Bloodletting & Miraculous Cures is Dr. Vincent Lam’s breakout first book of fiction, a collection of short stories that won the Giller prize in 2006. While working as a ship’s doctor on a cruise, Lam ran into Margaret Atwood and asked her to read his manuscript. She championed the book, and then everybody championed the book, and so it took me over ten years to give it a try. Guess what? It’s pretty worth championing.
The stories are all medical, in that they consider various illnesses and doctor situations (from medical school to emergency room to off-duty family member to mental crisis) but the medical framework is just a method by which to consider the human condition. How hard do we try until we’ve had enough? Whose life is worth more? How can you tell when it’s more helpful to be hands-on, or more helpful to let go? The stories in Bloodletting are all self-sufficient, meaning you can pick up almost any of them without reading the others, but characters recur and storylines progress, which is comforting. These characters are reliable, they are distinct, and they grow familiar. Some stories could have almost any doctor because the patient is the protagonist and the doctor just a foil, but in these cases it’s still nice to recognize a name. We can remember, perhaps, how that doctor reacted to a cadaver in first-year med school, and paint that on top of later actions.
Bloodletting & Miraculous Cures first stands out from the pack thanks to its subject matter. Lam knows the medical world and knows which details will be most interesting to the lay-reader. Sometimes it’s scientific, like the fact that CPR is exhausting and most civilians don’t thrust with enough pressure. Sometimes it’s more behind-the-curtain, like this insight into bedside manner:
I pull up a chair. “I understand you’ve been dizzy.” I was taught that sitting creates the perception of time. I cross my legs and maintain good posture.
“Extremely, terribly dizzy.”
“How long has that been?”
“Oh, a while.”
“A while.” I nod. “How long is a while?”
“It’s been bad for quite a while. Also, my foot is sore.”
“Quite a while.” I nod again. “All right. Would you say that a while is like a day, or a week, or like a month, or for instance a year? Give me a rough idea.”
Mrs. Withrow ponders this, she gazes up, looks at me with confidence and says, “Let’s just say a while.” She presses her lips with finality. “What’s your diagnosis, doctor?”
The hint about doctors sitting to create the perception of time is a fun insight. But this scene also demonstrates Lam’s confidence in the reader (to say just enough) and his sly humour, too. So maybe the medical storylines helped the book stand out at first, but it’s Lam’s exemplary writing that keeps our attention:
“We know the story, this twist. Just as Dr. Manolas and I talked around the loss of therapeutic opportunity, Niki and I know this plot without saying it. The bridge of air rescue can lead to this cliff. My ears are tight again. I swallow, they clear. The swelling in the narrow back compartment of Mr. Amiel’s head grows as the cabin pressure drops.”
Not only is Lam good with words, he pushes himself to experiment and test his limits. More than once he takes what would be an exciting bit of drama and buries it in a past-tense third-party re-telling. A news report, or a rehashed conversation that leaks all the tension out of a story he’d been carefully ratcheting up. Building and building just to – oh, never mind. It’s almost as if Lam is actively fighting against the Gray’s Anatomy and ER style hospital dramas which were so popular at the time of writing. Sure, bloody life and death is a thrill, but being a doctor is just as much about the times in between.