both in her late twenties and virginal despite being personable, intelligent and without a moral imperative to wait, Emma is fairly convincing. Her habit of assuming facts not in evidence is a little surprising given her job, but for the most part the hurdles between the characters are believable, and the one moment when my heart sank over a Tragic Misunderstanding was resolved on the following page, instead of irritatingly hanging around for a chapter and a half.
Though not my favourite of Phillip’s novels I did enjoy Lady Be Good, which is without question an above average romance novel that combines convincing protagonists, well developed secondary characters and two strong secondary plots against a background of romance between people of seeming incompatibility. - Alex

Bloodletting & Miraculous Cures - Vincent Lam

From the cover:

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.
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.

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).
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...
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.

A couple of page later, after Ming has gone and Fitz begins to drown his sorrows,

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